October, breast cancer carnival month

When October ends, will the pink carnival also end? Nope, because breast cancer will continue to dominate the fear of every woman in the Philippines where 1 in 13 will get the disease. The show goes on.....

As aptly said by Rosa Francia Meneses during the 1999 World Conference on Breast Cancer in Ottawa, “The greatest risk of getting breast cancer tomorrow is being born today in a developing country. The greatest risk of not surviving breast cancer today is being a woman in the Philippines."

In the Philippines, the Department of Health has more than once embarked on major breast cancer programs since 20 years ago. None has made any major inroad as seen by the country’s registering the highest growth in incidence rate worldwide while having the 12^th highest mortality rate. Only recently, the government’s Philippine Health Insurance Corporation opened the doors to more over-diagnosis and over-treatments of breast cancer by providing treatment funds for its qualified members.

And at the legislative levels of government, no bill has been written for the prevention of this environmental disease. All bills proposed were on early detection thru mammography – clearly riding this public health issue from a medical point of view and NOT on a people’s point of view, which is “we do not want to get breast cancer!” 

Media has even made itself part of the carnival by featuring the latest treatments, even alternative ones. All the 3 major television networks more than once took contact with the PBCN for their respective features for breast cancer month. However, the PBCN saw no reason to be part of the "carnival" - the glamorization, commercialization and misinformation. Either they wanted personalities with breast cancer to attract viewers, prop up the medical-pharmaceutical industry or present early detection as a preventive measure. It was best and prudent for the PBCN no to be used as a decor or worse, to be misrepresented to the public. All were grossly lacking in research and journalism depth. I challenged them to make a powerful feature on the risks and dangers of annual chest x-rays and mammograms but I knew none would take me upon it. So don't think that all the talk on breast cancer seen on television is reliable - they will simply go through the motions with not much substance.

So who will benefit with the October breast cancer awareness month? The medical—pharmaceutical-supplement network industry! Even a supposedly conscientious company has allowed itself to be used which would likewise benefit themselves. The entire awareness blah-blah-blah will simply scare women to seek medical solutions without addressing how they got it in the first place. And why would it be important for every patient to understand her environmental exposures which led to her breast cancer? Because her daughters, sisters, relatives, neighbors and co-workers will one day also get breast cancer – not from the genes but because of environmental risk exposures!

The PBCN has been observing several patients from specific areas but not limited to Angeles City (Pampanga), Guihulngan (Negros Oriental) and Bacoor (Cavite). What is similar to all is their ground water supply which is most definitely contaminated with carcinogens from different sources.

Then as far as occupational hazards would be the high incidence rate among government female workers – specifically public school teachers. The required annual chest x-rays have only done harm by exposing their breasts to repeated radiation particularly during their periods of vulnerability.

There is no such thing as early detection. It takes 5 to 10 years before the first symptoms of breast cancer are manifested. So-called long term survivors either had no cancer in the very first place (over diagnosis) or had non-aggressive types such as DCIS (Ductal Carcinoma In Situ) which was never life-threatening even without treatment.

Mammography is a medical risk factor for eventually getting breast cancer. Women are being told year in and year out that they are clear from the disease, only waiting for the time to be told, “I’m sorry Ma’m but you now have breast cancer,”

The October carnival happens every year but the tragedy of breast cancer must stop.
NO to mammography!

Another breast cancer program to surely fail.

It has now been more than14 years since the PBCN significantly changed the landscape of breast cancer advocacy in the Philippines. Since then, almost all hospitals have organized support groups and have launched various activities every October. A year ago, the Department of Health (DOH) and the Philippine Cancer Society, Inc. (PCSI) launched a program for medicine access for indigent patients with early stage breast cancer in a bid to improve survival rates in our country. But just like many programs in the past, it will surely fail.

                             

In her own words, the PCSI Executive Director said that cancer is an expensive disease and only when early detection is linked to cost-effective treatment can they stop women from dying. The Patient Navigation Program is meant to show that breast cancer is curable and shall be implemented in the East Avenue Medical Center (EAMC) in Quezon City, the Jose Reyes Memorial Medical Center (JRMMC) and Philippine General Hospital (PGH) both in Manila and in the Rizal Medical Center (RMC) in Pasig City.

Though survival is of great concern, the matter of a cure has been the subject of decades of efforts, funding, research since the 1970's worldwide. To this very day, there is no known cure no matter how much money one has, anywhere in the world. Thus, it is not only a matter of providing care and treatment for indigents but for all women - rich or poor. So what assurance can the DOH and PCSI give that their program can increase survival rates when all their past breast cancer programs have been failures?

In a Senate Hearing last year on pending breast cancer bills all focused on early detection, the head of the PGH Cancer Institute said that women die of cancer because of poverty. Does this make any sense at all? Then, the representative of the Philippine College of Surgeons said that breast cancer can be prevented if women have early pregnancy or multiple pregnancies. He even went further saying that even prophylactic mastectomies could be considered. Is this guy serious???  The PBCN was firm in putting forward placing priority in the prevention of the disease. The Philippines has the 10th highest incidence of breast cancer in the world and the highest in Asia. Rather than focusing our country's meager resources and limited capabilities in futile programs such as the above, it would be far more beneficial to embark on efforts on how breast cancer can be avoided by our women!

Breast cancer is an environmental disease and only by identifying and eliminating environmental causes can there be a declining incidence of breast cancer in our country. The first and immediately doable are for the Department of Health to:

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.

Only when government and society finally understands and recognizes that the state of our environment is directly linked to public health can our mothers, sisters, wives, daughters, relatives and friends be spared from breast cancer.