A Global Perspective on Breast Cancer

In the aftermath of the Global Summit on Breast Cancer in Budapest that was organized by Susan G. Komen for the Cure, it is not surprising that there is more coverage of the issue in the African press. Good thing, right? Maybe not if these few articles are an indication since the information contained in them is not entirely accurate.

In Angola,

“The minister of Family and Women Promotion, Cândida Celeste Tuesday urged women in Lubango city, south Huíla province, to carry out mammography tests to prevent and reduce the cases of breast cancer.”

Unfortunately, mammograms neither prevent or reduce cancer, they only detect it. In an article about the lack of radiologists and x-ray equipment in Kenya, we read that,

“A mammography seeks to expose benign cancers at an early stage.”

Again, unfortunately, there is no such thing as benign cancers. And then from Tanzania, we have “The Best–and Kindest–Cut for Women” by Mr. Onyango-Obbo who is Nation Media Group’s managing editor for Convergence and New Products. He writes about a New York Times piece that he saw about a young woman who made the difficult choice to have a double mastectomy after she found out that she carried the BRCA 1 gene. He writes,

“It was a chance Deborah wasn’t willing to gamble on. She took matters in her hands. She had a mastectomy, a procedure that would reduce her risk by 90 per cent and become one of a growing number of young women who call themselves “presurvivors” because they have learned early that they are genetically prone to breast cancer, and have the chance to do something about it before it strikes.

Going into the operation, Deborah’s and her mother’s main concern was how her new boyfriend would take it. He stood by her. In a colourful account, the writer recounted her dilemma: “She had stared at herself in the mirror, imagining the loss of her familiar shape. She wondered, unable to ask how the man she had started dating would feel about breasts that were surgically reconstructed, incapable of feeling his touch or nursing his children”.

Hopefully, our sisters will be inspired by Deborah’s example to make this agonising but, almost certainly, smarter choice and pray (a lot of it) that their partners will equal Jeff Zehr, Deborah’s boyfriend.”

While having a double mastectomy if one is genetically prone to breast cancer is certainly an option that may make sense, it is definitely not the only choice and also carries the usual significant risk of having major surgery.  One also wonders just how extensive the genetic testing facilities and general availability of gynecological and oncological care are in Tanzania that this would truly be an option, given the horrendous rates of maternal mortality, a number that has worsened in recent years, it seems unlikely.

It bears mentioning that this article was a bit of a smorgasboard written by someone whose title indicates that he specializes in consumer, not medical reporting–the second part was about anti-smell clothes.

Hmmm… so where is this disturbingly misleading coverage of breast cancer coming from? Bearing in mind that Komen gets substantive contributions from drug companies and makers of mammography equipment…or maybe with keynote addresses from outgoing Bush lackey Karen Hughes and as well as Laura Bush we should just put up the antenna for the smell factor. This quote from the conference promo sheds some light,

“By 2020, 70 percent of all cases of breast cancer will occur in developing countries,� said Riccardo Masetti, M.D., director of the Breast Surgical Unit at Catholic University in Rome and founder and president of Komen Italia. “And 70 percent of those with breast cancer will receive a late-stage diagnosis—stage III or greater.�

So why is there no mention in the Komen spiel about figuring out why this is happening? There are many factors, but one of the likely culprits is some of the cool stuff we are already exporting to developed countries like DDT and other pesticides and herbicides which are known carcinogens. Oh wait, I forgot, this opens up a huge market for exporting uber-expensive chemo drugs and radiology equipment, don’t want to do anything unprofitable like stopping the problem so we don’t have to then cure it.

Be that as it may, the problems faced by women with breast cancer in less developed nations can be truly horrendous,

“In many countries, women are afraid to talk about breast cancer for fear of being abandoned by their husbands and families; in India, Time Magazine reported recently, women with breast cancer may be forced to use separate utensils and plates because of the widespread belief that the disease is contagious.”

Women in Arab countries often do not go for treatment when they find a lump because of the shame of being seen by a male doctor or lab technician,

“One Saudi woman didn’t pay attention to the cancer growing in her breast because she was afraid of risk to be referred to a male doctor. Another was divorced by her husband on the mere suspicion she had the disease, and a third was dragged away from a mammogram machine because the technicians were men.”

While clearly breast cancer incidence has worsened in many parts of the world and needs to be addressed, we need to address why this is happening, simply exporting the U.S. medical industry is not the solution.