Every year breast cancer claims more than 650,000 lives worldwide.
Survival rates have been recorded to be as high as 90% in high income countries. In sub-Saharan Africa the rate is less than 40%.
A recent study found that the incidences of breast cancer in sub-Saharan Africa had increased by 247% from 1990 to 2019. The highest incidence was recorded in Nigeria.
For Breast Cancer Awareness Month we highlight four essential reads about the difficulties women in Africa must overcome to survive this cancer.
Catching it early
People living in low- and middle-income countries, such as Nigeria, are highly vulnerable to breast cancer. Surgeon and lecturer Olalekan Olasehinde explains that this is mainly because people in these countries seek medical help at a late stage when the disease is advanced. When breast cancer is at an advanced stage, it is harder to treat and people are more likely to die.
Olasehinde outlines the five things one can do to detect breast cancer early and reduce the risk of death. The signs to look for include lumps in the breast and changes in the size or shape of the breast.
Read more: Breast cancer: five tips from an expert on catching it early and keeping safe
The demon disease
Black South African women are the least likely segment of the population to have breast cancer but the most likely to die from it.
Medical anthropologist Emily Mendenhall was part of a study seeking to understand why. The study interviewed black women living in Soweto who had undergone treatment for breast cancer.
She reveals that diagnoses tend to be too late for successful treatment. The cancer may have spread to other parts of the body. In low-income communities, detection is low.
The women interviewed in the study also described the treatment as toxic and stressful and chemotherapy as much worse than cancer itself.
The author says understanding how patients feel about cancer and treatment can improve the way they are cared for, and help them cope better after diagnosis.
Read more: Demon disease, worse than HIV: Soweto women’s views on breast cancer
Mocked and laughed at
As if the cancer wasn’t bad enough, in a study of Nigerian women human development researcher Candi Nwakasi explains that they’re stigmatised for having it.
In interviews, one breast cancer survivor revealed: “I have been mocked … laughed at … embarrassed.” Another said she had not been given her job back after her cancer treatment was complete, and that her husband treated her unkindly after her mastectomy.
This stigma can result in social isolation, loss of livelihood and fear of seeking help.
The author says these qualities are particularly significant in Nigeria, where some people diagnosed with cancer may see it as a death sentence or refuse chemotherapy and surgery because they think those treatments can kill.
Read more: Surviving breast cancer: Nigerian women share their stories
Treatment challenges
In low- and middle-income countries, such as South Africa, adherence to treatment is a challenge. For example, outcomes are dependent upon patients following the recommended chemotherapy protocols and getting the recommended drugs at the right time.
Breast cancer expert Jenny Edge unpacks the challenges women face when it comes to getting treated. These include access to transport, socioeconomic level and social support.
Read more: Breast cancer patients in South Africa may find it hard to stick to treatment: here’s what they told us
Transport and access
Access and transport are a major barrier. Like many countries across the continent, few public health facilities in South Africa have the specialists and resources to treat breast cancer.
Jenny Edge explains that the majority of South Africa’s population – 80% – relies on the public health sector. And services, such as chemotherapy, are only available in tertiary hospitals which are located in urban centres.
She emphasises that the outcome from breast cancer should not depend on where a person resides.
Read more: Breast cancer patients in South Africa are battling to maintain treatment because of high transport costs
