Oct 13 - 19, 2008

Pakistan has the highest rate of breast cancer amongst all Asian nations. It is the commonest cancer representing more than one third of female cancers and about one fourth of all malignancies. Every year, approximately 90,000 women are diagnosed and 40,000 women killed by this disease in Pakistan; however, the number of unreported cases of breast cancer is expected to be much more.

This was revealed in a Pink Ribbon Campaign Pakistan report launched recently. The objectives of the Pink Ribbon Campaign are to make breast cancer an acceptable topic in the public domain in Pakistan, create widespread awareness about breast cancer and key aspects - its high incidence, its seriousness leading to fatality, impact on the life of the sufferer and the whole family and also the good news that if detected early Breast Cancer may be cured, and promote understanding and practice of self diagnosis.

The report says approximately 1 out of 9 women in Pakistan is likely to suffer from breast cancer at some point in her lives, whereas in India it is 1 in 22. Every 5th woman in Pakistan develops breast cancer after the age of 40. About 77 percent of invasive breast cancers occur in women over 50 years of age. Average age at diagnosis is 64. The greatest challenge is directing such a message that is enlightening and provides early detection and self diagnosis steps, without offending the stern social and cultural beliefs of these women and their families.

According to Omer Aftab, National Coordinator Pink Ribbon Campaign Pakistan, the report is giving an insight how we are struggling to tackle a gigantic task of tackling the problem of breast cancer with minimum available resources and on top of that in a highly conservative society. He said that Pink Ribbon Pakistan strives to significantly reduce breast cancer mortality in the country by creating widespread awareness on early detection and increased access to treatment. The report also highlights the myths and misconceptions prevalent in the society substantially hindering early diagnosis and even the treatment of breast cancer in Pakistan. Some of the myths and misconceptions include:

* Breast cancer only affects older women

* If breast cancer does not run in your family, you will not get it

* Only your mother's family history of breast cancer can affect your risk

* Breast cancer is a communicable disease

* Breast cancer can be a result of a curse/evil eye

* Breast-feeding increases the chance of breast cancer, etc.

The report further says all these myths and misconceptions are not true and due to lack of awareness and knowledge many women start believing and delay the process of diagnosis and treatment. There is no concept of Annual Screening or Mammogram for women aging 40 or above. Research and development is at its lowest in Pakistan and the absence of a Cancer Registry further substantiates this. There is no official collection of data, analysis or availability of statistics, and hence the prevailing national scenario is vague.

According to the report, multiple studies have demonstrated that breast-feeding is associated with reduced risk of breast cancer. In addition, the longer a woman breast feeds the better are her chances of cancer protection. Breast-feeding protects the baby from various diseases, develops bond between mother and baby and is a source of natural birth spacing. However, there is evidence that breast-feeding is on the decline in many developing countries.

The report also says that maternal health problems are widespread, complicated in part by frequent births. In Pakistan, of every 38 women who give birth, 1 dies. The infant mortality rate (101 per 1,000) and the mortality rate for children under age five (140 per 1,000 births) exceed the averages for low-income countries by 60% and 36% respectively. In Pakistan, about 19% of the population is malnourished, a higher rate than the 17% average for developing countries and 30% of children under age five are malnourished. The situation becomes adverse for children whose mothers are sufferers of breast cancer. Children, from zero to two years of age, of diseased mothers not only suffer because they could not be breast fed but also could not be properly taken care of by their mothers because of the strain of the disease.

In addition to this, in a family where a cancer patient is being treated, financial stress also increases and makes it more difficult to cater the nutritional and health needs of the family. Any attempt to reduce the prevalence of breast cancer in the country will definitely, in turn, benefit the health of the children and lead to a healthier, prosperous nation.

The report says that victims of breast cancer and their families often suffer the psychological consequences of trying to come to grip with this deadly disease. It severely impacts women's personal lives and relationships, sometimes shattering them completely. This problem is particularly pronounced in the Pakistani culture and society where relationships are so powerfully governed by social norms and rules. An increase in divorce rate amongst women who are diagnosed with breast cancer has also been seen. Thus women who are diagnosed with breast cancer not only need physical treatment but they also need the psychological and emotional support. Among women increased body weight and weight gain during adulthood are linked with a higher risk of breast cancer after menopause. Alcohol also increases risk to some extent, especially in women whose intake of folate is low, the report adds.

The Pink Ribbon Campaign was brought to Pakistan in 2004, when Women's Empowerment Group (WEG) observed the astonishingly high breast cancer prevalence in Pakistan. It was found that breast cancer was one of the fastest growing national concerns, yet was being neglected at all levels due to social and cultural restraints. To address this concern, the Nationwide Breast Cancer Awareness Campaign was initiated, with the aim to make breast cancer emerge as a premier health concern.

It may be mentioned that Pink Ribbon Pakistan, the National Breast Cancer Awareness Campaign is a non-funded, self-sustained campaign, driven by a large number of volunteers all over the country. The ownership of the campaign by the volunteers and friends of Pink Ribbon has given a sharp boost to the campaign within a short span of time and has become a reason of its tremendous success.