In 2019, Dr. Peter Brett relocated from Northern California to Saipan in order to bring cancer care to the Commonwealth of the Northern Mariana Islands (CNMI). Dr. Brett has been working as a Board-certified Oncologist for more than 25 years, primarily in private practice. Dr. Brett attended Stanford University for both his undergraduate and his medical degrees and completed his residency at Stanford University Hospital, as well as a Fellowship at the National Institutes of Health. He brings a wealth of knowledge and experience to Saipan.
When Dr. Peter Brett arrived in Saipan, cancer care on the island was almost nonexistent. While Commonwealth Healthcare Corporation (CHCC) staff had an interest in helping cancer patients, they did not have a program in place. The majority of patients were referred off-island to Guam, the Philippines, Hawaii, or the mainland US. While sending patients off-island ensures that they receive the necessary treatments and surgeries to achieve remission, it also interrupts their lives, increases the cost of care dramatically, and removes important support systems during a very difficult time.
Upon arrival, Dr. Peter Brett got right to work on building the CHCC Oncology Center from the ground up. He worked with American Society of Clinical Oncology (ASCO) consultants to fully train his staff on accuracy and safety practices, as well as on how to make the Center financially viable and sustainable. Because health insurance is a rarity in the CNMI, many medications and treatments are acquired free of charge through foundational support. The Center is now fully staffed with nurse practitioners, registered nurses, pharmacists, physician assistants, financial counselors, and patient navigators.
The Oncology Center officially opened to the public in 2020 and began to treat cancer using chemotherapy, immunotherapy, and targeted cancer treatment medicines. But Dr. Brett was alarmed at how many late-stage cancer patients were walking into the Center, seeking treatment for the first time. The majority of the cancers that Dr. Brett and his team are treating are cervical cancer, colorectal cancer, breast cancer, lung cancer, and mouth cancer. Mouth cancers are especially common, as well as being difficult to treat, painful, and disfiguring for those who suffer from them.
Dr. Brett and his team treat stage 3 and stage 4 cancers as effectively as they can, but the long-term outcomes of such advanced cancers are not good. Patients who require radiation or complex surgeries are also still referred off-island, although the Oncology Center coordinates all of their care for them.
Engaging the Community
The CNMI is a small community of islands, with a total population of roughly 50,000. In an effort to diagnose cancers much earlier, and thus produce better long-term outcomes along with minimizing treatments, Dr. Peter Brett and the Oncology Center have launched a full-scale marketing campaign focused on education and prevention.
Through live-streamed “Doc Talks,” social media ads, radio advertisements, press releases, and speaking to the public at community events, the Oncology Center team hopes to reach all of the residents of the CNMI. Engaging the community, especially the younger population, has the best potential for preventing future cancer diagnoses.
In terms of education, the team at the Oncology Center also stresses the importance of lifestyle changes, such as staying away from cigarettes, alcohol, and chewing betel nuts. Diet and exercise also factor into your overall health and can help to prevent cancers from forming.
CARES Is Born
Dr. Brett has been an advocate for early testing and detection of cancers since his arrival in Saipan. After working with so many late-stage cancers, he helped to launch the Cancer and Associated Risks Early Screening (CARES) program in March of 2022. CARES is free to any CNMI resident who would like to take advantage of the program, regardless of insurance status.
Participants can make a screening appointment by calling the Oncology Center. They then complete an interview with basic questions about health conditions, lifestyle, and family history, which determines what tests are ordered for them. If a patient has a first-degree family member over the age of 50 that has been diagnosed with cancer, they qualify automatically for genetic testing, which includes a swab that is sent off-island for additional testing.
Some of the screening tests that are ordered include color genetic testing, mammograms, breast removal surgery, pap smears, colonoscopies, CT scans, and oral screenings. Results of tests typically come back in 3-4 weeks, at which time the Oncology Center staff sits down with patients to discuss the findings. The comprehensive CARES program also offers cancer prevention counseling, vaccines, screening advice, testing, and follow-up sessions.
The benefits of early detection are numerous. Not only does detecting cancers early increase the effectiveness of treatments by 90-95%, but overall outcomes are much more positive. Future treatments and related expenses can be reduced significantly.
The CARES program is so important because cancer doesn’t just affect the person who is diagnosed; it affects their family and their community. It is a medical problem, a financial problem, and a social problem for millions of people. CARES can and should be used by those as young as 18 years old, for regular cancer screenings throughout their lives.
Eradicating Cancer in the CNMI is a Team Effort
If you have questions about how to best prevent cancer or any concerns about being diagnosed with cancer, Dr. Brett encourages everyone to reach out to the team at the Oncology Center.
The CHCC Oncology Center is open from 8-5 every Monday-Friday providing cancer care and cancer screenings, as well as education on cancer prevention. If you’d like more information about their services, or to schedule an appointment, you can visit https://www.chcc.health/cancercenter.php or call (670) 234-8950.