Breast Cancer in Pakistan at Alarming Levels

Prevalence of Breast Cancer in Pakistan
Mareeha Bashir-ullah
Lecturer, University of Lahore.
Breast cancer unfortunately is one of the most widely prevalent cancer among almost one-third of the women population of the world. It is highly alarming that this disease so widely spread and commonly occurring is not much debated amongst the healthcare policy makers nationally and internationally.
According to a recent research one in every nine women in Pakistan is suffering from breast cancer. The ratio of breast cancer mortality rate in Pakistan according to the international research is very high due to late diagnoses, limited healthcare access, little or noawareness regarding the disease, delay in the treatment of the cancer due to cultural taboos attached to it and most importantly economic constraints.
Many non-governmental organizations working in Pakistan have collected the data and verified that 90,000 new breast cancer cases are reported with 40,000 deaths each year. Generally breast cancer is diagnosed among the women aged above 40 year old and it constitutes about 23% of all cancer cases in women.
Each year approximately one million new breast cancer cases are reported worldwide. However, it should be noted that in many underdeveloped countries many patients suffering from the disease due to illiteracy and lack of resources are unable to treat and diagnose the disease, as a result many such cases are not even reported.
Pakistan being a developing country is unable to provide adequate healthcare facilities to its population as less than 1% of GDP is allocated to the health sector. Whereas, breast cancer can be prevented with early diagnoses which is possible only with detailed and thorough awareness of the disease and timely treatment with adequate health care resources.
It is pertinently important to raise awareness regarding the disease amongst the masses just like the Red ribbon of Aids awareness campaign, Pink ribbon breast cancer awareness must be prioritized due to the increasing cases of not only women suffering from it but in a very limited ratio men also suffer from it according to the international reports.
The Pink ribbon campaign should not only be carried out during the month of October, rather throughout the year active and rigorous campaign should be lead and awareness regarding the disease should be spread to support the individuals suffering from it.
Moreover, at the governmental level big steps should be taken to fund the campaign, involve healthcare providers and subsidized treatment should be provisioned to the patients suffering from the disease.
Breast cancer cure and treatment is dependent on the stage, tumor biology, type, age and health of the person. Throughout the Pink Ribbon campaign self-examination, clinical examination and mammography are much debated to diagnose the disease in the very early stage and more amenable to therapy.
At a comparatively advanced stage of breast cancer various other methods are adopted for the cure and treatment such as;
Surgery, which includes differ types of surgeries like; Lumpectomy, Mastectomy, Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy.
Secondly, Radiation Therapy is widespread, Chemotherapy for which various drugs are used such as Doxorubicin, Cyclophosphamide, Paclitaxel and Docetaxel.
Thirdly, Endocrine Therapy which is commonly known as hormonal therapy and others are Targeted Therapy, Immunotherapy and finally Palliative Care.
All these treatments and cure to breast cancer require adequate financial resources but unfortunately only a few of the hospitals in Pakistan are able to provide free or subsidized cost of the treatment.
As a matter of fact standardized healthcare or hospitals with proper healthcare professionals, radiologists and equipment’s exist only in the metropolitan cities of Pakistan and the rural or remote areas of Pakistan are underserved when it comes to healthcare resources.
Hence, women in far flung remote areas doesn’t even undergo the diagnoses of the disease. Magnetic Resonance Mammography this practice is highly essential and should be provided to all the small and mega healthcare units throughout Pakistan, as it serves to detect breast cancer at its early stage and many lives can be saved through it.
It is interesting that over the past twenty years in many parts of Pakistan we have come a long way specially in urban areas as breast cancer is openly discussed and campaigns are lead rigorously, before that even two decades ago talking about breast cancer was considered a big taboo.
However, in the far flung rural areas of Pakistan where literacy rate is low even discussion
on breast cancer is considered a shameful act as if referring to sexuality rather than adisease. It is due to this regressive mindset of ignorant people many women silently suffer from cancer and never get their diagnoses or treatment done in time which leads to higher mortality rate.
Consequently, continuous awareness campaigns should be carried out throughout the year especially in the remote areas of Pakistan to combat the rising cases of breast cancer.
Organized public awareness is the need of the hour, so that an organized strategy is adopted at the governmental level with the help of the world health organization for proper detection and screening of the disease all around Pakistan.
Healthcare professionals and policy makers should chart out a plan to initiate and setup multidisciplinary breast tumor boards in all the healthcare setups even in the tertiary healthcare units for a detailed examination, screening and comprehensive inexpensive treatment.
Moreover, breast cancer tumor registry, diagnostic and therapeutic facilities should be established at the district level to combat this rising health emergency and stringent measures should be adopted for the early screening and diagnoses of breast cancer.