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Subject: Breast Cancer - Call for More Awareness, Data, Treatment
WUNRN
BREAST CANCER - NEED FOR MORE
AWARENESS, DATA, TREATMENT, ESPECIALLY IN DEVELOPING COUNTRIES
A breast cancer awareness campaign in Pakistan -Photo:
Breast Cancer Care
LONDON, 26 January 2012 (IRIN) -
Breast cancer continues to be misunderstood, under-diagnosed and fatal,
particularly in developing countries, say researchers, despite more than one
million official annual diagnoses and almost half a million recorded deaths
annually.
Even with growing efforts from donors and health agencies to draw more
attention to chronic
non-communicable diseases, awareness about cancer still lags, said Sara
Stulac, clinical director in Rwanda for the US-headquartered Partners in Health
NGO.
"Just bringing up the fact that there are children suffering from cancer
in Rwanda, the reaction I often get is 'Oh, cancer - Africa - I never thought
about that'."
"We're victims of our own success, which is very good news," Harvard
University's director of Global Equity Initiative, Felicia Knaul, told IRIN,
referring to declining numbers of deaths from some communicable diseases in
developing countries.
The downside of that success is, "You go on to live through other risks
and get other diseases", she added.
The World Health Organization's (WHO) International Agency on Research on Cancer estimated in
2008 that breast cancer was the most frequently officially diagnosed cancer
among women, with an estimated 1.38 million cases.
It was also the most frequently reported cause of death by cancer for women.
Eighty percent of up to 3.7 million of deaths by cancer - all types - are
reported in developing countries, according to recent research Knaul co-authored with the Global Task
Force on Expanded Access to Cancer Care and Control in Developing Countries at
Harvard University.
Costly care
Women who reached Rwinkwavu Hospital in Kayonza District in eastern Rwanda,
where Stulac works, may have already unsuccessfully sought care elsewhere -
often at informal or ill-equipped health centres, she added.
As
a result, they frequently arrive at hospital with advanced stages of breast
cancer that are harder, more expensive and more painful to cure, said Stulac.
An estimated 70-80 percent of breast cancer cases are diagnosed at late stages
in lower- and middle-income countries, according to Knaul.
But even with early diagnosis, breast cancer can mean a painful and
debilitating death in cash-strapped countries where specialists are few and
costs are high, said Stulac.
"Over the course of just seeking a diagnosis, [patients] have depleted
their family's resources."
Cancer prevention and awareness campaigns are infrequent in low-income
countries. And when cancer is diagnosed, treatment options can often include
palliative care, which is scarce, expensive and stigmatized, according to 2011
oncology research.
The Vienna-based International Narcotics Control Board says 90 percent of the
world's opiate supply for pain relief is consumed in the most
developed countries, leaving little for poorer countries.
Gathering data
Knaul urged combating disease with data. "We have to help women to
diagnose more, even when we don't have good access to treatment because that's
how we'll get to know that the disease exists."
Since 1980, breast cancer cases globally have risen annually by 3.1 percent on
average, according to recent reports, and continued rises are predicted by WHO.
As a complex group of diseases for which there are few national registries, and
ones that lack access to diagnostics and treatment, cancer's true burden
remains unknown in many developing countries.
"We need to research at a very basic level of understanding what the
disease looks like. We need better data," said Stulac.
Knaul's report called for public health systems to boost cancer detection
alongside anti-poverty, maternal and child health, sexual and reproductive
health and HIV/AIDS
programming.
Breast cancer clinical trials in lower and middle-income countries can help
boost tracking and prevention - sorely lacking and almost non-existent in some
places, said Ismail Jatoi, chief of surgical oncology at the US-based Texas
University Health Science Centre.
"Conducting trials in these countries is a way of setting up
infrastructure within [health] centres that are conducting trials."
While an estimated eight out of 10 cancer cases worldwide are diagnosed in
poorer countries, research there only attracts 5 percent of global cancer
funding, according to the Global Task Force on Expanded Access to Cancer Care
and Control.
"When research and science have helped us come up with newer and better
medications, one of our goals should be to advocate for bringing those
medications not just [to] rich people, but [to] poor people as well," said
Stulac.
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