21st Anniversary Statement of the PBCN

 On July 20th this year was formalized the Cancer Coalition Philippines at UNILAB’s Bayanihan Hall in Mandaluyong City. Composed of the Philippine Cancer Society, I Can Serve Foundation, Cancer Warriors Foundation, Philippine Society of Oncologists, Project Brave Kids, Carewell Community Foundation and the Pharmaceutical & Healthcare Association of the Philippines, it aims to be the driving force in inspiring breakthroughs, catalyzing adoption of innovations and good practice models for safe, quality, accessible, affordable cancer care, better health outcomes and better futures for cancer patients, the survivors and their families. 

According to this coalition, “Cancer is a growing and serious public health concern. It is inextricably linked with the achievement of the country’s poverty reduction and development goals.” However, the real truth is that this coalition is the consolidation of the medical-pharmaceutical cancer industry, meant to further increase their market share in the growing lucrative epidemic of cancer in the country.

Cancer has no known cure in the entire world, for if it were so we would not have a problem at all. Despite advances in conventional and non-conventional treatments, patient mortality has not declined. The Philippines has the lowest survival of breast cancer while having the highest incidence rate of the disease among Asian Countries. In fact in the entire world, the Philippines has the 10th highest incidence of breast cancer where one out of 13 women will get the disease in her lifetime.

The Coalition gives emphasis on the financial burden of cancer yet hospital bills, professional fees and chemo drugs run up to the hundreds of thousands. Given the ever increasing incidence rate of breast cancer, not to mention the numerous cases of over diagnosis and over treatment, cancer treatment is figuratively a cash register!

Yes, the Philippine health system is in a very terrible mess and this Coalition together with PhilHealth and the Dept. of Health will even further aggravate public health with palliative legislative bills such as the Cancer Control Act being lobbied by the Coalition with the support of grossly uninformed Senators. Months away is the elections - DO NOT VOTE for Senators who support this coalition.

The Coalition wishes to increase investments for the prevention, early detection and optimal treatment of cancer. Let us then limit to breast cancer discussing their wishes in addressing a public health epidemic of more than two decades ago. (Hello? Where have you guys been?)

PREVENTION

Countless studies and evidences have connected environmental toxins and carcinogens to breast cancer. Mercury from mining, lead from cosmetics, chlorine from laundry detergents, dioxin from food and so many others that have been identified by the UN’s International Agency for Research on Cancer. Just recently, Monsanto’s popular weed killer was found to be cancer-causing in a multi-million dollar landmark court decision in the United States.

                                                                        Only by eliminating identified environmental causes of breast cancer in the country can we prevent women from getting the disease. But then, there is no money to be made with prevention, specifically a decline of breast cancer incidence.

EARLY DETECTION

It takes 5-10 years before the first symptoms of breast cancer are manifested. This is one factor why mammography is not reliable, given its 20%-40% margin of error for false positive and false negative.

Numerous studies published in prominent medical journals such as the New England Journal of Medicine and the British Medical Journal have raised serious questions about the value of screening mammography. They clarify that the benefit of mortality reduction is most probably smaller, and that over diagnosis is most probably higher, than has previously reported. Mammography reduces false reassurance and opens the door to misdiagnosis and over treatment.

Although no one can say with certainty which patient is over diagnosed, there is certainty about what happens to the patient: surgery, chemo and radiation – even on certain tumors that were never life-threatening, such as the commonly diagnosed DCIS (Ductal Carcinoma In Situ). In fact, whether a patient were found to be Triple Positive or Triple Negative, chemo is given.

The PBCN has time and again registered its opposition to several Senate Bills in the past which sought to institutionalize mammography in the country. Despite the worldwide controversy on the limitations and benefits of mammography, the Coalition wants to make it part of the government’s budget in the guise of early detection for their self-interests.  

CANCER TREATMENT

Before anything else, a review and evaluation of two particular government programs on breast cancer must first be done:

The Department of Health’s Patient Navigation Program launched in May 2011 to promote early breast cancer screening particularly among poor women and providing assured access to chemotherapy; and

The PhilHealth’s Z Benefit Package for breast cancer launched in July 2012 by then President Noynoy Aquino to provide for the entire treatment course for early breast cancer.

Urging Congress to provide funds for another cancer treatment without having duly assessed the above-mentioned programs clearly transfers cancer treatment from the government to the private sector – which the Coalition principally is. So why should additional public funds be used for a private initiatives such as the Philippine College of Oncology and the Pharmaceutical and Healthcare Association of the Philippines?

As opposed to the Cancer Coalition of the Philippines, the PBCN proposes the following strong actions which will immediately and significantly lower the incidence of breast cancer at the minimal cost, if any at all to the government:

STOP mandatory annual cancer-causing chest x-rays for all government employees and make it optional for pre-employment and pre-enrollment purposes. This alone will drastically reduce breast cancer because all women regardless of health status are being unnecessary exposed regularly to at least 1,000 millirads of cancer-causing radiation.

STOP the use of cancer-causing contraceptives (pills, injectable and implants) in its population control program because breast cancer is a hormonal disease. Women will not be placed at risk of breast cancer when the use of other methods such as condoms and rhythm method are encouraged instead.  

STOP operations of air-water-soil contaminating industries regardless of environmental clearances - specially identified mining operations that continue spill cyanide and mercury in the waterways of our country.

STOP the use of triclosan and parabens in all productions of various cosmetics and bath soaps/shampoos among other common consumer products. A Safety Chemical Act needs to be legislated to keep our people healthy and not be at risk of developing cancer from these identified carcinogenic substances.

"It is not for us to complete the task. But, we must begin it!" 

-  The Talmud

20 Solid Years of Fierce Breast Cancer Advocacy since 1997

Rosa Francia-Meneses had just attended the 1^st World Conference on Breast Cancer in Kingston, Ontario on July 1997. She was the lone breast cancer patient from the Philippines in that historical gathering to take strong action in eradicating the disease. Six months earlier, she had lost her left breast without her consent. But instead of finding the cure, she realized why all women were at risk of getting this incurable disease.

On her 45^th birthday, Rosa without any hesitation, boldly founded the Philippine Breast Cancer Network on August 28th 1997. It has now been a full 20 years since then and the landscape of breast cancer in the Philippines has radically changed.  The environmental causes of breast cancer has reached public awareness, the falsehood of mammography has become known and natural means have now been opted to by breast cancer victims.

From nationwide symposiums to live radio/TV interviews to Senate public hearings, the PBCN has steadfastly pursued its high level of patient advocacy as opposed to the pharmaceutical industry’s stranglehold on breast cancer. With the advent of social media, the PBCN has been able to widely disseminate valuable information, wilfully withheld by local media and government authorities. The terrible silence of pain and suffering by countless victims of this unacceptable public epidemic now has a very strong voice.

In a country where the majority of women remain marginalized in almost all aspects of modern life, one cannot imagine how many women and families the PBCN has empowered in the span of 20 solid years. With numerous testimonies from all over the Philippines and the entire world, the legacy of Rosa Francia-Meneses lives on. Her story, her struggle, her climb – her stolen breast, has touched untold numbers of lives the world over. And if not for breast cancer, Rosa would have been 65 years old today.

“Freedom from Breast Cancer”   

The PBCN takes this occassion to extend its heartfelt gratitude and appreciation to each and all who have unselfishly supported the PBCN in this most difficult journey.

DU30 SONA 2017 and Breast Cancer

The PBCN is greatly concerned about a highly pressing issue between women’s rights to family planning and the prevention of breast cancer.

In the 2^nd SONA of President Duterte, he asked the Supreme Court to lift the TRO on contraceptive implants such as Implanon and Implanon NXT. Duterte said the purchase of the contraceptives was not a “reckless purchase” for it was in preparation of the implementation of the RH law. He further said the stocks would soon expire and to better donate them to a nation who allows its use.

What is this contraceptive implant?

It is a contraceptive implant preloaded in a disposable applicator. Inserted in the inner arm, the implant contains 68 mg of the active substance etonogestrel which is a synthetic female hormone resembling progesterone. A small amount of the hormone etonogestrel is continuously released into the bloodstream for three years. The rod itself is made of ethylene vinylacetate copolymer, a plastic that will not dissolve in the body. Implanon NXT contains small amounts of barium sulfate (which renders it visible under X-ray) and magnesium stearate.

The result is no more menstrual periods by stopping ovulation, thickening the mucus around the opening of the cervix and altering the lining of the uterus, thereby providing pregnancy protection for a period of three years.  

Question: Isn’t monthly menstruation normal for all women? Then if so, interfering with a woman’s natural menstrual cycle could very well adversely affect her reproductive health!

This has already been experienced with birth control pills and Depo Provera, where women developed breast cancer among many other cancers within 2-5 years. But because implants have a much longer period of birth control, governments have thought this latest method to be perfect for population control, most especially among the poor sectors of society.

Let us now briefly view the history of Implanon:

2006 July 18^th – US FDA approves Implanon for birth control

2010 October – Implanon is discontinued and replaced by Nexplanon by Merck.

2012 Dec 21^st – Aquino signs the Reproductive Health Bill (Republic Act 10354)

2015 Dec 21^st – PhilHealth Subdermal Contraceptive Implant Package

2016 August – Supreme Court issued a TRO on Implanon and Implanon NXT

2017 July 24^th – Duterte asks Supreme Court to lift TRO or have DOH give to another country their supply of near expiring Implanon.

Just from the above, very glaring points of question come to mind:

1. Why was Implanon phased out in 2010, just four years after it was approved by the USFDA?

2.  If Implanon was already phased out and replaced by Nexplanon in 2010, why did PhilHealth purchase Implanon and not Nexplanon five years later?

The reason for the first is that Implanon was discontinued to reduce the risk of insertion errors. Nexplanon implants contain a substance called barium, which allows them to be easily located using X-rays and CT scans. Nexplanon is simpler and avoids placing the implant too deep under the skin. Considering that Implanon were given for free in targeted urban poor communities like in Tondo, Manila by mainstream NGO Likhaan Center for Women’s Health in partnership with the DOH, the risk of insertion errors was not a matter to be concerned with.  

For the 2^nd question, having been phased out in 2010, Implanon was either fully donated to our government or purchased at a give-away  cost that was very timely as a political campaign gimmick by Senatorial wannabe Risa Hontiveros, who at that time was appointed to PhilHealth for national electoral exposure.

The Supreme Court TRO was a result of efforts from pro-life sectors but what was overlooked is the risk of developing breast cancer from implants!

Going back to how these implants work by stopping menstruation, just imagine what can happen to one’s hormonal health? The female reproductive system will eventually go haywire and result into hormonal imbalance. If menopause is a natural occurrence for all women and hormonal replacement therapies (HRT’s) have been found to result into breast cancer, stopping menstruation long before menopause would also invite breast cancer because of the absence of natural estrogens and the entry of harmful foreign estrogens.

Further consider that it has been just a decade since these implants have been put into use. Only after a prolonged period of time will it be definitely known that this 3-year birth control product indeed causes breast cancer! So, would you want to take this risk?

The PBCN has had several cases of such implants that have resulted in serious breast concern:

Two were young mothers from Tondo who started to experience lumps in their breast just a year after having an implant from the NGO Likhaan. The PBCN advised them to have them removed immediately and instead practice the rhythm method or have their husbands use condoms.

One young mother was charged Php10k for the implant by her Ob-Gyn and when she wanted it removed due to breast problems she was experiencing, she was charged Php5k for the removal and told that the lumps in her breast only showed how effective the implant was.

This brings out a very terrible scenario!

Breast cancer is an epidemic in the Philippines. If many women die from breast cancer, then population is controlled, especially among the poor. If identified environmental causes of breast cancer are not eliminated, the incidence rate of breast cancer will grow higher than 1 out of 13. With the addition of these very harmful implants, 1 out of 8 women will get breast cancer ten years from now! Millions of pesos will be made by the medical-pharmaceutical industry and poverty will be addressed with the reduction of life among the poor because of breast cancer.

PBCN statement on the May 9th National Elections

Though breast cancer is also very much a political issue, the Philippine Breast Cancer Network maintains its distance from endorsing or aligning itself with any candidate or party in the forthcoming May 9^th elections. Regardless of the results, breast cancer affects all women whatever her political color. To maintain its integrity and advocacy, the PBCN focuses on what needs to be done to prevent breast cancer towards the ultimate eradication of this environmental health epidemic.

Of the following distinctions of the Philippines, what can be said to be lamentable and unacceptable? 

1. It is the only predominantly Catholic country in Asia since 500 years ago;

2. It is said to be the oldest democracy in Asia since a century ago;

3. It is the only country in Asia where English is widely spoken since a century ago; and 

4. It has the highest incidence rate of breast cancer in Asia and the 10^th highest worldwide since the past three decades.

Sadly though, the country’s political system has remained basically feudal and has yet to mature even after having ousted the Marcos dictatorship 30 years ago. Absent of a strong political party system, national public officials have continued to be elected simply based on pure popularity. Being such, legislators have all been ignorant on this public health epidemic and they have all always focused on early detection which is definitely far from prevention. Take for example, Senate Bill No. 1873 authored by Sen. Trillanes, SBN 2114 authored by Sen. Santiago and SBN 354 authored by Sen. Legarda. Worst of all, Senator Miriam Defensor-Santiago’s SBN 2114 during the 16^th Congress was lifted almost entirely word for word from the US Senate Bill 931 of the 113^th Congress.

Early in the term of President Noynoy Aquino, PhilHealth launched a Z Program providing free medical treatment for breast cancer. The PBCN registered its concerns on how the program would result in much over diagnosis and over treatment, other than not being able to cure breast cancer. Then by the latter part of his term, PhilHealth embarked on the wide distribution of contraceptive implants which will place many mothers at very high risk of getting breast cancer later on. At the end of his term, both of these programs will not be evaluated nor will the public ever hear about them because of their failures.

Now even cancer is being used as a vehicle for political office. This Cancer Party List aims for cancer patients and PWD’s to live a life of freedom through access to quality healthcare, medication, and equal rights through the following: 

1. Raising cancer awareness 

2. The development and implementation of policies that benefit cancer patients and PWD’s 

3. The rehabilitation and care of cancer patients and their loved ones. 

Are not their aims and goals also of the Department of Health? The PBCN turned down an invitation to join or support this party list primarily because it is no different from the Philippine Cancer Society.

All Presidential, Senatorial and Congressional candidates are thus challenged by the Philippine Breast Cancer Network to enact laws and directives to protect all women from the scourge of breast cancer, a few of which are the following which will not cost government a centavo:

   

1.      STOP mandatory annual chest x-rays for all government employees and make it optional for companies and schools during pre-employment and pre-enrollment. This alone will drastically reduce breast cancer because all women regardless of health status are being unnecessary exposed regularly to at least 1,000 millirads of radiation.

2.      STOP the use of hormonal contraceptives in its population control program because breast cancer is a hormonal disease. Women will not be placed at risk of breast cancer when the use of other methods such as condoms and rhythm method are encouraged instead.  

3.      STOP operations of air-water-soil contaminating industries regardless of environmental clearances - specially identified mining operations that continue to spill cyanide and mercury in the waterways of our country.

4.       STOP the use of triclosan and parabens in all productions of various cosmetics and bath soaps/shampoos among other common consumer products. A Safety Chemical Act needs to be legislated to keep our people healthy and not be at risk of developing cancer from these identified carcinogenic substances.

FREEDOM FROM BREAST CANCER!

Rosa lost her breast without her consent

Nineteen years ago, on the 10th of February 1997, Rosa underwent a frozen section after having been told it was just a diagnostic procedure, without being informed of likely losing her left breast. She woke up hours later, devastated that she had lost her breast without her consent. That particular day was the start of a personal journey that to this very day has touched countless lives of women facing the same ordeal. She was neither the first nor the only woman to have been traumatized by this unacceptable epidemic but that day ushered in the dawn of breast cancer advocacy in the Philippines.

Rosa moved fast forward, took strong action – being the lone Philippine delegate to the 1st World Conference on Breast Cancer in Kingston, Ontario 5 months later and establishing the Philippine Breast Cancer Network a month after her return home. Rosa had single-handedly changed the landscape of breast cancer in the Philippines in that brief period.

The day of her mastectomy, Rosa became a gladiator enslaved and thrown into the arena of mortal combat. She had no choice but to fight back and this she did to the very end with all her heart and soul with full honor and dignity! And just like Spartacus and Maximus, Rosa’s life and death began a movement to free the slaves. The only difference is that Rosa was a female gladiator in the killing fields of breast cancer.She never submitted to chemotherapy and radiation but instead pursued non-invasive and non-toxic measures.

To this very day, many women continue to be imprisoned by the prevailing ignorance and helplessness brought about by a most obscenely lucrative breast cancer industry. With barely any understanding at all, they are rushed to make hard and fast decisions without knowing all their options and without knowing what to expect from any treatment or intervention. With such blindness, they are led to the arena without the single most important weapon to confront the enemy - that of knowing and understanding breast cancer. They become pathetic torture victims who plead for their lives yet are slaughtered methodically. Their carcasses most often ending up in closed coffins or incinerators due to the severe violence they had been submitted to - with excruciating pain written on their faces that no make-up can hide. Many among them were robbed of the chance to fight back - denied that final victory over death!

It has been 19 years since Rosa lost her breast and the PBCN she started continues to lead the growing army of women breast cancer warriors in attaining their individual victories in the struggle with breast cancer! Despite its gigantic task and meager resources, the PBCN remains undaunted and keeps drawing strength from every breast cancer warrior.

For those who’ve lost their breasts, never lose heart. And for all who have heart, keep your breasts.

“Freedom from Breast Cancer!”

When will breast cancer end?

“If only it were detected earlier, something could have been done.” These are the often heard words of doctors. Very true, but what is that something? Breast removal? Chemo? But even then, when is early detection? How many years ago?

The reality is that breast cancer is most very often realized in advanced stages because it takes 5-10 years before the first signs and symptoms of breast cancer are manifested. This being the case, no woman can be blamed for seeking medical attention at advanced stages of her ailment because they never had any understanding of the disease in the very first place.

When does a woman know she is pregnant? Does it mean that when she misses a monthly menstrual cycle, it can be said she is pregnant? Only with a pregnancy test can she be positive she is pregnant. Therefore, it is only after the fact. Because even without a test, she will know she is pregnant as her tummy starts to grow. But what if a woman misses her monthly cycle but has never had sex, typically among nuns? Would a nun or virgin still submit to a pregnancy test? And what about lactating mothers who notice a lump in their breasts? Would they ever think of a breast disease, thinking that the lump is just milk?

Of course, pregnancy is different from breast cancer because the former is acceptable while the latter is not. Most, if not all women want to get pregnant but no women would want to get breast cancer. A woman can wait and see if she is pregnant but every woman would not want to wait and see if she has breast cancer. Doctors are then just waiting for all women to come to them when they already have breast cancer - and this is called “early detection?” Pregnancy tests are very safe and reliable while mammography is not safe and not reliable. Why else is a biopsy done after a mammogram?

Mammography is NOT early detection! Having annual mammograms is just waiting to be told one day that a malignancy is now detected, despite many years of undergoing mammography that showed benign results. Mammography has a margin of error of 20% for women 50 years & above and 40% for women below age 50 (false positive and false negative).  Mammograms have caused much over-diagnosis and over-treatment, especially in cases of DCIS (Ductal Carcinoma In Situ) because it is non-invasive. Somewhere between 30-50% of DCIS will go on to become invasive but 50-70% could safely ignore it and never have a problem. The dilemma is that there is no current technology to determine whether a woman’s DCIS will become aggressive or not. Because of this uncertainty, women are over-treated with surgery, chemo and radiation – simply waiting whether it will become malignant or not. Although DCIS is pre-cancer, the diagnosis brings much fear, bewilderment and difficult decisions for the woman and her family, most especially when understanding and knowledge of the disease process and non-invasive/non-toxic options are absent.

This October, the PBCN urges women and men to join us in removing the pink ribbon blindfold and ask “why are more and more women getting breast cancer?” Why has the incidence rate of breast cancer in the Philippines increased from 1 out of 32 in 1980 to 1 out of 13 today?  Why does our country have the highest incidence rate in Asia and the 10th highest worldwide? Why does government refuse to acknowledge the environmental and occupational risk factors for breast cancer when the evidence is already out there? The general public needs and deserves a full understanding of ALL potential risk factors for the disease that threatens ALL women – rich or poor, young or old, with or without child, learned or unlearned, Christian or Muslim, whatever ideology or political persuasion.

Government and media continue to focus on “lifestyle” risk factors such as diet and exercise, while ignoring the potential 60% of breast cancer cases for which they have no explanation. What about the role of chemical, environmental and occupational exposures? Why, when the WHO (World Health Organization) states that prevention (which is not the same as early detection) offers the most cost-effective long-term strategy for the control and decline of breast cancer in our country?

Why is primary prevention (stopping the disease before it starts) not given priority over treatment and care? Why are those with the power to influence decisions on public healthcare not acting on what we already know now? Why do they persist in refusing to acknowledge the role of environmental and occupational toxins by ignoring decades of evidence up to the present day on the link between lifelong (womb to grave) exposures to toxins and the escalating breast cancer epidemic in the Philippines?

Since 18 years ago when the PBCN was established, countless women from all over the country (as well as OFW’s worldwide) have taken contact by email, phone call and SMS for varying reasons: from asking what to do and asking for financial aid. All inquiries were promptly replied to: 24 hrs daily, 7 days a week and 12 months a year for the past 18 years. All were given information to arrive at fully informed decisions. But what the PBCN does, barely touches the surface. Not all women have internet nor a cell phone, and neither can the PBCN exist forever.

The PBCN addresses women with breast cancer, women not yet with breast cancer and women still to be born.  Though the first is most immediate, the last is what really matters. Ask any candidate in the forthcoming elections their stand on breast cancer and let us elect whoever will make our country free of breast cancer!  Whoever gets elected President or Senator has to firmly act and not continue the deafening silence of government on this grave public health epidemic. 

Living 16 years with breast abnormalities

At age 23, Analiza felt lumps on her breast and her fear for breast cancer led her to attend the PBCN's 3^rd Philippine Conference on Breast Cancer in the year 2000. The only girl in a family of four, they had lost their mother to breast cancer and all her brothers were very worried for her. To this day, she has been able to overcome her anxieties without submitting to any invasive or toxic treatments.

Upon learning of the environmental links to the disease, it was easy for her to understand what had most likely caused her mother’s breast cáncer and had also placed herself at risk. Their home was where her father kept all the pesticides used in the rice fields nearby their home in the beautiful province of Bohol.

Soon after the conference, she had her first thermal breast imaging which confirmed both of her breasts to be abnormal. A doctor advised her to undergo a mammogram and excision biopsy of the 4cm lump in her left breast – both of which she did not do. Instead, she followed all that she learned from the PBCN. Two years later, she did a repeat thermal imaging which now showed her left breast to be normal but with her right breast still abnormal. She was able to avoid any damage to her breasts.

Analiza, standing 3rd from left.

In 2004, she was an active participant in the PBCN’s 5^th Project BRCA, an intensive 5-day training course for breast cancer activists. With a wider knowledge and deeper understanding of breast cancer, she decided to again undergo the PBCN’s Battle Plan for breast cancer, but this time in a more intensive way than she did by herself.

At age 31, she had her 3^rd thermal breast imaging which still showed an abnormal right breast though her left breast remained normal despite presence of a lump. This no longer worried her because it did not matter whether it was malignant or not. She remembered very well that all malignancies are definitely abnormal but not all abnormalities are malignant. What was important was that she had learned how to deal with her breast abnormalities – that hers may most likely be of the non-aggressive type and that any aggressive procedure may just likely harm her.  She would rather continue with all she learned from the PBCN in addressing her breast abnormalities.

Now age 39, she is preparing herself for marriage and felt it best to have another thermal imaging.  The results have shown inflammations and she will again be doing a non-invasive and non-toxic approach. She understands that her body is constantly at risk from varied environmental risk exposures and needs to again do “house cleaning.”

Whether or not she has breast cancer is no longer an issue for her. She feels fine with her breast abnormalities and has been able to manage her health all these years. Her example has even greatly influenced her family, friends and acquaintances in avoiding environmental risk factors in their daily lives. She admits that had she submitted to an excision biopsy, she may most likely have been over diagnosed and over treated at age 25 for the lump on her left breast and would probably have not been able to enjoy a full life for the past 16 years – specially now that she is preparing herself for married life. 

Only with knowledge and understanding of breast cancer can one be empowered to arrive at fully informed decisions and take action. As one can live with breast cancer, more so that one can live with breast abnormalities.

"Freedom from breast cancer!"