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Sunday October 6, 2013 MYT 12:00:00 AM
Sunday October 6, 2013 MYT 1:40:14 PM
by audrey edwards
PETALING JAYA: Many Malaysian women are still very confused over breast cancer, leading to difficulties when making decisions on how to deal with the disease, experts said.
The situation is further compounded by the fact that many prefer to seek alternative therapies in the early stage of the disease and only get medical help when the cancer has spread.
Cancer Research Initiatives Foundation (Carif) chief executive officer Prof Dr Teo Soo Hwang said women also did not necessarily have correct information on the disease.
She clarified that breast cancer was not one disease but 10 different diseases at the genetic level, all of which could be called breast cancer.
Each type needed separate treatments, she said.
“It is different types of treatment for different patients. All of this is very difficult to understand and they need to make decisions,” she said.
She added that women who were diagnosed with breast cancer also had other issues to deal with, including body image, psychosocial concerns like fear of losing their husbands or of being disowned by their families because of the stigma and affordability of treatment.
Dr Teo said it was important to know that breast cancer was curable if treated early and with the right decisions and support.
To this end, Carif has undertaken a series of programmes and research, among them a collaboration with the Ladies Professional Golf Association under which funds are used for a subsidised mammogram programme and women who take the test also donate a blood sample for research and answer a questionnaire.
It also has a patient navigation programme to help women make key decisions about their breast cancer.
University Malaya Medical Centre consultant breast surgeon Prof Dr Nur Aishah Mohd Taib said alternative therapy was “strongly embedded” in Malaysian society and confused some women, who equated it to hospital therapies.
“One of the factors why they present late is health literacy,” she said. “Some women don’t even know that cancer can spread and that it is dependent on time.
“A lot of women have difficulty making decisions so they normally choose the easier ones first and then go to the hospital as the last resort.”
Dr Nur Aishah also said there were misconceptions that caused women to avoid going for a biopsy as they believed they tak boleh kena besi (the disease would spread if any metal cuts into the flesh).
Dr Teo said patients also sometimes focused on the side effects like losing their hair rather than the efficacy of the treatment.
Research has shown that 7% of patients do not complete their treatment and resurfaced later.
Some centres treating breast cancer have reported up to 15% of patients who completely “disappear” from treatment.
Breast cancer hits 18% of the Malaysian population and is one in three cancers that women get.
A study carried out in University Malaya Medical Centre, which was published in 2011, found that five-year survival rates had improved in patients sampled, with Chinese improving from 63% to 81.4%, Indians from 57% to 80.4% and Malays from 46% to 58.3%.
Further studies are being done to find out why Malay women have lower survival rates although they have half the risk of developing breast cancer compared to the Chinese.
Besides the disparity between women living in rural and urban areas, said Dr Nur Aishah, single women who were highly-functional also tend to be at higher risk as they might not be able to cope with the diagnosis.
Dr Teo added that the women were often given anecdoctal stories that alternative treatment worked for other patients but she reminded that it might not have been cancer but other conditions like a fluid-filled cyst.
She said some women even turned up with joss stick burns after seeking alternative treatment.
Survival rates for stage one cancer, said Dr Nur Aishah, was beyond 90% while it was beyond 85% for those with stage two.
Stage three and four cancers had survival rates of 50% and 10% respectively, she said, adding that it was important to note that there were women who had stage four breast cancer and were still alive.
“People still have a very fatalistic connotation to cancer. We should change the mindset of the community and tell them it can be overcome. You have to stomach the side effects but you can survive this,” she stressed.
Carif also obtains funding from other sources including the Education and Health ministries, Sime Darby, Petronas and Estee Lauder.
It also provides free genetic counselling and testing for women who have high-risk features, which allows them to determine if they have the BRCA1 and BRCA2 gene mutation that increases their risk to breast cancer.
Frequent breast screening can save lives says Rohani
Tags / Keywords:
Health, carif, breast cancer, nur aishah mohd taib, teo soo hwang
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