It was the summer of 1999. A bunch of us final year medical students were seeing patients in the crowded outpatient department at the Mayo Hospital in Lahore. Our professor called out to us to come see a patient in one of the consultation rooms. The patient was a young woman no more than 35 years of age. She had come to the hospital with a large breast mass. She said she had first felt the mas more than a year ago. After ignoring it for months, she had finally mustered the courage to talk to her husband about it. Together they had visited a local ‘peer saab’ who had given her a ‘taweez.’ When that didn’t help, they had gone to a local ‘hakeem,’ whose medicine hadn’t worked either. And now here she was. A hundred miles from home, at Mayo Hospital, hoping for a cure.
It was too late. It had been too late for several months. She had needed surgery and chemotherapy months earlier. As thins stood, the cancer had spread to her bone marrow and lungs. She died a few weeks later.
This is a sad story. Unfortunately this is also a common story. Fifteen years after that day at Mayo Hospital, I still see similar patients. Women continue to hide their illness. Out of shyness, they are reluctant to talk about it. In many cases women don’t draw attention to their illness because they don’t want to burdon their family’s limited resources. They only go see a doctor when the pain is too great, or the weakness unbearable. By the time they present to a doctor for diagnosis and management, it is almost invariably too late.
Breast cancer will affect one of every eight women in their lifetime. Punjab Cancer Registry data suggest breast cancer is the most common cancer in Pakistan. Unfortunately it is still taboo to talk about breast cancer.
Breast cancer can be beaten. The kind of treatment options that exist today were not available even a couple of years ago. Depending on the size and type of cancer, treatment options include surgery, hormone therapy and even targeted gene therapy. These treatments are available in Pakistan. But the golden rule of cancer therapy still applies: early detection leads to successful treatment.
October is Breast Cancer Awareness Month all over the world. It is time for us to spread the word on the need for early detection. We need to educate women about self examination and the need to see a doctor if they feel a breast lump. This will require more than just a few seminars here and there. This will require a shift in our mindset towards women and their health.
Breast cancer does not affect women only. It devastates entire families. And that is why we need to stop thinking of breast cancer as a women’s health issue, and start looking at it as a national health issue.