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Pakistan takes on breast cancer
With Pakistan posting the highest breast cancer rate in South Asia, the Pink Ribbon Project urges women to seek early diagnosis and offers free mobile screening services.
By Imrana Kausar
ISLAMABAD – Aisha Khan, 75, is grateful that she is still alive today, in part thanks to Pink Ribbon Pakistan (PRP) – an initiative aimed at imparting awareness about the danger of breast cancer among Pakistani women. PRP diagnosed her breast cancer three years ago.
"I was shocked after coming to know that my results were positive," she told Central Asia Online. "It was as if hell fell on me and I was left alone in the face of imminent death."
Khan – unlike the majority of breast cancer patients in Pakistan – was lucky because she received an early diagnosis and treatment.
"In Pakistan, one in every nine women has the risk of breast cancer," according to PRP National Co-ordinator Omer Aftab.
In fact, Pakistan has the highest rate of breast cancer in South Asia with 31.5 cases per 100,000 women per year, according to the International Agency for Research on Cancer (IARC)'s 2008 statistics. That year, Pakistan registered 19,271 breast cancer cases and 10,376 breast cancer deaths, according to the IARC.
Accurate figures are most likely higher, as many cases go undiagnosed, untreated and, therefore, unreported.
Early detection key to survival
PRP is working to reduce the numbers through public awareness and mobile screening programmes in rural and suburban areas in Lahore.
PRP has three trucks equipped with state-of-the-art mammogram machines and other medical equipment to provide mobile screenings for women and talk to them about breast cancer, PRP campaign organisers told Central Asia Online.
"It's a mobile clinic that operates in suburban areas where women don't have a hospital," Aftab said. "It's a free screening service at their doorstep."
PRP has provided more than 700 free screenings since the programme was launched in March 2009.
"We are also running a national mammography screening programme in 14 hospitals in 12 cities and an awareness programme in 50 districts across the country," he said.
The first step of the approach is to raise awareness about how dangerous breast cancer is and to inform the public of PRP's mobile screening services.
"Surprisingly, many of the detected cases don't go for further treatment just because of the social stigma," Aftab said. "Many women diagnosed with breast cancer go into severe depression and don't want to be treated."
PRP, which was founded in 2004, steadily has been building support from the government, through strategic alliances and by networking with women's groups to raise awareness and to make its services available.
Recently PRP signed a memorandum of understanding with the Ministry of Science and Technology and with the Pakistan Science Foundation with the aim of researching indigenous risk factors and of identifying regions at higher risk of the disease, Aftab said. To date nobody has conducted proper research in Pakistan on breast cancer.
Causes and cure
Breast cancer can be curable if detected early, according to doctors. However, the majority of cases in Pakistan are diagnosed very late because of lack of awareness and because cultural taboos also drive women to keep the disease secret, PRP said.
"Lack of screening facilities and of self-examination is the main cause of late diagnosis," Dr. Nehal Masood, section head of medical oncology at Aga Khan University in Karachi, told Central Asia Online.
"You cannot protect yourself from a cancer that you deny," he said. "You should be very careful about your symptoms, and particularly women at the age of 40 should start annual mammograms."
"They (women) should know their family history of breast cancer, and if somebody is at very high risk of breast cancer, she should start screening all these things quite early," he said.
Only about 5% to 10% of cases are genetic, Masood said. "The other causes of breast cancer are unknown."
Risk is higher in sedentary and post-menopausal women, he said. Other factors include consumption of alcohol, smoking and misuse of oral contraceptives.
"The main thing peculiar to Pakistani women is that the cancer affects young women," said Masood. "In the western Caucasian world, cancer is the disease of older women. However, the majority of the breast cancer patients in Pakistan are very young. We see here much younger patients aged 30 to 40, compared to patients aged 60 to 70."