While we seek to achieve our career objectives and business goals, there is one aspect of our lives we tend to neglect, our health. We have become accustomed to a more hectic lifestyle which has robbed us of prioritizing our health. We tend to postpone check-ups until we break down or have an emergency. One of the pertinent health issues many people face especially women is breast cancer.
October is Breast Cancer Awareness Month. Each year, various international bodies, organizations and other stakeholders embark on nationwide campaigns to sensitize the public and create awareness through initiatives such as community education, free screening exercises and fundraising campaigns to support the fight against breast cancer.
The very first time I heard of cancer was when a close relative passed about 17 years ago. At the time, I was very young so I didn’t really understand what it was. Later, I found out that she had died from breast cancer; a disease that has become a nightmare for many women.
Statistics
According to WHO, breast cancer is the most common form of cancer in women with an estimated 2.1 million women affected yearly and causes the greatest number of cancer-related deaths among women. In 2018, it was estimated that 627,000 women died as a result of breast cancer constituting approximately 15% of all cancer-related deaths among women.
WHO further notes that while breast cancer rates are higher among women in more developed regions, rates are increasing worldwide especially in middle to low income countries due to a lot of factors such as increased life expectancy, changing reproductive patterns, inadequate public education, lack of access to timely, affordable and effective diagnosis and treatment and the adoption of western lifestyles.
A documentary by CGTN Africa in 2018 revealed that the International Agency for Research on Cancer estimated that about 4,000 Ghanaians would be diagnosed with breast cancer by the end of that year. It also indicated that about 1,000 of those diagnosed were at risk of losing their lives. There are about 1.7 million new cases and 522,000 deaths recorded annually according to the Global Cancer Observatory.
Breast cancer is the second leading cause of death in Ghana. Late diagnosis, inadequate medical facilities and the growing costs of treatment are the major causes of death. Research has shown that early detection coupled with the right treatment, goes a long way to mitigate or control it, and presents a high chance of survival. On the other hand, late diagnosis presents a slim chance of survival. During this stage, treatment only improves the quality of life and may control the spread of the disease to some extent.
Myths, Misconceptions & Stigma
Majority of women who die as a result of breast cancer are diagnosed during the late stages. Apart from the major causes mentioned, there are also other factors that deter women from seeking early treatment.
In 2015, two of Africa’s foremost journalists, Nigeria’s Chika Oduah and Ghana’s Anas Aremeyaw Anas, set out to investigate the high spate of death among women across sub-Saharan Africa in the documentary Ghana: Cancer Ward through Africa Investigates series by Al Jazeera.
Their expose revealed a growing concern across the African continent – the myths, misconceptions and stigma that surround breast cancer. People believe that women who undergo mastectomy are not ‘complete’ or they will die if they go through chemotherapy. Many women diagnosed with breast cancer face stigma and are ostracized by society. Due to this, some women tend to resort to unorthodox or alternative treatment options to avoid facing stigma. Some also resort to herbalists and faith healers to avoid the high costs of seeking proper medical care.
Risk Factors
Studies have shown that there are various factors that cause breast cancer. According to the Centers for Disease Control and Prevention, most women are prone to breast cancer but not every woman will get the disease. Although breast cancer affects younger women, most breast cancers are diagnosed after age 50. On the Health Segment of Citi TV’s Breakfast Daily Show on 20th October 2020, Dr. Kelvin Osei, Medical Director of Optimacare Diagnostics spoke on the risk factors of breast cancer.
Age
The risk associated with breast cancer increases with age. Though research has shown that most breast cancers are diagnosed after age 50, younger women in their late teenage years and early twenties also stand at risk. At that age, it’s mostly the aggressive form known as triple-negative.
Family History
A woman stands at risk if any of their close family relations have previously been diagnosed with breast or ovarian cancer. For many women like me, our family history puts as at risk and it is important to get checked regularly. Though women are more at risk, men are also at risk of developing breast cancer especially if they have a strong family history.
Reproductive History
A woman’s reproductive history can also increase her risk of getting breast cancer. Having your first menstrual cycle at an early age, known as menarche and late-onset of menopause increases a woman’s risk.
Screening Methods
Regular breast cancer screening helps to detect cancer or any other abnormalities before there are any signs or symptoms of the disease. Let’s take a look at some of the breast cancer screening methods:
- Self-examination: Regular self-examination is a first step to notice any changes to your breast. This will help you to detect if there are any abnormalities such as lumps or boils. If you see such changes, report to your doctor for further investigations to be carried out.
- Clinical Breast Exam: Here, a doctor or nurse use their hands to feel for lumps or any other changes to the breast. At this stage, you may be required to undertake a scan if the health official observes any changes to be able to make a proper assessment.
- Mammogram: A mammogram is an X-ray of the breast. In most cases, a mammogram is the best way to detect cancer early and before it develops aggressively.
- Breast Magnetic Resonance Imaging (MRI): MRI is used along with mammograms to screen women who stand a high risk of getting breast cancer.
- Genetic Screening (for those with positive family history): For those with positive family history, genetic testing is one of the best methods to use.
Breast cancer treatment
In low to middle-income countries, the cost of treating cancer is high. Averagely, patients spent about $10,000 and over on cancer treatment in 2018. Unfortunately, many people can’t afford this. In a study conducted by G. Hughes et al on the Economic Cost of Breast Cancer in Ghana: The Komfo Anokye Teaching Hospital Experience indicated that the average cost per patient for the period under consideration was GH¢6,008.09.
Depending on the stage, treatment usually consists of chemotherapy, radiation and surgery. People with certain genes respond to medications which may not necessarily have chemotherapeutic agents.
What’s the way forward?
Though there have been several efforts by the government, health sector, organizations and other stakeholders, more needs to be done in the fight against breast cancer. A collective approach is required to champion this cause. So what’s the way forward?
Campaigns
Stakeholders need to intensify their campaigns and embark on all-year nationwide campaigns and community outreaches especially in rural and urban areas. Such programs will go a long way to sensitize the public and increase awareness on breast cancer its preventive measures, risk factors, possible treatment options among others.
Screening
Most health facilities organize free screening exercises for the general public during this period. However, regular and affordable screening initiatives should be organized by health officials, government agencies and other stakeholders. This will encourage more women to regularly visit health facilities for breast screening.
Policies
Over the years, the government has demonstrated commitment to quality healthcare with the implementation of various health policies and incentives such as the NHIS. The National Health Insurance Scheme which seeks to reduce the cost of healthcare for Ghanaians has been lauded by many. However, the NHIS covers a little fraction of medical costs for cancer patients.
The government needs to formulate health policies, incentives and subsidies that will make treatment affordable to the general public.
Social support
Many people continue to face stigma as a result of the disease while others have been ostracized by society. Breast cancer patients and their families need more community/social support to navigate the challenges. Having a strong support system can help patients deal with the adverse side effects of treatment etc. Micro-communities of survivors, health professionals and caregivers can go a long way to help patients and encourage them.
Research
Conducting extensive research will go a long way in making ground-breaking developments in cancer treatment. Sometimes, we may not see the importance of undergoing routine checks until it hits close to home. October is almost over. Please take advantage of the free screening exercises being organized by various health facilities across the country and get your breast examined. Get checked. Early detection saves lives!
References:
World Health Organization. (2018, September 12). Breast cancer. https://www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/
CGTN Africa. (2018, November 2). Ghanaian Doctors push awareness campaign on breast cancer. YouTube. https://m.youtube.com/watch?v=zNzOi-UEWCw
What Is Breast Cancer Screening? (2020, September 28). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/screening.htm
What Are the Risk Factors for Breast Cancer? (2020, September 14). Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
“Africa Investigates” Ghana: Cancer Ward (TV Episode 2015). (2015, December 17). IMDb. https://m.imdb.com/title/tt5317186/
Hughes, G. (2013, September 11). Economic Cost of Breast Cancer in Ghana: The Komfo Anokye Teaching Hospital Experience | Journal of Business Research. https://www.ajol.info/index.php/jbr/article/view/94077
CitiTube. (2020, October 20). Breakfast Daily: Tuesday, 20th October, 2020. YouTube. https://m.youtube.com/watch?v=vWhSqvCyd_g&t=1638s
Disclaimer: The information presented in this article were based on the cited references. Other details and inputs were made in consultation with Dr. Sylvester Mensah and Dr. Eliezer Bernard Owusu Ntim who are medical practitioners.
>>>Nana Akua Frimpomaa Amofa is a Writer and Creative Lead of Scripted Impressions, a creative consulting agency that helps individuals and brands tell their stories. She works as Senior Editor at El-Evangel Publications. Her work involves content development, strategy and review of publications. She is also the Project Lead for Community, a platform that provides support and resources to aspiring professionals and entrepreneurs. Connect with Nana Akua via Instagram/Twitter: @missamofa, LinkedIn: Nana Akua Frimpomaa Amofa, Email: [email protected]
