Breast cancer in Malaysia-still deadly, still presenting late

[kkmalaysia]

More research into the issues hindering the early detection of breast cancer in Malaysia is needed, says a local surgeon.

At a plenary session during the 1st Malaysian Egyptian Oncology Conference held in Kuala Lumpur recently, Professor Yip Cheng Har said there are still many barriers to be overcome in the management of breast cancer here. As Malaysia is categorized as a developing country, our breast cancer incidence rate is still lower than that in developed countries such as Australia and the US.

In Malaysia, the lifetime risk of breast cancer is one in 20, but the figure is different when it is broken down into each of the three main races. Yip said Chinese women have the highest risk (one in 16) followed by Indians (one in 17) and Malays (one in 28). On the other hand, Malay women tend to present at a younger age than the other races. Yip attributed this as being reflective of the population pyramid (ie, more young women in the Malay population). As a whole, the prevalent age group of women with breast cancer in our country falls in the 40- to 49-year-old range. In comparison, women in developed nations develop cancer later, at 50 to 59 years of age. [National Cancer Registry 2003-2005]

Referring to the University Malaya Medical Centre (UMMC) cancer registry from 1993 to 2008, Yip said, “Stage 1 diagnosed cancers increased from below 10 percent to about 30 percent. However, the persistent [number of patients] diagnosed with stages 3 and 4 [cancers] does not seem to come down. This is probably because there is a group of women who do not opt for medical treatment even if they have breast cancer.” The incidence of diagnosed women not seeking treatment is more predominant in the Malay population, where close to 40 percent only present when they develop stages 3 and 4 cancers.

In other developing countries, the reasons for late presentation of breast cancer include ignorance and poor education; geographical isolation; and inadequate medical care; and financial problems. However, Yip said those factors do not apply to Malaysia as our literacy rate is more than 90 percent.

Furthermore, Malaysia is a relatively small country and “nobody is truly isolated from a medical facility.” Yip suggested that the main problems facing Malaysia are most likely the lack of a screening program, the existence of social and cultural barriers to the acceptance of cancer, and trust in traditional medicine.

The perpetuation of myths regarding cancer also poses a serious problem. “We hear things like ‘It’s not painful, therefore it cannot be cancer,’ ‘Cancer only happens in the elderly’ and ‘Mastectomy means death’.”

She also commonly sees patients who come to her after visiting faith healers and bomohs, adding that these patients have scars such as cuts and joss-stick burns from alternative therapies. “Patients are scared of pain, yet they subject themselves to this, which I believe is more painful.”

In closing, Yip alluded to the importance of multidisciplinary care in improving cancer patient survival. She also said that health education programs are needed to emphasize that breast cancer can be cured if diagnosed and treated early, and that alternative therapy is ineffective.

Source: mims.com