October every year has been used to raise awareness about breast cancer. Various screening programs are held to enable as many people as possible know their status. These sessions are often free. Indeed, October has been christened the ‘pink month’ because of its dedication to matters of breast cancer. Corporate bodies run programs, the media devote ample airtime, all geared towards raising awareness of the treatable but cruel disease. The refrain often is ‘early detection and treatment save lives.’ This year was not any different. Despite the attention on covid-19 and Ghana’s forthcoming election, October still enjoyed its time for breast cancer awareness.
The concern, however, is will everyone go to sleep again and wait for October next year to begin discussions on breast cancer again? Patients of the disease, who cannot support their own treatment, do not have to wait till October before government and other benevolent institutions will come to their aid. Calls for increased funding for the treatment of the disease must not dry up after the thirty one days of October pass.
The policy and funding question
A consultant Surgeon and professor of surgery at the University of Ghana Medical Centre, Professor Joe Nat Clegg-Lamptey, has stressed the need for government to support needy breast cancer patients with funds through their treatment.
Currently, Ghana lacks a formal breast cancer control policy, and the heightened wakefulness about the disease created in October must spur health policy makers on to get down to do some real work so that come next year October, we would have made some strides in the policy arena to move the advocacy to the next level. A policy is important to comprehensively address all matters related to breast cancer. It will discourage the current piecemeal approach and hopefully lay out plans to reduce the incidence of the disease. It is not just enough to screen. After screening and positive result, then comes the real challenge of funding treatment. Although breast cancer diagnosis and treatment are covered by Ghana’s National Health Insurance Scheme (NHIS), only about 40% of the population is enrolled on the program making many people face important financial barriers to access health care.
The Chief Executive Officer of the National Health Insurance Authority, Doctor Lydia Dsane-Selby has entreated citizens especially breast cancer patients to sign unto the scheme to enjoy their packages.
“Most of the stuff is covered, the diagnosis and treatment depending on the type you have. Whether it’s surgery, chemotherapy or radiotherapy, we have tariffs for all. At the time you are ill, you mind needs to be free to concentrate on beating whatever illness you have, that is not the time to be worried about money. Let’s all keep our card active and breast cancer is covered by the NHIA comprehensively.”
Though it has been said simply, there should be real challenges why people do not turn up to enroll onto the scheme as one expects. These challenges must be addressed. Is the access to treatment of breast cancer fraught with the same problems cardholders of the scheme face when they show up with the NHIS card at the health facility with other ailments?
The hard facts
About 1.7 million people are estimated to be living with breast cancer, 522,000 persons die every year from the condition, and this is according to the Global Cancer Observatory. According to the National Strategy for Cancer Control (NSCC 2014-2017), about 50%- 70% of patients in Ghana present the advanced stage III and IV of the disease many months after first noticing a change in their breast. Breast cancer is one of the commonest forms of cancer. It is predominantly a female disease although a few men have been diagnosed with the condition.
The disease involves the uncontrolled growth of cells in the human breast. As dangerous as the disease is, not many people are aware of it and the annual October awareness creation, though not enough is a great starting point. Though, some have attributed superstitious reasons for the condition rather than medical, its effect on the human breast hasn’t waned. Breast cancer, if diagnosed early can be treated, but not much has been done in raising awareness about the disease until recently; the more reason why we must do more beyond the pink month.
Black women, 40 years and above are more at risk of suffering from the condition. Other risk factors include, smoking, drinking and genetic make-up of people. While almost nothing can be done about some of the risk factors, a lot can be done to reduce others.
Young people, breast cancer and stigmatization
Despite the general fact that the condition is prevalent amongst elderly women, some young persons too can be affected.
Beatrice is one of such young persons. She is a 28 year old nurse who was diagnosed of breast cancer 4 years ago and is 4 months pregnant. Her life has never been the same. Beatrice, after her surgery and losing one of her breast, lost her partner as well.
“The guy I was dating back then actually travelled out of the country before I was diagnosed of breast cancer. When he was about to return, I had no choice that to break the news of the loss of my breast before he comes to see me. It wasn’t easy but I gathered courage and told him, I showed him the scars on my chest. He acted as if it was normal until he came back though I wasn’t aware he was back. I only found out he was back and getting married on a group page.”
Beatrice’s experience sadly is true for many young patients and survivors of breast cancer. Their partners often vanish, leaving them to go through the horrifying phase, especially in cases where they are only dating and have not been bound by the commitment of marriage.
For some men, the thought of not having two breasts to ‘play’ with is a put off and will make them find ways of ending a relationship with a partner. While some will leave at the mention of breast cancer, a few may remain and see their partners through the treatment before saying good bye. This poses major mental health issues for ladies and plummets their self-confidence.
There are some who even fear that once a woman has breast cancer, the treatment regime will make it impossible for childbirth. But resident oncologist at the Korle Bu Teaching Hospital, Dr Mervin Boakye, explains that a breast cancer patient’s ovaries can be preserved as she goes through treatment to enable her get pregnant after treatment.
“Some people may develop breast cancer while pregnant, some may have breast cancer and can get pregnant after treatment. With patients who we know the treatment given can affect their ovaries, there are options that we have in place to preserve their ovaries”
There is stigmatization when it comes to breast cancer because people rather look down on patients with the cancer. But the general public should know that once one has breast cancer, it’s not a death warrant but rather time to provide love and care.
Breast cancer is within the human population. Fortunately, it is treatable once diagnosed early. It is not useful to wait till the next October before we screen. Screen should be a lifestyle. Once anything unusual is noticed with the breast attention must be given to it though not any unusual thing may be breast cancer. It is important to create a good atmosphere of love and care for friends and loved ones who get diagnosed with this condition. Stigmatizing those with the condition should not be encouraged and this can be overcome by public education. The discussion about breast cancer must be an all-round one and government and health authorities must work to ensure there is funding to assist those who cannot afford the cost of treatment.
The writer, Naa Adoley Moffatt, works with Citi FM and Citi TV.