More and more women in Trinidad and Tobago are trusting their breasts and their lives to the skilled hands of oncoplastic and reconstructive breast surgeon and surgical oncologist Rajendra Rampaul.
To them he represents new hope of preserving one of the key symbols of their womanhood even in the face of the threatened ravages of breast cancer.
In his private Pink Hibiscus Centre and at Trinidad’s first government-operated breast unit which he set up at the St James Medical Complex, he has been introducing women to many new oncology and diagnostic techniques. His Pink Hibiscus Centre was the first to do vacuum-assisted biopsies, and oncoplastic surgery.
Rampaul said these radical procedures have changed the face of breast cancer surgery and “women no longer have to be afraid that if they were told they are going to lose their breast and they are going to be lopsided.”
“Reconstructive surgery now offers good hope that young women and even older women do not have to live their lives feeling deformed.”
For the woman who does not like implants, he now uses fat liposuctioned from the tummy, re-injecting it into the breast after separating the stem cells from the fat cells.
In turn, he gets the satisfaction that “you now have a breast that is soft and warm and part of you”.
The 43-year-old breast specialist shared new techniques in breast care and cancer with an audience of health professionals, breast cancer sufferers, survivors and others at a lecture organised through the Breast Screening Programme of the Barbados Cancer Society at the Frank Collymore Hall Thursday night.
Speaking on Recent Advances In The Diagnosis And Management Of Breast Cancer, the Trinidad and Tobago specialist strongly promoted the idea of breast screening for early detection.
Afterwards, he told the Sunday Sun: “When you pick up cancers that are smaller you need less surgery, you need less drugs, it costs less, your down time is less and you live longer.
“You can’t leave the cancers walking through the door to be the size of grapefruits and think you are going to get a magic pill that is going to make it go away,” Rampaul argued. Also, though he acknowledged there was “better” drug development, he stressed these drugs only do better if you start the race with a little bit of help – screening.
“Barbados needs to get its tumours down and the only way to do that is to screen,” he said.
He is concerned about the rising incidence of breast cancer in the Caribbean, especially among younger women.
“In my 15 years of practising in Britain I have never seen as many women who are young afflicted with breast cancer as when I returned to Trinidad. I would say it is a regional problem which I believe may have something to do with genetics and lifestyle.”
Rampaul returned to Trinidad about five years ago after practising in England, determined to make a difference as a breast surgeon in spite of a colleague’s warning that “you cannot make a living as a breast surgeon”.
“But I said to myself, ‘I have done two fellowships in breast; I have spent half my working career in institutions dedicated to looking after breast cancer and breast diseases. If I can’t make it as a breast surgeon I really don’t belong here.”
He has experienced tough times trying to change the face of how people think, but he has stuck with it.
“Looking after women’s breast health is a specialty on its own,” he advised. And while as the surgeon he takes the lead, he relies on the input of his entire team for success.
“In order to provide high quality breast care you really need a team . . . . The additional thing is that there is a huge amount of goodwill when a woman comes and she is scared and she knows an entire team has been looking at her case and dealing with her.”
He is involved with the radiology, the biopsy, the surgery and the ecology. “I see my patients even when the breast cancer comes back right to the point of palliative care and end of life. I stick with patients to the end. This area of specialisation is intended to live with the patient through the whole journey.”
Rampaul called for a more supportive response by governments to the whole business of women’s breast health, urging them to provide the necessary resources.
“Women need rapid, accurate, up-to-date health care, especially in breast screening and breast diagnosis, so that those who are normal can return to work and be psychologically comforted and be happy, and those who have a problem can be fast-tracked to get the best quality care so that they could get back their lives,” he said.
