In the shadow of tall monuments, bustling bazaars and a rich culture, breast cancer casts a long, dark shadow over Pakistan. As the most common cancer worldwide, it is also the most common cancer in Pakistan, striking without mercy, claiming lives and breaking apart families. According to the World Health Organization’s Globocan estimates, more than 30,000 women in Pakistan are diagnosed with breast cancer each year and over 15,000 succumb to the disease. We ought to remember that these numbers are not mere statistics; they represent mothers, daughters and sisters torn from their loved ones. In high-income countries, five-year survival rates soar above 90 per cent due to advanced screening, timely interventions and robust support systems. Yet, in countries like Pakistan, these rates plummet because of a combination of low awareness, deep-seated stigma and inadequate access to diagnosis and treatment. The result? A disparity that turns a treatable illness into a death sentence for far too many.
WHO’s Global Breast Cancer Initiative (GBCI) seeks to close this gap. It targets a 2.5 per cent annual reduction in breast cancer mortality by 2040 through three pillars: awareness and early detection, timely diagnosis and comprehensive treatment and management. In Pakistan, where cultural taboos often silence conversations about women’s health and rural health infrastructure lags behind urban centres, these strategies are more important now than ever before. But beyond policy papers and projections, the human cost is etched in stories like Asifa’s - a 40-year-old mother from Sanghar, Sindh. Her journey embodies the raw agony of this fight - but also hope.
Asifa’s struggle
Asifa’s life, once defined by the common routines of motherhood, unravelled in December 2024. Married for over two decades and mother to four young children, she discovered a lump that upended her world. The diagnosis confirmed the dreadful news: she was suffering from breast cancer. Sanghar, her hometown in Sindh, does not have any tertiary care facility for cancer treatment. Compounding this, trust in local options is scarce. So, Asifa made the long journey to Lahore, to the renowned Shaukat Khanum Memorial Cancer Hospital and Research Centre. But she arrived unprepared for the marathon ahead.
“I thought it would be quick - perhaps a few days, maybe a week,” elucidated Asifa. “I didn’t pack shoes, just my old slippers. Can you believe it? I really had no clue,” she said while sharing her story with this scribe. Chemotherapy, surgery and radiation stretched into months. She stayed with relatives in Lahore, but the distance from her children gnawed at her soul. Resources were too thin to afford the back-and-forth travel. “Chemotherapy is tough,” she admitted. “But the real pain? Being away from my young children. Fighting this disease far from my family has been the toughest battle. Not knowing when I’ll see my children again,” she continued. Tears traced paths down her cheeks as she spoke, her voice breaking. “I wish someone would open a cancer hospital in my city,” she pleaded. “I could fight this disease near my loved ones,” she said with deep sorrow.
Why must our mother choose between life and being with her children? Asifa’s experience echoes the plight of countless Pakistani women from the southern parts of Pakistan where access to comprehensive cancer treatment under one roof - regardless of financial status - is out of reach.
A challenging disease
Cancer is not the type of disease that after completing active treatment, you don’t have to see a hospital. It means going back for scans regularly and have regular follow-up consultations, keeping a close eye on any changes in health. Patients need to have easy access to a facility with all these services. If a patient from Sindh manages to complete treatment in Lahore and needs follow-up for five years, would you expect them to keep going back and forth and have good compliance? Cancer is already a challenging disease and no one should have to suffer additionally, only because of where they happen to live.
Last year, in these very pages, I mentioned the heartbreak of a classmate’s return to the battlefield of cancer. Zahra had triumphed over triple-negative breast cancer, a notoriously aggressive subtype that attacks quickly and resists standard therapies. Her initial victory was hard-won. But the cancer clawed back, unrelenting. She is no longer with us; her absence is a gaping wound in the lives she touched. That loss lingers like a fog, a stark reminder that breast cancer’s war demands a multi-front assault: early detection, timely diagnosis and research - finding the genetic shadows where the roots of this disease hide.
A breakthrough study
This year, an incredible study has been published, peeling back the layers of Pakistan’s breast cancer enigma. Led by Dr Muhammad Usman Rashid, Senior Research Scientist at Shaukat Khanum Hospital, and his team, the research, ‘Genetic Landscape of Pakistani Familial Breast Cancer Patients Using Multigene Panel Testing’, has been published in the prestigious ‘International Journal of Cancer’. It is the country’s first large-scale, home-grown probe into inherited breast cancer, wielding next-generation sequencing (NGS) technology to better understand familial risks. Over 50 per cent of 263 women harboured a disease-causing mutation, with more than 90 per cent linked to BRCA1/2.
“This is a major step forward in understanding the genetic landscape of Pakistani breast cancer patients,” Dr Rashid enthuses. “It’s not just about finding the mutations - we’re proposing a practical, affordable genetic testing strategy tailored to our population,” he adds.
The team advocates a streamlined seven-gene testing panel, slashing costs and sidestepping the exorbitant fees of foreign labs. “Imagine a tool that reduces reliance on expensive overseas testing, informs national guidelines for genetic risk assessment and expands precision cancer care to even the remotest corners of Pakistan,” expresses Dr Rashid. In a nation where out-of-pocket healthcare expenses can bankrupt families, this is not just innovation - it is equity in action. This milestone paves the way for personalised medicine and prevention, offering new hope to thousands of families shadowed by inherited cancer risk. Imagine a young woman, her mother’s diagnosis a fresh scar: a simple blood test could flag her vulnerability to breast cancer, prompting vigilant screenings before the disease takes root.
The fight must go on…
Breast cancer is not one type of disease; it has different types that require different strategies to fight. Although we have made significant progress in fighting the stigma around the subject over the past decades, there is still a lot to be done. We need to continue our efforts to normalise communication about breast cancer and to emphasise the importance of self-exams and mammograms. There are still many women who present with their symptoms too late. The tragedy is that this is a type of cancer with very high cure rates if diagnosed early - yet thousands of women are losing their lives to it in our country.
Timely diagnosis and access to treatment demand infrastructure overhauls. Asifa’s journey underscores the tyranny of distance. We need satellite clinics spread across multiple cities and rural areas, linked to main hubs - tertiary care cancer centres - to manage this. Comprehensive cancer management means offering surgery, chemotherapy and radiation, along with psychological support, as well as pain and symptom management.
Zahra has left us feeling upset and angry towards cancer, but we are turning this distress into hope. Zahra’s friends and family rallied together to create a lasting legacy by raising over $30,000 to help dedicate a room in her memory in a cancer hospital being built in Karachi. Little drops of water make the mighty ocean.
If these experiences encourage even one woman to take a moment to check herself or encourage her to take the first step and visit a doctor after finding a lump, it could be potentially life-saving. Breast cancer may be ruthless, but so is our resolve. We are a resilient nation that took the first step towards fighting cancer by building Pakistan’s first comprehensive cancer hospital, with public support, three decades ago. We are a generous nation, among global leaders in philanthropy. We can achieve anything once we make up our minds.
This October, let’s renew our commitment to fighting breast cancer. In honouring the fallen and championing the fighters, we continue to build a legacy of hope. As the battle rages on multiple fronts, let us fight with all we have - for all our mothers, daughters and sisters.
The writer is a LUMS alumna and a community social worker with special interest in public health, philosophy and human rights. Her X handle is mariamibkhan.
She can be reached at
mariamk27hotmail.com
Breast Cancer Awareness Month has been
observed in October since the eighties. It is called ‘Pink October’ as people around the world adopt the pink colour and display a pink ribbon to raise awareness about the importance of prevention and routine screening for the early diagnosis of breast cancer, now the second most commonly diagnosed cancer globally.
Let’s have a look at how some countries observed and ran campaigns with regard to Breast Cancer Awareness in the recent past.
*In Pakistan, Shaukat Khanum Memorial Cancer Hospital and Research Centre ran the ‘Pay Attention to Yourself’ (#IPledgeToCheck) campaign to normalise conversations about breast health and fight stigma, using Pink Tea Parties, in-person awareness sessions, Breast Cancer Days and strong TV/press outreach focused on self-examination and early detection.
*In South Africa, the Cancer Association of South Africa (CANSA) launched the ‘Dry & Detect Towel’ initiative - using everyday towels as a conversation starter to teach breast self-examination and promote early detection. A swing tag directed users to a dedicated microsite, with staff and volunteers engaging communities and leveraging media coverage to amplify the message.
*In Malaysia, the Society for Cancer Advocacy and Awareness Kuching (SCAN) fielded the ‘Pink Warriors’ survivor team at the Sarawak International Dragon Boat Regatta - an annual international paddling competition in Borneo that draws teams from around the world. By racing in multiple categories, they attracted strong public and media attention and showed that survivors can be fit and fabulous.
*In Europe, Europa Donna launched ‘the Cancer Currency’ campaign to highlight the value of women with MBC (Metastatic Breast Cancer) by creating ‘currency’ (working with the artist who designed the US $50 and $100 bills) with real women experiencing MBC, they launched an inspiring video to bring this initiative to life.
*In Ivory Coast, Hope Life organised the fourth edition of the ‘Slam Rose’, an urban poetry contest to grow awareness about breast cancer in the younger population, as well as many other activities such as free breast cancer screening and physical activity events.
*In Lebanon, ‘the Bread Exam’ is a bread recipe that implicitly teaches women how to self-check for breast cancer.
Source: Union for International Cancer Control (UICC)