Daily Times

The World Health Organization disseminated information regarding breast cancer, which remains one of the two most common kinds of cancer prevalent in the world today. Pakistan has the highest rate of breast cancer incidence in the Global South, which makes it extremely important for Pakistanis to equip their hospitals with treatments featured by advanced technology for treatment and protection, and the latest research to battle the disease. In 2020 in Pakistan, approximately 26,000 women were diagnosed with breast cancer, and over 13,500 women died of the disease. And most recent demographic trends suggest that this rate is likely to escalate in the coming years.

Much of it has been attributed to the lack of diagnosis, screening, and treatment centres. Pakistani women lack easy access to suitable knowledge and appropriate awareness about health and medical facilities at large and breast cancer in particular. This is owed significantly to gender-based discrimination and patriarchal structures that do not enable women to prioritize healthy lifestyle adjustments. More than half of the population constitutes women, so sexually transmitted diseases (STDs) and breast cancer have been tremendously common diseases among women in Pakistan.

These pose multifaceted barriers to increased literacy about healthcare, cure, and prevention. As Pakistan is a developing country with low-income groups residing mostly in rural areas, it remains fraught with deteriorating health infrastructure, with the populace seldom concerned with the concept of personal hygiene.

Pakistani women lack easy access to suitable knowledge and appropriate awareness about health and medical facilities.

Socio-economic conditions and cultural factors also play a major role in the increased incidence of this disease. At some stage of life, 1 in 9 Pakistani women has been diseased with breast cancer. These factors inhibit women from breast cancer early screening, diagnosis, and subsequent treatment in many areas of Pakistan such as in the province of Punjab. It is imperative to identify this gap and explore the barriers that hinder women from the timely pursuit of treatment.

Breast cancer, however, has not only been rampant in rural areas. The city population is affected with equal measure. Urban women have been diagnosed at an advanced stage, impacting the prognosis negatively. Other factors like age, family history, body mass index, physical activity, marital status, breastfeeding, oral contraceptives, smoking, and menopausal status have aggravated the disease incidence.

Modern lifestyles with excessive consumption of processed foods contribute glaringly to breast cancer. Findings show that stark vitamin D deficiency in Pakistani women contributes to the development of breast cancer.

Even if it is treated, breast cancer has the tendency to expand to other areas of the body, and this has led to women facing cervical, ovarian, and uterine cancers too. It also leads to psychosocial stress, as patients are hesitant to undergo the exhausting process, which is not only emotionally traumatic but physically draining and financially unaffordable. This goes for patients as well as caregivers and family members who go through denial to acceptance of the disease.

Pakistan faces an acute shortage of healthcare centres for conducting affordable mammograms for early detection of the disease. Added to it is the exorbitant cost that more than half the population is unable to afford. The easiest technique, however, is Breast self-examination (BSE) which allows women to self-check on a monthly basis. This can have a substantial effect on reducing morbidity and mortality associated with breast cancer. In Pakistan, 89% of breast cancer patients are identified at a later stage and 59% at an advanced stage with fewer chances of survival.

Self-checkup is important, but one should regularly have oneself checked by a trained medical practitioner and nurse at health centres too. They enable women to use the Breast self-examination technique once a month, especially those who cannot afford expensive mammograms at regular intervals.

What should we do to combat and prevent this disease?

Health literacy stands at the forefront of the prevention of breast cancer. There is an imperative requisite to shift from negative sociocultural perceptions of cancer, where women believe that cancerous cells will spread to the unborn child, hide breast lumps from family members, and refer to religious clerics for spiritual advice and support. According to a recent study, 40.7% of Pakistani women wasted their time using alternative medicines, 17.1% ignored breast lumps and 10.6% were diagnosed late because they wanted to avoid being seen by male doctors. So we require inclusive and culturally-sensitive educative programs at grassroots and community levels with massive awareness campaigns to break the sociocultural stigmas tied to breast cancer.

We must actively address the urgency of breast cancer, as Pakistan is in the dire necessity to commence multi-pronged strategies at community and national levels for better reporting and documentation of cases. We must encourage early examinations and detection of breast cancer in young and old women and stand strongly against the barriers to the provision of better health facilities and accessible diagnosis. Pakistan needs to uplift its healthcare system to fill the gap in the absence of advanced equipped infrastructure and qualified staff.

Pakistan needs a national policy that entails effective training programs for mammography, a supply of oncologists, and nursing specialists. We need comprehensive databases to document breast cancer death rates, its causes and symptoms, and accurate annual occurrence for early management.

Let us all join hands to save lives.

About Author

Dr Maryum Nouman is an expert clinical oncologist and an emerging research author. She has gained diversified experience in the field of medicine, surgery, and infectious diseases. She has worked at different hospitals including Jinnah Postgraduate Medical Center, Civil Hospital, Pak Onco Care, Dow Medical Health Science, NESCOM Hospital, Islamabad, etc.

The writer is a freelancer.