Early diagnosis key to treating breast cancer

EVERY year in October we commemorate cancer, especially breast cancer.
We call it Pinktober with the colour pink being feminine.
The main aim for this commemoration is to let women know the symptoms of breast cancer and to present themselves early for treatment.
Why do we commemorate breast cancer and not other cancers?
That is because breast cancer is the most common killer of women.
Any woman can get breast cancer despite your status.
We can all talk about risk factors associated with breast cancer but the bottom line is as long as you are a woman, you are a target.
For the past 13 years, I have treated woman suffering from breast cancer at the Port Moresby General Hospital cancer clinic.
I see about 20 women every day for breast cancer alone.
Half of these are new cases and the other half are those with complications or recurrence despite completing the full six cycles of chemotherapy.
I have seen women who walked in happily smiling and telling me all is good and I have also seen those who walked in with a feeling of no hope, crying, confused and sad.
I have also seen those who walked in with strength, courage and the hope of fighting cancer.
It is a disease that will play with your emotions once you are diagnosed with it.
I have seen the distress family members go through with their loved ones.
Despite all that, I still don’t see breast cancer as a death penalty for those who are diagnosed with it.
It is not a death penalty because once you are diagnosed with breast cancer at a very early stage, you can be cured.
It becomes a problem when it spreads beyond the breast.
With the current facilities we have in the country, surgery and chemotherapy alone can cure breast cancer if we diagnose and manage it at a very early stage.
I have noticed certain factors that prevent women from going early for treatment:

•  IGNORANCE – most women despite feeling a lump on their breasts don’t want to seek medical attention immediately until it spreads;
•  FEAR – once diagnosed with early stages of breast cancer, most women when thinking of surgery and chemotherapy, are very scared to go through it and disappear for many months or years until it spreads and they are left with no option but to got to the hospital; and
•  OTHER treatment options – many women resort to herbal treatment and divine intervention for healing.
  I have not seen a herbal medication cure cancer in the last 13 years I have been managing breast cancer.
  There are people who market their products on the streets, social media and other avenues but none of them have come forward to see me at the cancer clinic to prove that their medicines work.
  In fact most patients I see with late stage cancers were initially on herbal treatment in their early stages; and,
•  FAMILY pressure/obligation – It’s not easy for a family when discussing surgery for women in the early stages of cancer. Many will oppose the idea because they want women to have children and to continue to breast feed.
  Apart from factors mentioned above that prevent woman from coming early for treatment, there are also woman out there who feel a lump in their breast and decide to come quickly to the hospital to get checked and treated.
  We have technical issues within our health system that delay treating early stage cancers:
•  AVAILABILITY of cancer screening centres – most hospitals in the country do not have cancer screening facilities. Patients not have a pathway to follow when they suspect they might have cancer;
•  DIAGNOSTIC facilities – Port Moresby General Hospital is the only centre that receives all specimens from all around PNG for histopathological diagnosis. There are less than five doctors who sit in the laboratory and do the diagnosis. Imagine the thousands of sample coming in monthly to be tested. Those who are in Port Moresby are lucky because receive their results quickly.
  Others outside of Port Moresby might wait for months.
  Cancer does not wait. It keeps growing and spreading:
•  IMAGING facilities – we have very limited ultrasound scan and mammogram machines. Patients can wait for a month to get a scan done;
•  TREATMENT facilities – Treatment consist of surgery, chemotherapy and radiation. We have a good number of general surgeons in the country who can conduct breast surgery.
• We do not have chemotherapy centres in all hospitals in PNG except for Port Moresby General Hospital, Angau Memorial Hospital and Kundiawa Hospital. Radiation facilities in Angau are currently not working. Port Moresby General Hospital is currently building a state of the art cancer centre which will include radiation facilities. We are hoping that it will be open next year; and,
• AVAILABILITY of cancer drugs – we do have ongoing issues with regular supplies of cancer drugs.
  Now that I have summarised most issues affecting management of cancer, let me say that cancer needs a team effort to fix it.
  Early diagnosis and treatment is the golden rule.
  We all co-operate to fix it, it’s up to us.

Dr eter Olali
Internal Medicine Specialist/
Medical Oncologist
Port Moresby General Hospital