READER may notice I have wandered from my usual plantations, commodities, history, heritage and nation-building. No palm oil, cocoa, coffee or even a railway carriage this time.
I hope you will indulge me, because this subject is closer to home and, quite literally, closer to my heart.
Through two decades of observing and occasionally accompanying Sandakan Pink Ribbon’s work, I have seen how breast cancer reaches far beyond hospitals into families, workplaces, household finances, employers, charities and the often unseen work of caregiving.
So, perhaps this piece is not such a stranger to the business pages after all.
Business, like health, is ultimately about people. Pink October reminds us that awareness begins with a ribbon, but its real measure is whether knowledge, care and companionship reach the woman who needs them.
Every October, the world turns a little pink. Ribbons appear on lapels, buildings glow after sunset, charity runs fill streets, and hospitals, schools, companies and community organisations organise talks, screenings and fundraisers.
Survivors tell their stories, families remember those they have lost, and women are reminded that noticing a change and seeking medical advice promptly can matter profoundly.
For 2026, the World Health Organisation (WHO) has chosen a particularly human theme for Breast Cancer Awareness Month: “Every story is unique, every journey matters.”
In 2024, an estimated 2.4 million women were diagnosed with breast cancer worldwide and about 694,000 died from the disease. Breast cancer was the most common cancer among women in 164 of 186 countries, while around 70% of breast-cancer deaths occurred in low- and middle-income countries, where access to early detection, timely diagnosis and comprehensive treatment remains more limited.
Those figures explain why October matters, but numbers can become strangely bloodless. Two-point-four million diagnoses sound enormous; one frightened woman outside a consultation room feels very different. Pink October must take us from statistics to stories, from awareness to action, and from ribbons to people.
A ribbon is only the beginning
The pink ribbon has helped make breast cancer discussable in workplaces, schools, shopping centres, boardrooms and homes. That itself is an achievement.
There was a time, including in parts of Sabah, when even saying the word cancer could make people uncomfortable.
I remember programmes where some women declined breast-health materials with a familiar Sabahan response: palis-palis. Let it pass us by.
At one session, when educational breast images appeared, several women covered their eyes as though they had wandered into an X-rated movie. Amusing for a moment, yes, but the challenge was serious: how do you promote early diagnosis when fear makes the subject itself difficult to discuss?
Those experiences taught me something Pink October campaigns everywhere probably recognise in different forms: information alone does not automatically change behaviour.
A brochure can explain symptoms, a poster can encourage action and a doctor can present evidence, but before knowledge changes behaviour, trust often has to overcome fear. Trust takes time.
From Sandakan to a much larger story
In Sabah, Sandakan offers one example of how community-based breast-health work can grow over time. Beginning in 2006, awareness and support efforts were developed with the involvement of healthcare professionals, volunteers, patients, survivors and family members, with early support from Duchess of Kent Hospital and IJM Plantations Bhd.
Among those involved were Mary Alex Mansiw, drawing on her background in radiography and diagnostic imaging, and Dr Zorina Khalid, then Director of Duchess of Kent Hospital.
The work gradually extended beyond the hospital into communities and schools, reaching places including Keningau, Apin-Apin, Lahad Datu, Kota Kinabalu and Beluran. Over time, the grassroots initiative evolved into the independent Sandakan Breast Cancer Support Association, better known as Sandakan Pink Ribbon.
This year marks twenty years since those early beginnings. I recount this not because Sandakan is exceptional, but because its experience is one small Malaysian version of something repeated around the world.
Somewhere, a nurse is explaining a lump to a frightened patient. Somewhere, a radiographer is guiding a woman through mammography. Somewhere, a surgeon or oncologist is discussing treatment. Somewhere, a survivor is sitting beside someone newly diagnosed.
Somewhere, a researcher is seeking better diagnostics or therapies. Somewhere, a daughter accompanies her mother to hospital, while a volunteer folds chairs long after an awareness programme ends.
Pink October belongs to all of them
One lesson from Sabah is the importance of taking health education beyond formal healthcare settings.
Schools became useful because information could travel home. Teach a student something about breast health and she may tell her mother, who tells an aunt or sister.
Somewhere along that chain, a woman who has postponed seeking advice may finally act. There may be no press conference or viral post, yet one conversation may have changed the timing of a diagnosis. Public health often advances quietly.
WHO’s Global Breast Cancer Initiative has three practical goals: diagnose more cancers early, complete diagnosis within about two months of the first warning signs, and ensure most patients receive the full treatment recommended for them.
That may sound clinical, but the barriers are often very human. A woman must notice that something is wrong, seek help early and then cope with distance, cost, work, childcare or fear. The journey from symptom to treatment is therefore not only medical. It is also social, financial and emotional. That is where community organisations matter most - helping bridge the gap between health policy and the woman who needs care.
A scan cannot measure fear
When I asked Mary what two decades of breast-cancer support had taught her that professional training could not, her answer stayed with me. A scan can identify a tumour, but it cannot measure fear. Medicine can prescribe treatment, but it cannot prescribe companionship. That requires people.
Behind a diagnosis may be a mother worrying about her children, a daughter thinking about ageing parents, or an employee worrying about treatment and livelihood. Cancer enters the medical record as a diagnosis, but it enters the household as a disruption to ordinary life.
This is why care cannot end at diagnosis, surgery, chemotherapy, radiotherapy or medication. Emotional and psychological support matter too, as do listening, dignity and helping patients understand what is happening to them. Sometimes the most credible voice in the room belongs not to a professional, but to someone who has walked the same road.
Frightened patients can become survivors, and survivors in turn become encouragers. The woman who once needed a hand to hold may later be the one offering hers to someone else. She can say, “I understand,” not because she has studied the experience, but because she has lived it. That is compassion completing one circle and beginning another.
The people behind the pink
Pink October can sometimes appear almost too polished: pink lighting, T-shirts, merchandise and photographs. There is nothing wrong with these things when they draw attention and mobilise support, but symbolism should not become an end in itself.
The ribbon is not the work. It reminds us of the work.
Behind every visible campaign are people whose contributions rarely make headlines: doctors and nurses, radiographers and laboratory staff, surgeons and oncologists, counsellors, researchers, cancer societies and Pink Ribbon groups, volunteers, sponsors, families and caregivers, and survivors who turn their own difficult experience into somebody else’s source of strength.
I should also recognise a Cambridge friend, Professor Datin Paduka Dr Teo Soo Hwang, whose contribution reminds us that the breast-cancer frontier is also found in laboratories, genomic databases and research partnerships.
As founding chief executive of Cancer Research Malaysia and its former chief scientific officer, she helped build research focused on Asian cancers. Together with the University of Cambridge and Subang Jaya Medical Centre, Cancer Research Malaysia developed the largest genetic and genomic database of Asian breast cancers to date, addressing a long-standing gap when less than 5% of characterised breast-cancer genomes came from Asian women. Her work has helped advance understanding of cancer risk and precision medicine for Asian populations. Her honorary OBE in 2018 recognised outstanding scientific leadership and services to medical research, including Malaysia-UK collaboration.
And to the many, many others working at the frontiers of breast-cancer research, diagnosis, treatment, advocacy, navigation, support and care, often without much public recognition, thank you. Your work keeps moving hope from ribbon to reality.
In Sandakan, years of operating almost nomadically from hospital rooms, homes, offices and rented venues eventually led to a permanent support centre. The building itself is not the achievement. Its significance is that, for a voluntary organisation, walls and a door can mean that help has an address.
The real infrastructure of breast-cancer care is partly physical, through hospitals, scanners, laboratories and treatment centres. But it is also human infrastructure: trust, information, accompaniment and communities willing to care.
There is another reason Pink October deserves a measured tone. Not every breast-cancer story ends happily. Some women recover, some live for years with the disease, some experience recurrence, and some die far too young. For families who have lost someone, October can bring memories not easily wrapped in cheerful pink.
Any serious commemoration must leave room for that grief. Courage, too, has no single template. It may mean undergoing treatment, seeking another medical opinion, asking for help, accepting help, continuing to work, resting, telling one’s story or choosing privacy. Pink October should empower people, not prescribe how they should experience illness.
After October comes November
The real test of any awareness month begins when the month ends. In November, the pink lights are switched off, banners come down, charity-run medals go into drawers and social-media feeds move on. Breast cancer does not consult the calendar.
Someone will still discover a lump in November. Someone will wait for a biopsy result in December. Someone will begin treatment in January. Someone will complete treatment, while someone else will receive news she hoped never to hear.
That is why the most important word in Pink October may not be pink. It may be continuity.
Can awareness continue after the campaign? Can health systems shorten delays? Can families and community organisations keep supporting? Can companies accommodate employees facing treatment or caregiving responsibilities? Can donors continue helping when there is no dinner or charity run? Can survivors keep accompanying newcomers? Can governments, hospitals, researchers, businesses and civil society keep narrowing inequalities in diagnosis, treatment and support?
These are harder questions than choosing a shade of pink, but they are the questions that matter.
Keep showing up
After twenty years in Sandakan, Mary describes what remains strongest not as pride, but gratitude: gratitude to healthcare professionals, survivors, volunteers, benefactors, families and, above all, the women who allowed others to accompany them through some of the hardest passages of their lives.
Her reflection can travel far beyond Sabah: “Awareness may save a life, but compassion gives strength to the life being saved.” That, to me, captures the real meaning of Pink October. Raise awareness, encourage prompt action, support appropriate screening, strengthen diagnosis and treatment, fund research, close inequalities in access, support patients and survivors, remember those we have lost, and acknowledge the countless organisations and individuals doing this work, whether in Kuala Lumpur or Kota Kinabalu, Sandakan or Sydney, Nairobi or New York.
No single association owns the pink ribbon, no city owns the cause, and no country has finished the job. The ribbon belongs, metaphorically, to everyone willing to help carry what it represents.
Perhaps that is why such a small piece of coloured fabric has endured. It cannot diagnose cancer, deliver chemotherapy or comfort a frightened family, but at its best it reminds us to do something humans can do remarkably well when we choose to: show up for one another.
So when the world turns pink this October, admire the lights, join the walks, wear the ribbon and support the fundraisers. Then remember the harder part. When November comes, keep showing up.
Because every story is unique, every journey matters, and nobody should have to walk that journey alone.
Joseph Tek Choon Yee has over 30 years of experience in the plantation industry, with a strong background in oil palm research and development, C-suite leadership and industry advocacy. The views expressed here are the writer’s own.
