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

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!

PBCN Position on Senate Bills on Breast Cancer

Philippine Senate Committee on Health

Public Hearing on SBN 1873

10am, Tuesday, 20 May 2014

I am registering my strongest objection to Senate Bill No. 1873 authored by Sen. Trillanes, as well as SBN 2114 authored by Sen. Santiago and SBN 354 authored by Sen. Legarda.

Our country has had the highest increase in breast cancer incidence rate worldwide for the past 30 years, where today, is the highest in Asia and 11^th highest worldwide. One in every 13 women will get breast cancer which is a serious and urgent public health epidemic that has never been fully addressed by government. To even aggravate matters, SBN 1873 and SBN 354 will further worsen the situation by opening the floodgates, leading thousands of innocent victims to the medical-pharmaceutical slaughterhouse of slash, poison and burn.  

According to the US Department of Defense Breast Cancer Research Program, an estimated 30% of all breast cancer cases (both invasive and DCIS) are considered to be over diagnosed and over treated. Over diagnosis is diagnosis of cancers that would not have presented within the life of the patient. Overtreatment can occur in two ways—either in over diagnosis, where any treatment is unnecessary, or with the administration of more aggressive therapies than is necessary. It has recently been estimated that one to three deaths from overtreatment occur for every one breast cancer death avoided.

Despite the PBCN’s concerns submitted during Public Hearings to both Houses of Congress since 2010, government has not taken any concrete action to curtail the most common form of cancer that has caused tremendous misery, sufferings and untimely deaths to thousands of women –young or old, rich or poor, learned or unlearned, with or without child, Christian or Muslim, urban or rural. Instead, the Department of Health and PhilHealth have even embarked on programs that have even worsened the breast cancer crisis.

In May 2011, the Department of Health (DOH) and the Philippine Cancer Society launched a medicine access program through a patient navigation scheme targeting indigent women diagnosed with early stage breast cancer. Health Secretary Ona said that cancer is a costly disease, with the cost of medicines and treatment way out of reach for many of our people. The scheme would provide medicine entitlements to poor and vulnerable sectors for priority disease such as cancer. Has the Senate ever looked into the progress or failure of this program?

In July 2012, Philhealth launched the Z Benefit Package, providing for P100,000 for the entire treatment for early breast cancer. But in reality, PhilHealth members prefer going to private hospitals rather than any government hospital. Majority of  patients in government hospitals seek free medical treatment but are not PhilHealth members. Has the Senate ever reviewed the progress or failure of this program?

  

Participating in above-mentioned breast cancer treatment programs were the East Avenue Medical Center (EAMC), the Jose Reyes Memorial Medical Center (JRMMC), the Philippine General Hospital (PGH) and the Rizal Medical Center. PhilHealth also includes contracted government hospitals in each region. Has the Senate ever made an investigation on the success or failure rates of all these hospitals in their respective treatment of breast cancer?

Without knowing and validating diagnostic and treatment success or failure rates, this August Body is now intending to fund another “white elephant” in supposedly addressing a known environmental disease? Despite the fact that Philhealth has a gigantic reserve fund of Php117 Billion to fund the Z Benefit Package, why does SBN 1873 want to allocate additional funds?  Is this another Napoles scam in the making in the guise of addressing a public health crisis by exploiting breast cancer? Or is this another diversion of funds for the coming presidential elections, similar to when PhilHealth spent a large amount for TV Ads for the former PGMA in the 2004 elections?

Going back to PhilHealth’s Z Benefit Package for breast cancer:

1.      How are patients diagnosed with breast cancer? By mammograms? Is the Senate Committee on Health aware that mammography is now under extreme doubt as to whether it is truly reliable and whether mammography has significantly saved lives? Very recent studies, most notable of which was the 25 Year Canadian Study which concluded that annual mammography in women aged 40-59 does not reduce mortality from breast cancer and 22% of screen detected invasive breast cancers were over-diagnosed. In a 10 year German study, it showed that mammography did more harm and had negligible benefits.  The Swiss Medical Board acknowledged that there was no evidence to suggest that overall mortality was affected while emphasizing the harm of mammography  — in particular, false positive test results and the risk of over diagnosis.

2.      What is PhilHealth’s definition of Early Stage Breast Cancer because in its selection criteria were stated Stage 0 up to– Stage 3A?  It seems PhilHealth does not even know what early stage breast cancer is.

3.      What are the safeguards against over diagnosis and over treatment?  Many cases are of the DCIS type (Ductal Carcinoma In Situ) which is non-invasive and when left untreated, will in many cases not develop into a  life-threatening disease.

4.      Why are only specific chemo drugs included in the list? Is it because they are the most effective, the cheapest or the only ones available? Worst of all is if these particular drugs are in need of human experiment or about to be phased out!  For example, Avastin was approved by the USFDA for metastatic breast cancer in 2004 only to be revoked in 2011because there was no evidence that it extended life or improved quality of life while causing severe adverse reactions. 

5.      What would be the standard treatment since medical institutions vary in their  respective approaches to breast cancer? For the same breast cancer patient, opinions vary between surgeons and oncologists and between surgeons themselves and oncologists themselves.  

  

So why then will all the above mentioned Senate Bills be enacted and funded when it is very clear that more harm than good will happen? It is imperative that our Senators conduct a deeper inquiry on WHY our country has a breast cancer epidemic and what must be legislated to truly address this public health crisis – not by seeking a cure but focusing on the environmental causes of breast cancer.       

Presently severely tarnished by the pork barrel, the Senate can possibly redeem  itself by enacting laws to protect all women from the scourge of breast cancer, a few of which are the following which will not cost 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.

      Danny Meneses

      President

      Philippine Breast Cancer Network

SIGN THE ONLINE PETITION  now to junk all pending Senate Bills on Breast Cancer. We can no longer be silent!

Breast Cancer and the Philippine Senate

In several occasions in the past years, the PBCN had attended Congressional and Senate public hearings on proposed legislative bills on breast cancer. In all of them, focus was on early detection by annual mammograms. The PBCN always submitted its position against mammography and instead proposed efforts to address this public health epidemic with prevention actions.

As can be seen in the 13th, 14th, 15th and 16th Congress, all proposed Senate Bills carried a medical perspective and upon further study, were actually lifted from similar bills proposed in the US Senate.

SBN 2019 of Sen. Santiago was on the hospitalization of women medically with breast cancer but who have health plans.

In the 14th Congress, SBN's 2017 of Sen. Santiago, SBN 1815 of Sen. Villar and SBN 78 of Sen. Legarda were all focused on mammography and early detection.

SBN 3071 of Sen. Trillanes was about breast cancer benefits in Philhealth's coverage of its members.

SBN 1784 was for the enactment of Breast Cancer Patient Protection Act of 2007 in continuation of her SBN 2019.

For the 15th Congress, SBN 1399, SBN 1110 and SBN 189 were for the enactments of previous bills proposed by Senators Legarda, Villar and Trillanes.

It was during this period that the PBCN attended a public hearing and submitted its position while voicing out its strong view on the matter of early detection and vehemently questioned the medical perspective on breast cancer, while urging government to look into and act on the environmental causes of the disease.


In the current 16th Congress, the Senate is about to enact the Breast Cancer Patient Education Act by Sen. Santiago, the Breast and Cervical Cancer Potection Act by Sen. Trillanes and the Breast Cancer Detection Act of 2013 by Sen. Legarda.

All these acts will not only result into the furtherance of a public health epidemic beause of overdiagnosis and overtreatment but worse, will not stop our women from getting breast cancer. The Philippines has had the highest increase of breast cancer incidence worldwide for the past 30 years and yet nothing is being done to identify and eliminate the environmental causes of breast cancer.

The most recent studies in North America and Europe have already confirmed what the PBCN has long been saying about mammography and early detection. Yet our "well-meaning" Senators have either refused or have been coerced by the multi-billion medical-pharmaceutical industry not to act in favor of our people.

The Senate Committee on Health chaired by Sen. Guingona has scheduled another public hearing on breast cancer this May 20th 2014 and the method by which the PBCN was being invited was very much insulting. Without any previous communication, they called to simply ask if the PBCN would be interested to attend. Attend what? Another circus of totally uniformed Senators on the true issues on breast cancer?

The PBCN still hopes for a courageous Senator who will truly champion the welfare and interests of our people! That of eliminating the environmental causes of this public health epidemic that chooses no one regardless of economic or social status. Breast Cancer does NOT have to happen!  

2014 World Cancer Marketing Day

"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." - Rosa Francia Meneses, 1999 World Conference on Breast Cancer

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The primary goal of the World Cancer Day on February 4th is the significant reduction of death and illness caused by cancer by the year 2025. Previously set to 2020, the organizers led by the Union for International Cancer Control (UICC) will always extend the deadline because cancer is an incurable disease.

Considering that UICC was founded 80 years ago when cancer was not yet a prevalent disease, it would be interesting to know how such an organization can possibly exist for such a long period and now come up with a most overarching goal. In the world cancer day's website, one is even asked to sign up for a “cancer free world!” 

During the 2002 World Conference on Breast Cancer in Victoria, B.C., I was accosted by a Berkeley Professor for the PBCN handouts which stated “Stop Breast Cancer!” Short of saying that I was out of my mind, he categorically stated it will never happen. The global movement for the eradication of breast cancer, of which the Philippine Breast Cancer Network is a part of, carries a patient's perspective as opposed to the medical point of view. In this regard, our advocacy is much, much bolder than that of the UICC.

The UICC will never have in its Board of Directors, well respected doctors and scientists who will not tow the line of the pharmaceutical industry. Supporters of the UICC include AMGEN, Roche, Boehringer Ingelheim, GlaxoSmithKline, Pfizer, Bayer, Novartis, Sanofi and MSD. Would anyone ever think that the UICC would ever bite the hand that feeds it? Rather, it would serve themselves to nurture a lucrative cancer market! 

Early 2012, a cancer stake-holders consultative meeting was held under the wings of the UICC. Just like the World Cancer Day which sounds and looks good, it didn't smell nice. They will forever push lifestyle and pharma but never touch on the environment.Cancer meetings that look good but smell bad!

Even the Department of Health has no standing program on cancer which is not even listed in its disease surveillance because for the DOH, cancer not a disease that needs to be seriously addressed. Looking back, all their past programs on breast cancer have failed miserably from the time it embarked 20 years ago to reduce the incidence rate of breast cancer in the country. 

All it can offer is the Medicines Access Program of DOH-NCPAM which caters to the medicinal needs of patients who cannot afford treatment for Breast Cancer Stage I-IIIA Patients through the Philippine Cancer Society. Try availing of this. Another breast cancer program to surely fail.

Then, under its Z Benefit Package, PhilHealth announced in 2012 that it would provide to its members P100,000.00 for the treatment of breast cancer (stage 0 to IIIA). In reaction to this, I warned PhilHealth of the over diagnosis and over treatment of breast cancer.  Yet now, the Pre-Authorization checklist for breast cancer is no where to be found in the website of PhilHealth! Was it scrapped just a few years after it was offered to its members? If so, why?

Patients are the major stakeholder and they must be at the center of all decision making. Women do not want to have breast cancer yet they are being led to believe that with early detection, there is a cure. So are women being made to have annual cancer causing mammograms? Prevention is knowing and avoiding identified environmental carcinogens.

The World Cancer Declaration's Target # 3 states: "To reduce exposure to cancer risk factors." If they really mean on having a world free of cancer, you do not reduce but eliminate known environmental causes of breast cancer! The incidence rate of breast cancer worldwide has nearly tripled since 1980 and will certainly be a "run away train" in the years to come. In our country, 1 in 13 Filipino women will get breast cancer.

One of the Global Advocacy Messages states, “That the success of early detection programs can be measured by a reduction in the stage of the cancer at diagnosis with earlier diagnosis associated with a reduction in the risk of dying from cancer."

It takes 5 to 10 years before the first symptoms of breast cancer are manifested. How then can there ever be early detection? So all women must undergo annual mammograms year in and year out until one day they are told that they already have breast cancer? Will all women starting at age of puberty be periodically screened for breast cancer? Will women with early diagnosis, even of the non-invasive type be made to lose their breasts and later submit to chemotherapy just to supposedly make sure she is said to be cancer-free and cured? How I wish it were as simple as that!

And now, the Philippine Medical Association (PMA) is calling for the return of local public hospitals and health centers to the control of the Department of Health (DOH) because local government units (LGUs) have failed to adequately provide quality health services to the people. The shortage of 930,000 doctors was even cited. Unfortunately, as I had earlier shown, the DOH can not or will not truly act on the cancer epidemic, except to banner pink ribbons and support pharmaceutical initiatives. The solution lies not in having so many doctors but in having lesser patients!

Yes, the World Cancer Day is one huge marketing event of the cancer industry – just like the breast cancer month every October. I would like to refer to a parable about saving babies from drowning in a river. All heroic efforts were focused downstream until one asked "who’s throwing all of these babies into the river in the first place!" To truly end breast cancer, we must look upstream and stop the cause.

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!