Cancer spares no one but early detection can save lives – PAHO/WHO
By Kristen Macklingam
Each year in the Americas, more than 462,000 women are diagnosed with breast cancer and almost 100,000 women die from this disease.
In Latin America and the Caribbean, breast cancer ranks as the first cancer type among women regarding both new cases and deaths.
According to the Pan American Health Organisation/ World Health Organisation (PAHO/WHO) Resident Representative in Guyana, Dr. William Adu-Krow, although breast cancer is thought to be a disease of the developed world, almost 50% of breast cancer cases and 58% of deaths occur in less developed countries.
He explained that in Latin America and the Caribbean, a greater proportion of breast cancer deaths occur in women under 65 years of age (56 %) as compared to North America (37%).
The PAHO/WHO Resident Representative also pointed out that if this current trend continues, by the year 2030, the number of women newly diagnosed with breast cancer is projected to increase by 34 % in the Americas.
Dr. Adu-Krow on Tuesday at a Cancer Awareness event stated that in Guyana, breast cancer is the leading cancer among the various forms of cancer. It is also the “number one” cancer that affects females.
“It accounts for almost 17 % of all cancers and 27 % of cancers in females. There were 1,074 cases of breast cancers among females and 16 among men. Breast cancer incidence and mortality rates were highest in women older than 65 years, peaking in those aged 70-74 years in 2012. In 2014, breast cancer accounted for 19.1 % of all deaths from cancers.”
Low survival rates a result of multiple factors
He emphasized that the low survival rates in less developed countries can be explained mainly by the lack of early detection programmes, which result in a high proportion of women presenting with late stage-disease, as well as by the lack of adequate diagnosis and treatment facilities.
It was reiterated that cancer spares no one but that early detection can save many lives.
“Early detection in order to improve breast cancer outcomes and survival remains the cornerstone of breast cancer control. Limited resource settings with weak health systems where breast cancer incidence is relatively high and the majority of women are diagnosed in late stages have the option to implement early diagnosis programmes based on awareness of early signs and symptoms and prompt referral to treatment.”
It was further explained that in high-income countries, organized screening programmes with mammography have led to earlier diagnosis, and coupled with effective treatment, have led to reductions in breast cancer mortality.
Challenges in implementing some effective screening initiatives
However, there are many challenges in implementing such effectively organized screening programmes in limited resource settings such as Guyana and regardless of how many agencies conduct free screening in this regard, it is useless unless there is effective referral and quality management, Dr. Adu-Krow noted.
“Low-cost screening approaches, such as clinical breast examination, could be implemented in limited resource settings. Many low- and middle-income countries that face the double burden of cervical and breast cancer need to implement combined cost-effective and affordable interventions to tackle these highly preventable diseases. PAHO/WHO continues to promote breast cancer control within the context of national cancer control programmes with strong recommendations for the integration of this programme into Non-communicable diseases prevention and control,” he said.
National Cancer Plan in the making for Guyana
According to Dr. Adu-Krow, in December 2018, Guyana’s Public Health Ministry with support from the International Atomic Energy Agency (IAEA), Austria and PAHO, conducted a National assessment that will guide the identification of strategic lines of actions to be included in a National Cancer Plan.
This National Cancer Plan, that is presently under development, calls for collaboration with all stakeholders, including Non-Governmental Organisations (NGOs), for the development and implementation of evidence-based policies, guidelines and protocols on prevention and control, as well as capacity building for health care providers and community organisations to improve cancer-related morbidity and mortality.
“Cancer spares no one. It touches the rich and poor, young and old, men, women and children. In addition to the financial cost of the disease, cancer has important psychosocial repercussions for patients and their families and remains, in many parts of the world, a stigmatizing disease,” the PAHO/WHO Resident Representative added.
Meanwhile, the Cancer Institute of Guyana (CIG), a non-profit organization, has documented the diagnosis and treatment of over 1000 persons, including men and women in Guyana, with cancer, specifically of the breast between the years 2015 and 2018.
For this year, just over 100 women were diagnosed with breast cancer so far and they were being treated, this number is expected to increase as the cancer institute seeks to raise more awareness.
These statistics were presented by Oncologist and Medical Director of the Institute, Dr Sayan Chakraborty during a press briefing last week, at the Institute’s building located in the Georgetown Public Hospital Corporation (GPHC) compound.
“In 2015, there was about 267 patients who were treated … almost every year; in 2017, we saw a spike, there were 300 patients who were treated at the Cancer Institute through radiation therapy. The trend is always 266, 267, gradually creeping up, sometimes it’s been going down, so we cannot ignore this situation which we are dealing with,” he stated.
Dr Chakraborty emphasised the fact that men could also be victims of breast cancer, but, according to him, there is usually a misconception behind this.
“It’s a misconception that breast cancer can only happen in ladies. Breast cancer – a very small percentage – is found in men. So, it’s not that breast cancer is exclusive to women; it is not so, but it can also be found in men,” the doctor had said.
Additionally, Cancer Institute Medical Outreach Director, Dr Syed Ghazi stressed the importance of bringing awareness to the various forms of cancer which account for a large number of deaths of women yearly.
“So, why is it important to make people aware of what’s going on? It is important because if you know, in South America, it is like 400,000 new cases every year of women and men together – 120,000 women die every year, 96,000 of those women died with breast cancer and the other 36,000 die from cervical cancer,” Dr Ghazi noted.
Breast cancer is one form of cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, and fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. Both young and older women are being advised to get screened if these signs become visible.
