Gibraltar Health Authority · Cancer Services

Expert cancer care,
close to home.

Comprehensive, patient-centred oncology delivered locally at St Bernard's Hospital — from diagnosis and multidisciplinary review to systemic therapy, follow-up and supportive care, every step of the way.

95%SACT delivered locally
90%+Patient satisfaction
WeeklyCancer MDT meeting
2016Service established
Our Story

Our Story

From cross-border travel to world-class local care — a decade of transformation

Before 2016

The Challenge

Cancer patients in Gibraltar had to travel to Algeciras (Spain) or the United Kingdom for chemotherapy. This placed a significant burden on patients and families, with the added stress of unreliable frontier crossings.

September 2016

A New Beginning

The Ayling-Buttigieg Chemotherapy Day Unit was officially opened at St Bernard's Hospital by the Chief Minister. For the first time ever, Gibraltar could deliver chemotherapy locally. Funded by the generous philanthropy of Mrs Margaret Ayling, in memory of her late husband Leslie Ayling and her parents Anthony and Lucia Buttigieg.

2016–2019

Building the Service

The unit grew rapidly: weekly Cancer MDT meetings, oncology clinics, and a commissioned team from Xanit International Hospital. The foundations of a comprehensive local cancer service were laid.

2019–2021

Expansion & Resilience

A new in-house oncology team was recruited. During COVID-19 in 2020, while cancer centres across the UK reduced activity, GHA Cancer Services continued to operate as normal — delivering oral chemotherapy and bloods at home, coordinating referrals, and ensuring every patient received the same standard of treatment, including expensive immunotherapy regimens.

November 2025

"Hope Starts Here"

On 27 November 2025, Minister for Health Gemma Arias-Vasquez officially opened the new Oncology Suite on the 5th floor of St Bernard's Hospital. The chemotherapy area doubled from 4 to 8 chairs, clinic rooms increased from 2 to 5, and a dedicated acute care bed — named in honour of the late Edith Dawson — was added. Made possible by a major investment from the Barzilai Foundation and a significant donation from Breast Cancer Support Gibraltar, with a large outdoor therapeutic terrace planned for 2026.

Meet Our Team

A dedicated multidisciplinary team committed to delivering the highest standard of cancer care

SACT Nursing Team
Mr Juan Román Alonso
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Mr Juan Román Alonso

Clinical Nurse Specialist

SACT & Head of Nursing
Mrs Raynelah Osborne
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Mrs Raynelah Osborne

SACT Nurse

Mr Jorge Zacarías
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Mr Jorge Zacarías

SACT Nurse

Mr Juan Ramón Vázquez
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Mr Juan Ramón Vázquez

SACT Nurse

Nursing Assistants
Ms Syane Llufrio
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Ms Syane Llufrio

Nursing Assistant

Mr Jason Barceló
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Mr Jason Barceló

Nursing Assistant

Palliative Care Nursing
Ms Jamesina Trevelyan
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Ms Jamesina Trevelyan

Palliative Care Nurse Practitioner

Ms Nicole Pizarro
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Ms Nicole Pizarro

Palliative Care Nurse Practitioner

Haematology Nursing
SP
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Mrs Selina Perez

Clinical Nurse Specialist, Haematology

RL
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Mr Ricardo Lozano

Clinical Nurse Specialist, Haematology

Pharmacy Team
Mrs Mamta Moreno
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Mrs Mamta Moreno

Clinical Pharmacist

Oncology Pharmacy
RJ
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Mr Rafael Jiménez

Clinical Pharmacist

Oncology Pharmacy
Administrative Team
Mrs Soraya Stone
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Mrs Soraya Stone

Cancer Coordinator

Mrs María Sánchez Carrión
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Mrs María Sánchez Carrión

Genesis Care Secretary

Mrs Katrina Olivero
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Mrs Katrina Olivero

Oncology Clerk

Medical Consultants
Dr Marta Robles
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Dr Marta Robles

Consultant Medical Oncologist

Breast & Gynaecological Cancer

Dr Cristina López Escolà
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Dr Cristina López Escolà

Consultant Medical Oncologist

Thoracic, Head & Neck & Lower GI

Dr Bronwen James
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Dr Bronwen James

Specialist in Palliative Care

Dr Álvaro Flores
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Dr Álvaro Flores

Consultant Clinical Oncologist

Visiting Consultant

Radiotherapy

Dr José (Pepe) Durán
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Dr José (Pepe) Durán

Consultant Haematologist

Dr David Ballesteros Quintanilla
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Dr David Ballesteros Quintanilla

Consultant Medical Oncologist

Clinical Director, Cancer Services

Genitourinary, Upper GI, HPB & Melanoma

What We Have Achieved

Key milestones and capabilities of GHA Cancer Services

💊

>95% SACT Delivered Locally

We are capable of administering over 95% of systemic anti-cancer therapy regimens in Gibraltar, following the same protocols and medications approved by NHS, NICE and the Cancer Drugs Fund.

🔬

Royal Marsden Partnership

Tissue samples are sent to the Royal Marsden NHS Foundation Trust laboratories for complex molecular analysis, ensuring personalised treatment with the most advanced diagnostics. Click to learn more →

🧊

Scalp Cooling

We offer scalp cooling technology to reduce the incidence of chemotherapy-related hair loss, improving quality of life during treatment. Generously donated by Breast Cancer Support Gibraltar.

🧬

Advanced Diagnostics

We utilise platforms including Oncotype DX and DPYD pharmacogenomic analysis to personalise treatment plans and anticipate potential toxicities before they occur.

📋

Weekly Cancer MDT

Every new cancer case in Gibraltar is reviewed at our weekly multidisciplinary team meeting, ensuring personalised treatment plans including complex surgical referrals to UK centres. Click to learn more →

📉

Reduced Hospital Admissions

We have significantly reduced emergency admissions related to SACT toxicity through careful patient selection and the introduction of the pre-chemo MDT review process.

👩‍⚕️

Nurse-Led Consultations

We introduced personalised nurse-led consultations to guide patients through managing side effects of systemic anti-cancer therapy.

💻

First Electronic Patient Record

Cancer Services introduced the first fully electronic patient record system at the GHA — all our clinical records are digital, thanks to close partnership with the GHA IT team.

>90% Patient Satisfaction

Our patient experience survey consistently exceeds 90% satisfaction, reflecting the warmth, compassion and professionalism of our team.

📊

30-Day SACT Mortality

We have reduced our 30-day SACT mortality rate — a key quality benchmark used across NHS England — reflecting our commitment to safe, evidence-based treatment and careful patient selection.

🚚

UK Company Partnership

Through our partnership with a specialist UK company, chemotherapy and immunotherapy treatments are prepared in England and shipped to Gibraltar at significantly lower cost — ensuring our patients receive the same high-quality medications at better value.

"I have felt a very close and warm relationship from the cancer team towards my person, giving me the confidence to ask and inform myself. I come to my appointments like coming to see my family."
— GHA Cancer Services Patient Survey

Your First Visit

What to expect at your first oncology consultation at GHA Cancer Services

📋

Before You Arrive

By the time of your first visit, your case will already have been reviewed following referral from your specialist doctor. In many cases, it will have been discussed at the Cancer MDT (Multidisciplinary Team), where different specialists assess and agree on the best plan for you.

🩺

What Happens During Your Consultation

Your oncologist will carry out a full assessment of your situation, including:

✔ Your diagnosis and previous test results
✔ Your current symptoms
✔ Other medical conditions you may have
✔ The medications you are currently taking
✔ Your overall physical condition
✔ Review of scans, blood tests and biopsy results

The aim is to decide together with you the most appropriate next step — which may include treatment, further investigations, observation, or supportive care.

📊

Assessing Your Physical Condition

Before offering treatments such as chemotherapy or immunotherapy, we assess your physical condition to understand whether treatment is likely to benefit you. One of the main tools we use is the ECOG Performance Status:

ECOGWhat it means
0Fully active — able to carry on all normal activities without restriction
1Able to carry out light activities, but limited in physically demanding tasks
2Able to look after yourself, but unable to work; up and about more than half the day
3Limited self-care; spending more than half the day in bed or a chair
4Completely dependent; unable to carry out any self-care

We may also use the Karnofsky Performance Scale (0–100), where higher scores indicate better physical function.

⚕️

What This Means for Your Treatment

Patients with a good physical condition (typically ECOG 0–2) are more likely to benefit from SACT (Systemic Anti-Cancer Treatment), which includes chemotherapy, immunotherapy, targeted therapies and similar treatments.

If your physical condition is not optimal at the time of assessment, we may:

🕐 Allow time for recovery before starting treatment
💊 Focus first on improving symptoms — pain, infection, nutrition or fatigue
📅 Reassess you at a future appointment
🤝 Recommend an approach focused on symptom control and quality of life

In some cases, active cancer treatment is not the best option, as it may reduce quality of life without meaningful benefit. This is always discussed openly with you.

💛

Supportive and Palliative Care

Supportive or palliative care does not mean stopping care. It means focusing on helping you feel as well as possible. This may include:

🩹 Pain control
🤢 Nausea management
😴 Fatigue support
🍽️ Appetite and nutrition
💬 Emotional support
👩‍⚕️ Specialist nursing
🏥 Symptom control
🤝 Palliative care coordination
📋

Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)

A DNACPR decision means that if your heart or breathing stops, cardiopulmonary resuscitation (CPR) will not be attempted. This is a medical decision, made carefully and in discussion with you and your family. It does not mean stopping all care — you will continue to receive all other appropriate treatments, pain relief, and supportive care.

DNACPR decisions are:

🤝 Made in discussion with you, where possible
🔄 Reviewed if your condition changes
📝 Documented in your medical records
💛 Always focused on your dignity and comfort

If you have any questions about DNACPR, please speak with your consultant, specialist nurse, or the Palliative Care Team.

🎒

What to Bring to Your First Visit

To make your consultation as useful as possible, please bring:

💊 A list of your current medications
⚠️ Details of any allergies
📄 Any recent medical reports, if available
❓ A list of questions you may have

We strongly recommend attending with a family member or friend. Having someone with you can help you better understand the information discussed and provide support during the consultation.

📝

Your Regular Medications & Repeat Prescriptions

During your cancer treatment, your oncology team may occasionally extend your regular repeat prescriptions to avoid disruption to your ongoing medications. However, we strongly recommend that you manage your repeat prescriptions through your GP, as they are best qualified to:

🔍 Review whether you still need each medication
🔄 Consider switching to alternatives that may be more appropriate during SACT
📉 Adjust doses as needed while you are on cancer treatment
🛑 Stop medications that are no longer required or may interact with your treatment

You can request your repeat prescriptions online using the GHA Repeat Prescription Form:

📋 GHA Repeat Prescription Form →

📺 Understanding Chemotherapy — Watch This Short Video

This helpful video explains how chemotherapy works and what to expect during treatment.

Understanding Chemotherapy Video

Every patient is different. During your first visit, we will review your case carefully and explain your options clearly — including expected benefits and possible risks. Our aim is to offer the most appropriate plan based on your individual situation and needs.

Patient Information

A guide to Systemic Anti-Cancer Therapy (SACT) for patients and carers

💊
What is SACT?
Chemotherapy, immunotherapy & targeted treatments
💉
How is treatment given?
Routes of administration & access devices
✍️
Agreeing to treatment
Consent, treatment aims & second opinions
🩸
Blood tests & bone marrow
Understanding your blood count results
🛡️
Risk of infection
Neutropenia, food safety & prevention tips
❤️‍🩹
Anaemia & bleeding
Low red cells, low platelets & what to watch
🤢
Nausea & digestive problems
Anti-sickness drugs, diet tips & bowel changes
💇
Hair changes
Hair loss, scalp cooling & regrowth
👄
Mouth problems
Soreness, ulcers & oral care during treatment
😴
Fatigue
Managing tiredness during & after treatment
🖐️
Skin, nail & nerve changes
Neuropathy, skin reactions & nail care
🫀
Blood clots (DVT)
Risk factors, symptoms & when to act
👂
Kidney & hearing changes
Monitoring kidney function & tinnitus
🤰
Sex, contraception & fertility
Protecting partners, fertility & family planning
💬
Feelings & emotions
Coping with anxiety, low mood & support
Late effects of chemotherapy
Long-term side effects & monitoring
🧬
Genetic Testing & Family Risk
Inherited genes, testing process & counselling
🤧
Flu Vaccine & Cancer Treatment
Why vaccination matters during treatment
☢️
Radiotherapy Side Effects
Site-specific effects & skin care advice
🏡
SACT & everyday life
Work, travel, driving & daily activities
🚨
When to seek urgent help
Emergency signs & who to contact
🚭
Smoking & Cancer
Why quitting matters & how we can help
🔎
Clinical Trials
Research studies & access from Gibraltar
⚠️
Alternative Therapies
What the evidence says & staying safe
💜
Advanced Cancer
Understanding, treatment & support
Cancer Myths
Truths and lies about cancer
☀️
Sun Exposure & SACT
Protecting your skin during treatment
🔍
Cancer Causes & Risk Factors
What increases cancer risk & how to reduce it
📊
Cancer Staging & Grading
Understanding how cancer is classified
🔮
What is a Cancer Prognosis?
Understanding your outlook & survival statistics

Contact Us

Cancer Services

+350 200 72266
Ext 2545

📍

Location

Cancer Unit, 5th Floor
St Bernard's Hospital
Europort Avenue, Gibraltar

🕐

Opening Hours

Monday – Friday
08:00 – 17:00
Chemotherapy Suite: 08:30 – 16:30

🆘

Acute Oncology

24h via A&E
+350 200 72266
Ask for on-call oncology

Cancer Kits

Practical support for patients currently undergoing cancer treatment — generously donated by our local cancer charities.

We offer Cancer Kits to people currently undergoing treatment as a practical aid to recovery. These kits are supplied free of charge and can be ordered for yourself or a friend or family member.

💉
Chemo Kit

Specifically tailored for patients undergoing chemotherapy

To request a kit, please contact our Cancer Services team directly. Kits may also be requested on behalf of a patient.

Breast Cancer Support Gibraltar donating comfort bags to GHA Cancer Services
🎀

A Message of Gratitude — Breast Cancer Support Gibraltar

"We are proud to support our patients through the donation of comfort bags for those undergoing their first chemotherapy treatment. These thoughtfully assembled bags — containing lemon tea bags, shower gel, toothpaste, products for dry lips and skin, a gel cream, and a motivational phrase — will undoubtedly provide comfort and support during this challenging time. The practicality of the bag itself further adds to the convenience for our patients. Your kindness and support play a vital role in making the journey through chemotherapy more manageable and uplifting for those in our care."

GHA Cancer Services, in appreciation of Breast Cancer Support Gibraltar's generous donation

Useful Resources

Support organisations and information for patients, families and carers

Cancer Relief Gibraltar

Over 40 years supporting people living with cancer. Free professional, practical, emotional and social support services for anyone affected by cancer.

Visit Website

Breast Cancer Support Gibraltar

Local charity raising awareness about breast cancer and offering support, information and practical advice to those affected.

Visit Website

Bosom Buddies Cancer Trust

Gibraltar charity supporting anyone who has suffered from any type of cancer. Peer support from those who understand — males and females all welcome.

Facebook Page

Prostate Cancer Gibraltar

Raising awareness of prostate cancer in Gibraltar, promoting PSA testing, and supporting those affected by the disease.

Visit Website

Pancreatic Cancer Awareness Gibraltar

Working today to change tomorrow — raising awareness of pancreatic cancer in the Gibraltar community.

Visit Website