KUALA LUMPUR: Rashidah Isa was pregnant three years ago when she was diagnosed with Stage 2 breast cancer.
Rashidah, 41, said she wanted to go for surgery after her delivery but her newborn had heart problems and she had no one to take care of his needs and two children, one of whom also has a disability.
“It was a challenge travelling from Negri Sembilan to Melaka Hospital for my child’s treatment. My mother was already old and my husband has other children from another marriage to take care of.
“The doctors are angry with me for not getting treatment quickly. I wanted to but they don’t understand my predicament, ” she said.
Rashidah, who now lives in Melaka, said her cancer is now at Stage 4. A doctor at the hospital is helping to process her application for welfare assistance.
Meanwhile, Zeeda Aziz, 40, diagnosed with Stage 2 oesteosarcoma (bone cancer) in 2007 at age 27 said she had to drive for more than five hours from her home in Sungai Petani, Kedah, to Hospital Universiti Sains Malaysia, in Kelantan, about 310km away.
Although her husband is an engineer, they exhausted all their savings paying for her mother’s hotel stay to care for her, hiring a baby sitter and providing for her two young children and getting a prosthetic implant, which later did not work out for her, she said.
Zeeda, who used to be actively involved in the Society for Cancer Survivors Malaysia programmes in rural areas, said that from her interaction with villagers in Sungai Petani, Kuala Muda and Kulim, the lack of funds drove some to turn to bomohs.
Some villagers also could not afford the transportation, treatment or childcare costs and cost of medicines for rare cancers.
Universiti Malaya Cancer Research Institute director Prof Dr Nur Aishah Mohd Taib said 30% to 40% of cancer patients who went to Universiti Malaya Medical Centre (UMMC), and 60% to 80% of such patients who went to other hospitals in other parts of the country, especially from the East Coast, turned up with advanced disease or Stages 3 and 4 cancer.
The reasons for patients delaying treatment are complex and sometimes for multiple reasons, she said.
Dr Nur Aishah, a breast surgeon, cited the case of a patient with an ulcerated bleeding breast who sought various alternative therapies before going to hospital.
She was diagnosed with Stage 3 breast cancer and was given chemotherapy. The tumour shrank but she was not keen to have her breast surgically removed despite doctors and nurses telling her to get treatment. Eight months later, she returned with a large tumour that had spread to the liver that needed further chemotherapy but subsequent courses no longer worked for her and she died.
Dr Nur Aishah said psycho-social support services in hospitals were much needed to assist patients in navigating through the treatment regime, get good symptoms control and not fall out of treatment, and cope with anxieties and depression.
In UMMC, for instance, there were only two psychologists servicing the whole hospital, while hospitals in advanced countries have specialised nurses or social workers or counsellors to support cancer patients, she said.
Breast Cancer Welfare Association president Ranjit Kaur concurred that patients often do not know how long they are supposed to wait for diagnosis and treatment or which doctor they need to see.
Some adopt a “don’t want to know” and “don’t want to hear” attitude, going into denial or are ignorant about the disease, she said.
She said the Malays tend to be more fatalistic as they hear about more people dying from the disease than living.
“It’s a vicious cycle. If patients think there is no hope, they are less likely to seek treatment early and hence, the low chance of survival but if more people seek timely medical treatment and are living, the perception may change, ” she said.