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Breast cancer: a disease, not a death sentence
Published in Almasry Alyoum on 27 - 10 - 2009

Thousand of Egyptians joined the annual "Breast Cancer Race for Cure" this week, one of several events marking the international Breast Cancer Awareness Month
“It's a disease, not a death sentence,” explains Sahar Tharwat, a breast cancer survivor in her forties. “This is a curable disease."
Tharwat is an upper-middle class housewife and one of the oldest members of the support groups held at the Breast Cancer Foundation of Egypt (BCFE), the first and only foundation specialized in raising awareness and support for this form of cancer.
Tharwat was first diagnosed in 2003, one year before the establishment of BCFE. “My mother was diagnosed with breast cancer in 1970, and she is alive today," she said. "So when I first knew about my disease, I had to either give up like my aunt -- who died six month after her diagnosis -- or follow my mother's approach. I chose the latter."
According to the World Health Organization (WHO), breast cancer remains a common -- and frequently fatal – disease. It is the most commonly diagnosed cancer in women and the second-ranking cause of cancer death in the Eastern Mediterranean region. More than 1.2 million women are diagnosed with breast cancer annually worldwide. Nevertheless, there are no national statistics for breast cancer patients in Egypt.
Tharwat explained that support groups give these women room to vent their feelings and let them know that they are not alone. She divides breast cancer victims into three categories. “Upper class women, who don't talk about it because they're deeply ashamed. They prefer one-on-one sessions instead of support groups," she said. "Lower-class women, who tend to talk and listen too much and hence sometimes have misconceptions. Then there are middle-class women, who are keen to learn the facts and raise awareness."
Tharwat has also seen cases where women under treatment for breast cancer suffer violence from their husbands, who in some cases end up divorcing their sick wives to marry the nurse.
Breast cancer was often referred to as the "bad disease" due to misconceptions associated with it -- such as it being contagious or 100-percent fatal. But these taboos are slowly but surely being challenged, says Mohamed Shalan, surgeon and head of BCFE.
“There's no doubt that awareness increased in the past five years,” says Shalan, pointing out that he attended a gala dinner for breast cancer victims last week, and that a plethora of literature is now available on the subject.
Awareness campaigns, funded by the ministry of health, were launched for the first time this year on Egyptian television. This year, BCFE has coordinated with the Suzan G. Komen for the Cure Foundation; the Suzanne Mubarak Women for Peace International Organization; the Suzanne Mubarak Regional Center for Women Health and Development; the Egyptian Ministry of Health; the National Cancer Institute; USAID; the Institute of International Education; the University of Florida; and the International Union Against Cancer.
The ultimate objective is to "break the barrier of silence," which is also the name of the project that aims to raise awareness and train people. It will also serve as an advocacy group, while calling for a screening program that will begin at the Suzanne Mubarak Regional Center for Women Health and Development in Alexandria
The collaboration coincides with the launch of a BCFE service center that will provide mammogram testing, prosthetic devices and support groups on a bigger scale. BCFE is conducting its research in cooperation with the Egypt Telecommunication Company, where studies will be conducted on some 18,000 female employees.
At the 15th annual Multidisciplinary Symposium on Breast Diseases and the first international breast health educational program, Nancy Brinker, goodwill ambassador for cancer control at the WHO, delivered an address on the power of advocacy. Brinker, also the founder of the Susan Komen for the Cure -- one of the leading non-profit organizations in research and awareness of breast cancer worldwide -- spoke to Al-Masry Al-Youm English Edition on the cultural barriers she had to face while fighting breast cancer.
"When we started this work 30 years ago, it was a very different world: there were no text messages, no Internet, no patient support groups," she recalls. "There was very limited awareness: patients didn't know they could meet with different physicians, there were only eight or nine cancer drugs on the shelves. Now we have websites and all sorts of information is available. It isn't perfect, but we've made huge gains."
According to Brinker, there were at one time taboos associated with breast cancer even in the United States. "In the US, they called it 'the big C' and we weren't allowed to print the word 'breast' in the newspaper," she said. However, she added, women are still at risk "because we still don't know exactly what causes cancer."
Brinker went on to point out that the global population was expanding and aging; that there is tsunami of smokers worldwide; that bad nutrition habits and unhealthy lifestyles prevail; and that in many cases people face polluted environments. "We know what to do, we just haven't extended the political will to let it be done," she said.
It is not only a matter of having access to national statistics, she said. How do you treat people that have been diagnosed? How to gain access to cancer care? How to treat people in poverty-stricken areas? The challenge, she said, requires all government and non-government entities to join forces.
"Cancer causes poverty, and poverty causes cancer -- it's a simple formula. Because if you have cancer, and you have to pay for the treatment, it can drive a middle-class family into poverty," she said. "And if you're already poor, you're almost certain to die from it since you won't get any treatment or won't know where to go to get treatment."
According to conference speakers, the average current incidence rate among Arab countries is around 25 per 100,000, with approximately 80,000 new cases diagnosed annually. Almost half of these female patients are below 50 years old, and median age is 49 to 52 years old compared to 63 years old in industrial nations.
Though some Arab countries have excellent cancer treatment centers, the lack of high quality infrastructure, limited resources and unequal distribution of health resources among different health services remain major obstacles. Other factors, such as cultural taboos and stigmas about cancer, also serve to deter people from seeking treatment.
People power and pink ribbons
Over 10,000 people participated in a breast cancer awareness event on Saturday morning dubbed "Egypt Race for the Cure," held at the Pyramids of Giza. The event was organized as part of an international Breast Cancer Awareness Month campaign that lasted throughout the month of October.
“Race for the Cure” was organized by NGOs Susan G. Komen for the Cure and the Breast Cancer Foundation of Egypt and was held under the auspices of First Lady Suzanne Mubarak. In attendance were a number of Egyptian ministers and foreign dignitaries, along with school children, members of civil society organizations, celebrities and public personalities. Security measures were stepped up due to the presence of high-profile figures. Plainclothes state security officers, along with those from a host of other security apparatuses, were out in force.
The vast majority of participants donned white t-shirts with pink ribbons -- the symbol of breast cancer awareness. Owing to the immense number of participants, there was very little room to actually run on the relatively narrow track. Dozens of sinewy youths at the head of the pack were the only ones with the opportunity to sprint. Most participants strolled shoulder-to-shoulder along the well-paved 1.5 kilometer downhill course. A large number of foreign participants were also involved in this event.
Shuttle buses transported participants to the starting line shortly before the commencement of the race at 10am. The race started from behind the Great Pyramid of Mycerinus while the finish line was located between the Pyramids of Cheops and Chephren.
To the disappointment of many participants, there was nobody distributing water or Gatorade at the finish line. Food and beverages, however, could be purchased at a number of promotional booths. Moreover, the race was overcrowded with cars and busses in the busy touristic Pyramids area.
Booths piled with literature and donation boxes were also set up, where volunteers stressed that early detection and prevention of breast tumors/cancers are preferable to treatment. A number of live musical performances, dances and speeches were delivered.
It was a rare display of "people power" in a country where virtually all “unofficial” marches and demonstrations are outlawed.
Additional reporting by Jano Charbel

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