Breaking the culture of silence surrounding breast cancer is one of the biggest challenges facing doctors. While high-profile awareness campaigns and education are vital, the key to tackling one of the biggest killers of women in the UAE is changing attitudes and bringing about a shift in the way the disease is perceived, doctors say. Crucially, the younger generation needs to be educated about the fact that breast cancer can affect anyone - and can strike at any age.
Each year, hundreds of women of all ages across the country are diagnosed with breast cancer. Traditionally, breast cancer has been a taboo subject and this has led to a large number of late diagnoses and, ultimately, unnecessary deaths. Authorities and various charities are now going to great lengths to introduce a change in cultural attitudes towards self-examination and open discussion. In October last year, the UAE was selected as one of 10 nations to take part in an international campaign to raise women's awareness of the disease. The selection was based on diagnosis and mortality statistics.
Doctors believe one reason for late diagnoses in the UAE is the cultural taboo surrounding women's bodies. Dr Mariam al Otaiba, the senior doctor at Abu Dhabi's Makkah Specialised Medical Centre, said breast examinations still did not feature as part of regular check-ups. "In the clinic we generally do not automatically do breast exams," she said. "We tend to do them if patients come with specific complaints or if we think it is related to anything the patient is getting treated for.
"We do give advice and strongly encourage all patients to take certain cancer-prevention precautions." Last month the Health Authority Abu Dhabi (HAAD) announced that 80 medical professionals throughout the emirate had completed a four-month training course to equip themselves with the skills to set up cancer initiatives in their communities. These would focus on awareness, early detection, treatment and support services.
Health organisations across the country are now acting to address the problem of late diagnosis, predominantly caused by the lack of self-examination. Speaking when The Global Initiative for Breast Cancer Awareness campaign was launched in Abu Dhabi last year, Dr Jalaa Taher, the senior programme manager for the initiative and a senior doctor at the Ministry of Health's National Screening Programme for Women and Children, said action was needed sooner rather than later to stop preventable deaths.
"It is well known that women come late for a diagnosis and the problem here is awareness," she said. "They are not aware of the importance of self-examination and we need to change this. It is only recently that breast cancer has become an acceptable topic to discuss. There is often a stigma attached to it and people do not want to be associated with it." Between 1998 and 2007 the National Cancer Registry, based at Tawam Hospital in Al Ain, recorded 2,121 cases of breast cancer. Seventy six of these were in patients younger than 30 years old. The most common age for diagnosis in the country is between 45 and 49.
The Break The Silence campaign, launched in October 2007, aimed at dispelling a number of myths and stressed the importance of self-examination and early diagnosis. One of the key goals of the campaign, the first to cover the whole country, was to encourage women to have regular mammograms, especially if they had a family history of the disease. Three mobile units toured the country offering check-ups.
"We have seen a positive response to the campaign, there were many people willingly coming from far to ask about the self exams and to learn and ask for brochures and booklets," said Dr Rawda al Mutawa, who was part of the campaign. "Most of these people were men coming to get information for their wives and daughters. "Awareness doesn't just sprout, so obviously we saw a rise during the campaign and we are back down to an initial disinterest, but that shouldn't be discouraging because awareness and education comes in stages. People still need more awareness about breast cancer. We can't create this awareness in a matter of days because it needs to be part of the culture."
Dr Mutawa said the campaign would continue to spread the message, especially during October, which is global breast-cancer awareness month. "Our first campaign was part of the first step, which was introduction," she said. "The next step is to make the population truly realise the importance of taking action and measures to identify the illness early. "I think there is a general awareness but the next step is to make sure that it is continuous and gradual so that we can properly equip the population with the necessary tools and education to take care of their health."
* The National