I am a cancer specialist, working in a tertiary hospital in a metropolitan city. I am very passionate about woman cancer management and preventive oncology. Sometimes the patients we see in the OPD tell us a lot about the roadblocks that are beyond just creating cancer awareness in the society, writes Dr Mathangi J.
One such story of a patient that really disturbed me was when a 70-year-old lady was brought to my OPD. There was a pungent odour filling my room. I could understand that she had a locally advanced fungating tumour that had got infected. Our usual instincts are that the family is not taking care of her. But to my shock, the family was also looking for the reason for the pungent odour in the house for quite some time and could not make it out. Finally, the son realised it was coming from his mother. He forcefully took her to the nearby hospital to find out the reason, where again the doctor had to examine this non-cooperative patient to find a 15 cm fungating bleeding mass in the breast.
This scenario gives us a lot to ponder:
Social Taboo:
It was difficult for the old lady to talk about the lump in the breast to the family members. She was feeling very embarrassed. In general, it’s a taboo to discuss women's issues like menstrual cycles and breast openly. Mothers don’t discuss such things even to their children in conventional families. A single mother finds it even more difficult to discuss it with her only son.
The last Priority:
Women are raised to believe that their life is dedicated to the welfare of their family. She keeps not only herself as the last priority but also her health issues. This makes her postpone the attention to her health issues over petty daily commitments or to the financial requirements. This delay prevents herself to be presented in early stages – the golden time to treat and cure.
Women are raised to believe that their life is dedicated to the welfare of their family.
Fear and Pain:
The moment a lady notices a lump in the breast, she wants to believe that it’s nothing bad. She jumps into the phase of denial that it should not be cancer. She gets scared of diagnoses that she postpones meeting a doctor. She keeps justifying herself that the lump is not really bothering her in any way, nor painful. Cancer is never painful in initial stages.
Economic dependence:
The thought of financial requirements for treatment prevents her from getting it. Most of our women think that her treatment is an economic burden to the family. Most of them lack economic independence to take care of their own treatment. They are either dependant on spouse, parents, siblings or children. This makes her feel guiltier preventing herself from seeking good quality and timely medical care.
Most of our women think that her treatment is an economic burden to the family.
Abandoned women:
Apart from the financial burden, the lack of productivity also leads to a lot of women being abandoned by their spouses, children and at their workplaces. Many of them lose their jobs or are denied professional growth opportunities once the diagnosis is known. Also, the myth that Cancer is infectious leads to a lot of patients being isolated by their own families. (Cancer is not infectious)
The myth that Cancer is infectious leads to a lot of patients being isolated by their own families.
Reach of awareness programmes:
Though lots of activities are done round the clock to improve cancer awareness and breast health, unfortunately, the reach to every household is a long way to go. Many of the primary health care providers are themselves yet to be trained about breast examination and when to approach a doctor.
Western data:
Extrapolating western data, it’s always believed that breast cancer is a disease of the elite and affluent population and is caused by obesity and lack of physical activity. In India, out of our experience, we see a lot of lower socioeconomic women with very small breast presenting to us in advanced stages of breast cancer. In addition to the chemicals in food, air and water, the possibility of role of malnutrition in our country to cause mutations and cancer should also be kept in mind.
In India, out of our experience, we see a lot of lower socioeconomic women with very small breast presenting to us in advanced stages of breast cancer.
Early stages are curable:
The truth that breast cancers in their early stages are treatable with very good chance of complete cure should be imbibed in the minds of every woman. This would help them seek medical attention as early as possible. The cheaper false promising alternative therapies are also a reason why many women present to us in very advanced untreatable conditions.
To detour the roadblocks:
- Take your women at home for regular health checks.
- Mammography and Pap Smear should be a part of their health checks
- It’s not a taboo. Ladies…Let’s talk and encourage others to talk
- Train all the primary health care workers to reach the deeper parts of society
- There is LIFE AFTER CANCER… they are equally productive as they were before diagnosis
- Cancer is not infectious.
- Let’s make our women economically independent.
Prioritise Yourself And Your Health.
By Dr Mathangi J, Senior Consultant & In Charge, Department of Radiation Oncology, BGS Gleneagles Global Hospital, Bengaluru. The views expressed are the author's own.