Academic journal article Bulletin of the World Health Organization

Awareness Is the First Step in Battle against Breast Cancer: In Developing Countries, the Majority of Women Diagnosed with Breast Cancer Do Not Survive Because Their Cancer Is Detected Too Late. Motunrayo Bello Reports on the Challenges of Dealing with Breast Cancer in Nigeria

Academic journal article Bulletin of the World Health Organization

Awareness Is the First Step in Battle against Breast Cancer: In Developing Countries, the Majority of Women Diagnosed with Breast Cancer Do Not Survive Because Their Cancer Is Detected Too Late. Motunrayo Bello Reports on the Challenges of Dealing with Breast Cancer in Nigeria

Article excerpt

Like many Nigerians, Betty Anyanwu-Akeredolu believed breast cancer was a "white woman's disease" something that could never happen to her. So when she felt a lump in her breast in 1997, she reacted as many of her countrywomen might have done: "I chose to keep it all to myself. I was hoping I could wish it all away."

Several weeks later, however, she was inspired to seek treatment after seeing a documentary on Carol Baldwin, an American woman who was diagnosed with breast cancer and had a double mastectomy more than 20 years ago, and who has since become a leading campaigner and fundraiser for breast cancer research.

"I realized that I had to confront it" says Anyanwu-Akeredolu. "I had to talk to someone, and I said to myself, 'if what I felt just a few weeks ago turns out to be cancer, I will recover as this woman did"'

Anyanwu-Akeredolu tells with pride how she received her full treatment, including a mastectomy and radiation therapy, at the University College Hospital in Ibadan. "Several Nigerian survivors tell stories of how they travelled to developed countries for treatment. But not many people have the luxury of this choice. The Nigerian health system is all they have. We have the health professionals with the skill and willingness to deliver better health care but they are constrained by the lack of infrastructure and an enabling environment"

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The desire to share her story prompted her to found the Breast Cancer Association of Nigeria, an organization that galvanizes action against breast cancer through public education, patient support, advocacy and research. "I was determined to speak out. Just as I needed to hear from someone who had recovered from breast cancer, I wanted to be that person other women could feel reassured by, the one to tell them that if I could recover here in Nigeria, so could they"

Felicia Knaul, director of the Harvard Global Equity Initiative, Secretariat of the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, also believes women with cancer need more role models, or 'champions' as she calls them. "Having seen a champion who continues to live with the disease is very important for women with cancer," she says. "Survival rates are improving. With earlier detection and treatment, evidence from around the world demonstrates tremendous hope for survival and for many years of healthy life"

Just as Anyanwu-Akeredolu did, Knaul decided to help others deal with the disease after being diagnosed with breast cancer in 2007 at the age of 41 in a clinic in Cuernavaca, Mexico and then receiving almost all of her treatment locally. Soon after her diagnosis, she founded Cancer de Mama: Tomatelo a Pecho, a programme that promotes research, advocacy, awareness and early detection in Latin America.

Anyanwu-Akeredolu and Knaul's support groups are important for promoting awareness of breast cancer in low- and middle-income countries, where illiteracy, religious beliefs and health, gender and social inequities often prevent women from having access to services and information, particularly on the importance of seeking treatment early if cancer is detected. Further, Knaul says, the advocacy power of breast cancer can be harnessed to promote broader efforts to empower women and to promote women's health in general.

Knaul said stigma and discrimination also severely hamper women's decisions and ability to seek medical advice if they find a breast lump. Women often struggle to "come out" publicly about their breast cancer for fear of being abandoned by their partners or of losing their jobs.

According to the International Agency for Research on Cancer, breast cancer is the most frequently diagnosed cancer among women, with an estimated 1.38 million cases diagnosed worldwide in 2008. It is also the most frequently reported cause of death from cancer in women in both developed and developing countries. …

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