No database for breast cancer patients

Breast Cancer is known to be the most common malignancy affecting women countrywide. It threatens over 0.8 million female lives in Khyber Pakhtunkhwa (K-P) alone and is responsible for a number of cancer-related deaths in the province. However, despite the disease’s severity, lack of a national registry for breast cancer patients has made it impossible to formulate comprehensive health policies on the matter.

So far, the only data available for the disease is generic information acquired through hospitals providing medical assistance to women with breast cancer, including Shaukat Khanum Memorial Cancer Hospital, Institute of Radiotherapy and Nuclear Medicine and Hayatabad Medical Complex besides medical centres in different district headquarters across K-P. Professionals involved in awareness campaigns believe that over 50 per cent of patients diagnosed with breast cancer die without treatment. “Women often refuse to come forward, deny medical checkups and avoid treatments. This is primarily due to the stigma associated with the disease and the fear of isolation which follows diagnosis.” According to Provincial Health Association President Dr Saima Abid, people need to know that around 40,000 women die annually in Pakistan including 15,000 in K-P, despite the fact that early diagnosis—in stage one or two—has over 90 per cent chances of survival in most cases. “There is a severe lack of screening facilities [in K-P] on top of a poor referral system and inaccessibility to treatment for breast cancer patients, which shrinks the survival rate. Thus we desperately need a comprehensive data base to help formulate adequate policies and bridge the knowledge and action gap,” shared Abid. As per the Provincial Health Association President, the K-P assembly has adopted a resolution for Breast Cancer Control Program and notified two committees comprising of politicians and technical [health] experts. “A steering committee will be formed to oversee the formation, structuring and execution of the Breast Cancer Control Program, where technical experts will look into the needs including the number of treatment centres, diagnostic services and specialists needed to bridge the gap.”

Breast cancer: 25% of cases occur in women below 40

Speaking about women’s reluctance in seeking expert opinion, especially in the case of chest pain, she said that the most important reason is the absence of female experts. There is a single breast surgeon in all of Khyber Pakhtunkhwa, while local cultural norms further inhibit women from actively seeking expert guidance. According to Dr Abid, although female staff is available in the province for ultrasound and other examinations, local women are not open to the idea of being operated by a male surgeon. “Moreover, there is also the fear of breakups [if married], unacceptability [if unmarried] and of course, financial issues which keep women from going for expert consultation. Which is why in many cases patients often tend to go for temporary relief through consumption of anti-biotics but that doesn’t work for every chest pain.”

“I have been urging my students to join oncology so that we can have dedicated centres in every district with a perfect referral system to female health experts. Once a proper system is in place, we can then focus on maintaining a comprehensive registry which will encourage others and ultimately we can work towards nationwide prevention and control of breast cancer,” she told The Express Tribune.

Published in The Express Tribune, August 8^th, 2020.