First, it was a small lump in my left breast and it hurt a little but I ignored it. I knew something was wrong but I was too afraid to tell my controlling husband,” says Ms Sumayya, a breast cancer survivor. “But then when the pain started on regular basis, I told my husband about it and he freaked out,” she adds. Sumayya, now in her 40s, belongs to an orthodox community where nobody takes women’s illnesses seriously and talking about breast cancer is considered a taboo. Her husband instead of helping her left her in the lurch. She went to different homeopath doctors and bogus ‘pirs’ and ‘fakirs’ but nothing subsided her shooting pain. Then her own family came to her rescue and took her to a cancer hospital where she was treated and recovered. Today, she is settled and got married again. “I am fine today. I urge all women to go for a check-up as soon as they start noticing any change or lump in their breast. There is no point wasting time going after fake pirs and fakirs,” tells Sumayya.
Breast cancer has been declared by the World Health Organization as the most common cancer, globally affecting women and claiming the lives of thousands of women every year. With 90,000 breast cancer cases being annually reported in the country and over 40,000 deaths caused by it, Pakistan has the highest rate of breast cancer in Asia, though early diagnosis can save lives and make a difference. Lack of awareness is the key reason of highest incidence and mortality rate in Pakistan. In a country where speaking about health issues specifically related to women is frowned upon, urging people to take these issues seriously is a difficult task. This harsh and tragic reality aggravates the inequity surrounding women’s breast health education initiatives in the local community. Awareness surrounding breast cancer is incredibly important as early detection, often through screening, can catch the disease when it is most treatable.
Breast Cancer Awareness Month (BCAM) is an annual international health campaign organised by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. It is celebrated in many countries. This yearly event is more than just a way to raise funds for breast cancer research. It helps to increase awareness for the second leading cause of cancer deaths in women.
This year’s BCAM theme focuses on buddying up with one another because no one should fight cancer alone. “We hope that both men and women can partake and ‘buddy’ with their loved ones to protect themselves by going for regular mammograms and practice breast self-examination for early breast cancer detection,” says an official statement.
The Pink Ribbon is the most prominent symbol of breast cancer awareness. It is worn to honour those who have been diagnosed with breast cancer.
Pink Ribbon Pakistan (PRP) is a non-funded, self-sustained and the only organisation in the country which is dedicatedly working on the issue of breast cancer with nationwide outreach since 2004. “At the outset in 2004, talking about Breast Cancer was not easy in the society where this fatal disease was largely associated with female sexuality, but Pink Ribbon campaigned so effectively that not only the taboo was broken and Breast Cancer was included in the narrative of mainstream media but also the government acknowledged the cause and made Breast Cancer a priority in national health agenda,” elucidates Omer Aftab, CEO of Pink Ribbon Pakistan.
To observe the 17th anniversary of PINKtober, Pink Ribbon plans to expand awareness about breast cancer across Pakistan. (Pink Ribbon named October as PINKtober). The organisation intends to conduct a host of activities in the entire month and devise programmes for every week of October. “In first week of October, we will raise awareness on conducting the mammogram test for early detection of Breast Cancer. It will be stressed that women of age bracket 40 and above should go for mammogram at least once in two years. Due to our efforts, there has been a 400 per cent increase in mammogram in Pakistan helping women surviving breast cancer,” informs Omer Aftab, CEO Pink Ribbon Pakistan.
“On October 8th, important government buildings, monuments and schools/colleges will be illuminated pink to limit the taboo associated with this disease. In third week, Pink Ribbon will focus on creating awareness on the importance of adopting healthy lifestyle. In fourth week, the organisation will share stories of young patients about how they defeated breast cancer. Pink Ribbon also plans to partially open Pakistan’s first dedicated hospital for the treatment of Brest Cancer in Lahore,” shares Omer Aftab.
Breast Cancer is responsible for taking 40,000 lives each year which is quite alarming.
With insufficient treatment facilities and lack of awareness, there is a strong need to establish a dedicated breast cancer hospital. Realising the utmost privation of quality healthcare facilities for Breast Cancer, Pink Ribbon laid the foundation of Pakistan’s first dedicated breast cancer hospital in 2017 in Lahore.
Pink Ribbon has already constructed 12,000 square feet of grey structure with the help of donations. Upon completion, the hospital will give women state-of-the-art diagnostic and treatment facilities under one roof. The organisation urges philanthropists to donate generously for this noble cause.
Shahida Hussian, 59, Director Performing Arts at Lahore Grammar School, was detected with Breast Cancer five years ago. “I casually mentioned presence of a dimple in my left breast to a friend who got alerted and forced me to go for a check-up. I got my mammogram done and ultimately underwent surgery. The real struggle began thereafter. There were six cycles of chemotherapy and with every therapy came the side effects such as hair fall, nausea, swelling and so on but my determination led me through all that,” explains Shahida Hussian. “I fought with breast cancer with a positive attitude. I never thought that I would die of cancer. My only concern was my children especially when they had lost their father long time ago. This thought forced me to follow the treatment religiously. When my six weeks of radiation treatment ended, the next day I was in school. When I went through chemo, I never lied on bed. I never wore a scarf or a wig. I used to move around with bald head because this was the way God wanted me to be,” she elaborates.
She strongly recommends that there should be separate doctors for those who recover, “The sword of cancer recurring is always hanging on survivors, so they need complete attention. Pink Ribbon’s initiative called ‘Pink Angels’ is admirable in this regard as I believe there should be a support system of cancer patients who talk to each other, share their experiences and guide each other,” suggests Shahida.
Unfortunately, women belong to lower middle class have to bear a lot, besides enduring their illness. The story of Shehnila depicts the true picture of our male-dominated society. “I felt a little pain in my breast, initially I didn’t care but then when it was intensified, I told my sister about it. Our culture does not allow us to talk about our illnesses openly. I, along with my sister, went to different doctors and ‘hakims’ but nothing worked out. Then I told my husband about it after much thought. He was furious but then when he saw that my condition was getting worse, he took me to a hospital where I was finally treated,” narrates Shehnila. “Today I am fine. Had I gone for my treatment earlier, I would not have gone through a lot of pain,” she adds. “There is no point lingering on with your pain and illness only because of fear of the society – Log kya kehain gay. Your health should be your priority. A timely treatment can definitely save your life,” points out Shehnila.
The story of Samina Ali, another breast cancer survivor, is also impressive. Samina, Manager Customer Services at a leading architectural firm, came back from USA in 2005. “On noticing a dimple in my left breast, I thought it a part of ageing process. Six months went by when my elder sister on a routine check up to her gynaecologist also took me with her. On inspection the doctor immediately referred me for mammography and biopsy. No fear and no apprehension could change the test results. I was diagnosed with Breast Cancer. Being a health-conscious person, it took me some time to cope with the fact,” tells Samina Ali.
“It is a painful process, your body changes, there are no hair on head, no eyebrows, and no eyelashes, and there is swelling. Strangers stare at you, say hurtful things. All this is quite weird, however, I survived that all with great strength of mind,” she illustrates.
Samina laments that there is no support system in Pakistan. “You need a person who could tell what is going to be the next stage; there are so many little things one requires information on. I still remember a young unmarried girl who used to come from Multan and she was so poor that she had to borrow money for every visit. I remember a woman whose breast was literally oozing out and she kept on placing bread (chapatti) and relying on spiritual medication,” recalls Samina. She has pledged herself to support the breast cancer survivors in every possible way. “This is also the aim of Pink Ribbon; to structure a group of breast cancer survivors who can guide new patients. This could prove really valuable,” opines Samina.
Adopting a healthy lifestyle: Do you know that 40 per cent of the disease can be prevented by simply following a healthy and balanced lifestyle? The immune system plays an important role in preventing different diseases, including breast cancer. For boosting your immune system, your first line of defence is to choose a healthy lifestyle that includes taking a healthy diet; practicing hygiene; being physically active, getting adequate sleep and managing stress levels.
A sedentary lifestyle is linked with weight gain and a heightened risk of breast cancer, therefore, physical activity is highly recommended to women who are at an increased risk of breast cancer.
A healthy diet: It can help in preventing and fighting breast cancer. The food contains plenty of compounds such as carbohydrates, proteins, fats, vitamins, minerals, fibre and water that are very helpful in fighting against cancer cells. Balanced nutrition boosts circulation and increase tissue oxygenation and helps reduce inflammation and acids in the body. Carbohydrates give the body the fuel it needs for physical activity and proper organ function. Everyone should use organic and fresh food. Garlic, ginger, carrot, cabbage, cilantro, broccoli, onions, black pepper, cauliflower, brown rice, sprouted wheat, flax seed, mint, basil, oregano, gourd and zucchini help reduce chances of getting breast cancer.
Self-awareness: Many doctors stress the importance of breast self-awareness. Some of the signs that women should look for include: a lump, changes in the size and shape of the breast, swelling or redness, nipple discharge or rash, or skin dimpling (like an orange peel). Women should report any breast changes to their health care providers right away.
Mammogram: Women of age 40 and older should go for a mammogram test every year. A mammogram is an X-ray of breast cancer. It is a screening tool that is used for the detection of breast cancer in women who might have breast problems such as a lump, pain, or nipple discharge and also in women who have no breast complaints. It detects breast cancer, benign tumours, and cysts before they can be detected by palpation (touch). Mammograms have been in the use for past 30 years but the past 15 years have improved the quality of both the technique and the results to a great extent. Having a mammogram only takes about 20 minutes and the discomfort is minimal. It is not harmful or painful whatsoever. The mammogram units can be found in laboratories. Moreover, Pink Ribbon Pakistan has implanted 2 mammogram units of the highest quality and detection rate and the functioning will start from early Oct 2021. Take a mammogram because early detection saves lives.
Erum Noor Muzaffar is the editor of You! magazine. She can be reached at [email protected]