Current Breast Cancer Reports

, Volume 10, Issue 3, pp 157–169 | Cite as

Palliative Care in the Caribbean Through the Lens of Women with Breast Cancer: Challenges and Opportunities

  • Dingle SpenceEmail author
  • M Austin Argentieri
  • Natalie Greaves
  • Karen Cox
  • Sheray N. Chin
  • Margo Munroe
  • Gemma Watson
  • Heather Harewood
  • Alexandra E. Shields
Global Breast Cancer (BO Anderson and C Duggan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Global Breast Cancer



Across the Caribbean, too many women are presenting with advanced breast cancer and dying with little or no access to palliative care. No comprehensive assessment of current capacity to deliver palliative care in the region exists, largely due to limited data. We assess the challenges in delivering palliative care for breast cancer patients in the Caribbean, highlighting the needs and experiences of low-income women through emblematic patient narratives.

Recent Findings

There is an urgent need to improve access to palliative care and pain relief throughout the region. Challenges include insufficient healthcare infrastructures to support cancer care, tremendous unmet need for palliative care, pervasive opiophobia resulting in limited access to opioids for pain relief, patients’ reluctance to engage with clinical care, and the widespread use of complementary and alternative medicines prior to the acceptance of conventional care.


There is an urgent need to improve access to palliative care and pain relief for cancer patients in the Caribbean. Strong regional collaboration, provider and patient education, improved access to opioids, and innovative models for palliative care that reflect the culture and resources available in the region have the potential to measurably improve palliative care delivery.


Caribbean CARICOM Breast cancer Palliative care Community-based palliative care Opioids Complementary and alternative medicine 


Compliance with Ethical Standards

Conflict of Interest

N.G. declares involvement with the Barbados Palliative Care Association.

D.S., M.A.A., K.C., S.C., M.M., G.W., H.H. and A.E.S. declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Dingle Spence
    • 1
    • 2
    • 3
    Email author
  • M Austin Argentieri
    • 3
    • 4
    • 5
  • Natalie Greaves
    • 6
  • Karen Cox
    • 7
  • Sheray N. Chin
    • 2
    • 3
  • Margo Munroe
    • 8
  • Gemma Watson
    • 9
  • Heather Harewood
    • 10
  • Alexandra E. Shields
    • 3
    • 4
    • 11
  1. 1.Hope Institute HospitalKingstonJamaica
  2. 2.Faculty of MedicineUniversity of the West IndiesKingstonJamaica
  3. 3.Jamaica Cancer Care and Research InstituteUniversity of the West IndiesKingstonJamaica
  4. 4.Harvard/MGH Centre on Genomics, Vulnerable Populations, and Health Disparities, Department of MedicineMassachusetts General HospitalBostonUSA
  5. 5.School of Anthropology and Museum EthnographyUniversity of OxfordOxfordUK
  6. 6.George Alleyne Chronic Disease Research CentreUniversity of the West IndiesCave HillBarbados
  7. 7.Caura Palliative Care UnitSt AugustineTrinidad and Tobago
  8. 8.Princess Margaret HospitalOncology CentreNassauBahamas
  9. 9.Cheshire Hall Medical CentreProvidencialesTurks and Caicos Islands
  10. 10.Faculty of Medical SciencesUniversity of the West IndiesCave HillBarbados
  11. 11.Harvard Medical SchoolBostonUSA

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