Breast cancer is a major global health challenge, causing about 2.3 million incident breast cancer cases and 685,000 deaths globally in 2020. It is the leading cause of cancer mortality in women worldwide.
Its impact extends beyond the physical illness into the emotional, financial, and societal aspects of the lives it touches. As we come to the end of Breast Cancer Awareness Month, I want to take some time to speak about the importance of education, early screening and diagnosis, and the multifaceted challenges posed by breast cancer. In addition, this article will shed light on the often overlooked but critical topic of mental health, stigma, financial burdens, and the need for support during the breast cancer journey.
Every year in October, I educate women about Breast cancer. That’s because, for every adult woman, the threat of breast cancer exists whether you acknowledge it or not. According to the World Health Organisation (WHO), nearly 38% of all diagnosed cancers in women in Nigeria are breast cancer. From a public health perspective, considering the lack of awareness, the average income level and the cost of treatment paints a very dire picture. For many, it is a death sentence, or at most, it significantly changes their lives. Women are not the only ones affected as, in most cases, they are the home’s primary caregiver. One personal experience reminded me of the destabilising effects of a potential cancer diagnosis.
While breastfeeding my 2nd child, I felt a big lump on my right breast. I had initially thought it would disappear after breastfeeding. After about a year, it persisted. (It is recommended that breastfeeding women have their breasts evaluated a few months after breastfeeding. This practice will allow the breast to return to a semi-neutral state – the breast might have reduced to a pre-pregnancy state). Although the lump was not increasing in size and was not painful, it worried me constantly. I had to go for an ultrasound at Lagos State University Teaching Hospital (LASUTH). Because I was a medical practitioner, I took the scary scan report to one of our consultants in General surgery, and he referred me for further imaging. When the result was out, it was suspicious of a malignant growth. I was terrified, but my consultant reassured me and insisted we wait till we had a biopsy report.
I had a core biopsy done and waited two long, torturous weeks for the histology reports. I felt like I already had breast cancer and became anxious and fearful. To my relief, the reports revealed a benign growth (Fibroadenoma). While I felt relief, I realised that few people are that lucky. For others, the reverse might be the case. Early detection is always key to recovery.
Knowledge is power, and when it comes to breast cancer, awareness can be life-saving. Early detection and treatment can significantly improve the chances of recovery. The first step in early detection includes monthly self-breast exams and scheduling routine clinical breast examinations and mammograms if 40 years and above. Understanding that a lump is not the only sign is crucial. Do not ignore changes in the breast’s size, shape, appearance, skin dimpling, nipple changes, and persistent pain. Recognising these warning signs early and promptly seeking medical attention can increase the chances of early diagnosis and more effective treatment. Prevention of breast cancer is possible and can be done through reduction of alcohol consumption, cessation of smoking, weight loss, increased physical activity, and breastfeeding where possible.
Regular screening is an essential component of early breast cancer detection. While mammograms are typically recommended for women over 40 years and above, self-breast and clinical breast exams are vital for all ages. Regular self-exams empower individuals to become familiar with their breasts’ normal look and feel, making it easier to spot any changes. Clinical breast exams conducted by healthcare professionals provide an additional layer of screening. Promoting the importance of these practices is pivotal in the fight against breast cancer, as early detection significantly improves survival rates. You can find more information on how to screen yourself here
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Several challenges to breast cancer make early detection, diagnosis and treatment a significant battle. Only a smaller proportion of patients in most low- and middle-income countries are detected at earlier stages of the disease. There is a significant problem with access to care, quality of care, cost of diagnosis and treatment and psychological issues surrounding diagnosis and treatment. Recognising these challenges and actively working to address them is paramount in improving the overall breast cancer journey.
A breast cancer diagnosis is a seismic event. It can send shockwaves through one’s life, leading to anxiety, depression, and profound emotional distress. The challenges don’t end with the diagnosis, as treatment often takes a physical and emotional toll. Patients can grapple with fear, self-esteem issues, and body image concerns.
Unfortunately, Cancer stigma is a significant problem. Globally, people fear discrimination, negative societal views, gender norms and feelings of shame. It makes it difficult for patients to discuss their experiences and seek the support they need openly. This can make it difficult for patients to accept treatment in time. Breast cancer patients’ emotional and psychological well-being is as important as their medical treatment. Addressing these mental health aspects with support, counselling, and resources is essential for a holistic approach to breast cancer care.
The cost of treatment can be a significant burden, leading some to make difficult financial decisions. Moreover, a lack of support from family, friends, or the healthcare system can exacerbate the physical and psychological toll of the disease. It’s crucial that we, as a society, work towards de-stigmatising breast cancer, making healthcare more affordable, and providing robust support systems for patients and survivors.
In conclusion, breast cancer is not just a medical condition. It is a life-threatening disease with far-reaching impacts on life and well-being. The journey encompasses physical, emotional, financial, and societal challenges. Proper education, early screening, diagnosis and treatment are essential. Also, addressing the various issues around breast cancer can provide a more holistic and practical approach to this battle. Additionally, recognising the profound impacts on mental health, combating stigma, alleviating costs, and extending unwavering support to those affected is the key to empowering individuals on their path to recovery and resilience.
Perpetua Mbanefo has over a decade of work experience as a physician, public health professional, researcher, healthcare advocate and coordinator. She is currently a medical manager at Reliance Family Clinics. Find out more about her here (https://www.linkedin.com/in/nedolisa-perpetua-mbanefo-33243997/)
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