Deputy Managing Editor
sampson.nanton@cnc3.co.tt
For 41-year-old Luanna Duncan, the fight against stage four breast cancer is about more than enduring treatment, managing pain and holding on to hope.
Luanna has found a bigger purpose, one of ensuring that other patients do not lose their chance to live because the medication they need is unavailable in Trinidad and Tobago’s public healthcare system.
Duncan knows what it means to face a cancer diagnosis and the uncertainty that comes with it.
She was diagnosed in 2019 with stage 2 breast cancer, and today, after years of treatment with several highs and lows, her cancer is stage 4.
But as she navigates her own treatment, she is increasingly worried about fellow patients who depend on the public health system for essential drugs that are now difficult to obtain.
Some members of her WhatsApp support group, Cancer Warriors, are frightened and discouraged. Others who have turned to private pharmacies and healthcare providers to obtain their medication are running out of money.
And, according to Duncan, the group has been mourning the deaths of members amid the shortages.
“I am sad and angry at the same time because the health system is failing us,” she wrote in a WhatsApp message on October 11, reporting the death of another cancer patient that morning, just days after an earlier group member had died.
The woman who died had left behind four children under the age of 18, two of whom have special needs.
For Duncan, the losses have reinforced her determination to speak out about the shortage of cancer medication and the consequences for patients who cannot afford to pay privately for treatment.
“I cannot think about myself alone,” she said during an interview in Chaguanas on October 8.
“I have friends who need it. I need to advocate for them.”
Cancer patient Luanna Latoya Duncan speaks with Guardian Media about keeping postive while battling stage four cancer, at her Monterose home, Chaguanas on October 8.
ROGER JACOB
The cost of going private
Duncan said one of the drugs affected by the shortage is Faslodex, the brand name for fulvestrant, a hormonal treatment used for certain types of breast cancer. She had received the medication as part of her treatment before her cancer progressed, but said other members of her support group still needed it.
She also raised concerns about the availability of anastrozole and letrozole, hormonal therapies used by some breast cancer patients.
Duncan said obtaining the injections privately could cost between $4,000 and $5,000 a month, placing treatment beyond the reach of many patients and their families.
“In private institutions, just that injection is $4,000 to $5,000, and that is monthly,” she said.
“You can’t just leave them there and say this medication they don’t have, because you’re leaving them exposed to a threat.”
In her October 11 message, Duncan said some patients whose relatives had been helping them purchase medication privately were now running out of funds.
The financial pressure adds another burden to an illness that can already affect patients’ ability to work, support their families and maintain their quality of life.
For those who cannot secure the prescribed drugs, the uncertainty can be particularly distressing.
Duncan urged healthcare administrators to address the shortages, warning that patients need consistent access to the treatments prescribed by their doctors.
Cancer patient Luanna Latoya Duncan speaks with Guardian Media about keeping postive while battling stage four cancer, at her Monterose home, Chaguanas on October 8.
ROGER JACOB
From stage two to stage four
Duncan was first diagnosed with stage two, oestrogen receptor-positive (ER-positive) breast cancer in 2019, when she was 34.
Her treatment included a lumpectomy, chemotherapy, 30 consecutive days of radiation and, eventually, a mastectomy. Subsequent clear scans gave her reason to believe she had overcome the worst of the disease.
But in 2024, the cancer returned.
Duncan said the disease had spread behind her breastbone, resulting in a stage four diagnosis.
She recalled that the news was frightening, particularly because of the widespread perception that advanced cancer is inevitably fatal.
“I was scared because a lot of people believe stage four is a death sentence, but I learned for myself,” she said.
“I jumped from stage two to stage four. I had no stage three. But what I learned is, stage four is not a death sentence.”
Her treatment initially included Zoladex, which suppresses ovarian function and reduces oestrogen production, alongside Faslodex, which works by blocking and breaking down oestrogen receptors in cancer cells.
However, following further disease progression, her oncologist changed her treatment. Duncan said recent scans showed tumour growth after a stressful period, and she was subsequently placed on oral chemotherapy.
Her experience has also taught her that understanding the specific characteristics of a cancer is important when discussing treatment options.
Duncan said her cancer is ER-positive but is not progesterone receptor-positive or HER2-positive. She emphasised that breast cancer is not a single disease for which every patient receives the same treatment.
“All cancers are not treated the same,” she said.
She encouraged patients to learn about their diagnoses, understand their histopathology reports and work with their doctors to make informed decisions.
“People need to read and not just sit down, so that you can work with your doctors and ask them for the next best treatment,” she said.
She also warned patients against misinformation on social media, particularly claims encouraging people to reject chemotherapy.
“Listen to your doctors, take your treatment, and don’t listen to misinformation on social media telling people don’t take chemo,” she said.
Cancer patient Luanna Latoya Duncan speaks with GML's Deputy Managing Editor Sampson Nanton her cancer outreach and support group activities aiding local cancer patients and survivors during the interview at her Monterose home, Chaguanas yesterday.
ROGER JACOB
Turning her experience into advocacy
Duncan’s determination to help other patients led her to share her cancer journey openly on TikTok and Facebook.
Inspired by media personality Nicole Dyer-Griffith’s willingness to discuss her own health experiences, she began documenting her treatment and answering questions from people who contacted her.
As interest grew, the conversations developed into a wider support network.
“We talk, we have group discussions, and when we’re at clinic we communicate,” Duncan said.
“We keep informed.”
The group, which she named Cancer Warriors, aims to provide support and advocate for other people living with cancer.
Its members share information and experiences, but the growing concern over medication shortages has given their conversations a more urgent focus.
Duncan said the group is working towards organising a 5K charity run to raise funds for patients who cannot afford to purchase treatment privately.
She also urged young people to consider medical insurance before they become ill. She said insurance helped her manage the substantial expenses associated with radiation treatment and scans during her earlier cancer journey.
Cancer patient Luanna Latoya Duncan speaks with Guardian Media about keeping postive while battling stage four cancer, at her Monterose home, Chaguanas yesterday.
ROGER JACOB
A plea beyond the pink ribbon
During Breast Cancer Awareness Month, Duncan wants the discussion to extend beyond awareness campaigns, screenings and pink ribbons to the practical needs of people already living with the disease.
Early detection remains important, she said, but patients who have been diagnosed must also be able to access the treatment their doctors prescribe.
For Duncan, the shortage is not an abstract problem of procurement or distribution. It is a source of fear among people who are already confronting the possibility of losing their lives.
She is continuing her own treatment while trying to support fellow patients, some of whom are struggling to meet the cost of medication outside the public system.
For Duncan, true breast cancer awareness also requires urgent state action to put medication back on pharmacy shelves.
“If they could look into getting the necessary drugs at the hospital in a timely manner so persons wouldn’t have to miss six months of treatment and wonder when we are going to get the medication, it would be very helpful,” she pleaded.
“Give hope to the cancer patients.”
“We all deserve a fair chance to live, to survive,” she said.
“We didn’t ask for this.”
