ENCORE #162! – Breast Cancer: Liberia

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in January of 2017.

The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need. - See more at: http://www.liberianobserver.com/health/%E2%80%98breast-cancer-curable%E2%80%99

Why should this matter to you? Why should the matter to me?

I COULD wallow in guilt. That would be both easy and satisfying! Instead, I’ve decided I’m going to take a character I’ve created in a science fiction short story, and send him on a few adventures. Most likely, he’ll be travelling with a hard-thinking woman who will become his perfect match. They’ve already started out rebuilding the educational infrastructure of Liberia in the future middle of this century. I’m thinking the two of them need to make a trip to Liberia. Separately – where they’ll meet and butt heads.

The driving issue will be breast cancer education, diagnosis, and treatment in these three West African countries that hold a special place in my heart. From the sale of the stories, I’ll donate the money to breast cancer research in those places…

Liberia suffered through a horrendous time of civil war, starting three years after I left. The First Liberian Civil War lasted seven years, followed by two years of semi-peace, and then the Second Liberian Civil which lasted for four more years until the women of the country told both sides, “Enough is enough. Be done.”

I can only imagine more than public marches and protests were brought to bear on the men of the country to quit their war. As a result, a woman was elected president and in recent history met with Michelle Obama.

As for progress against breast cancer – well, that’s slow. Most of the country’s infrastructure had been smashed. Even when I was there, the JFK Medical Center had become run down. Apparently it was used by both rebel forces and by international medical personnel during the wars. Of its original four institutions only three remain.

As well, breast cancer detection and treatment face two main hurdles – the first is awareness. When we visited, I think it’s safe to say that medical care in the three countries was roughly equivalent to what we could get in the US in the late 1950s. That include cancer awareness. In the 1950s, cigarette companies touted the fact that “More doctors smoke Camels than any other cigarette” (http://360jokes.com/wp-content/uploads/2011/07/more-doctors-smoke-camels.jpg) Breast cancer was spoken of in hushed voices – if it was talked about at all – because it involved, you know…BREASTS. Despite Howard Hughes, or perhaps because of him, breasts had become dirty and you certainly didn’t talk about them in public!

The attitude toward breasts in Liberia today is similar. But an equally huge issue is treatment of cancers that people DO have. I have documented in this blog the cost it took to rid my wife of cancer. I’ve continued to write because despite the fact that she is five-years-cancer-free, there are countless things she has to deal with as a result. Even here, the divorce/break up rate among women diagnosed with breast cancer has never been studied – though one study found that there was no correlation (https://academic.oup.com/jnci/article/91/1/54/2549274/Marital-Stability-After-Breast-Cancer), it involved a group that may have typically been stable anyway. Clearly more research is needed so that more effective supports might be put in place. I cannot imagine that Liberian men whose wives, fiancés, or girlfriends are diagnosed with breast cancer can find much community support!

At any rate, this is an area that needs study and support for the men and women involved.

Lastly, the kinds of treatment we have available here is most likely unavailable to your average Liberian woman…

Breakthrough, anyone?

Resource: http://cancer.iaea.org/newsstory.asp?id=184, http://tlcafrica.com/press_release_liberian_cancer_society_re-activation.htm, http://www.capitoltimesonline.com/index.php/news/item/1647-breast-cancer-on-the-rise-liberian-women-urged-to-get-screening

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #78: The “Future” of Breast Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: Is it WHEN or IF there will be a cure for breast cancer…and can there even BE a single cure?

With the rapid development of a vaccine against the COVID19 virus, I started to wonder if the advances made developing it would spill over into the fight against breast cancer. While it seems to be at least a POSSIBILITY a huge roadblock stands in the way.

"Experts now know that breast cancer isn’t one single disease. There are many different types of breast cancer with different causes and treatments.”

Where COVID19 was a single virus – even though variants continue to pop up – it was the same virus that infected everyone; breast cancer has not only variants, but entirely different diseases, so we could never do a massive campaign against breast cancer the way it was carried out against COVID19. At any rate, I’ll go into this more in a later essay, but for now, I’ll shelve the vaccine investigation and move on to my initial question, “Is there a cure for breast cancer?”

One similarity between COVID19 and the varieties of breast cancer was that its treatment depends on a number of factors. Every body’s response to the challenge to the immune system, whether it was COVID19 or breast cancer was different. Socioeconomic status (how rich/poor/employed/unemployed/where they live, etc.) also has an impact. The SES of both COVID19 and breast cancer victims determines the recovery of that person. As well, the stage of the cancer, its location, number, and size of tumors; the molecular and genetic characteristics of the cancer; and the overall health and treatment priorities of each patient will affect the success of any cancer (or COVID19) treatment.

The short and sweet of breast cancer and its treatment is, “There’s still no cure for breast cancer that has spread to distant parts of the body. However, treatment can help prolong and improve quality of life in people with MBC.”

Perhaps the first thing that is done when doctors discover breast cancer is to identify the type and stage.

Once that happens, oncologists (cancer doctors) can talk with the patient and devise a treatment plan. For my wife’s oldest friend, the treatment was a lumpectomy and radiation. For her, it was a double mastectomy followed by aggressive chemotherapy. It all depends. We live in a wealthy country, and perhaps the country with the highest level of technology to deliver healthcare. Does it GET to us? No idea (I also discovered that it depends entirely on the source of the ranking – which of course, can be deeply affected by the agenda of the organization issuing the ranking.) In the state I live in, The Mayo Clinic in Rochester, MN is among the top 10 cancer care hospitals in the country. As might be said for any of the hospitals so ranked, there is inevitably a “trickle down” effect. While the main work is done at the ranked hospital, everyone knows that you can move “up the ranks” as you search for treatment for your own, personal diagnosis.

Some types of breast cancers are: Estrogen receptor-positive; Progesterone receptor-positive, Human epidermal growth factor receptor 2 (HER2)-positive, estrogen receptor-negative, progesterone receptor-negative, HER2-negative. Breast cancer is also identified by where it was found in the breast as well as if it has progressed to the lymph nodes. Each step of diagnosis determines the treatment plan.

At any rate, I’ve detailed different types of treatments on the blog, the end result right now of course, is that “There’s still no cure for breast cancer that has spread to distant parts of the body.”

At least for now!

Resources: https://www.healthline.com/health/breast-cancer/breast-cancer-cure, BC Vaccine - https://medicine.wustl.edu/news/personalized-cancer-vaccines-for-breast-pancreatic-cancers-show-promise/ Best Cancer Treatment Hospitals: https://appliedradiationoncology.com/articles/top-cancer-hospitals-named-for-2020-2021 Image: https://hips.hearstapps.com/hmg-prod.s3.amazonaws.com/images/breast-cancer-vaccine-royalty-free-image-1571330334.jpg?crop=0.668xw:1.00xh;0.175xw,0&resize=480:*

ENCORE #161! – BREAST CANCER: Cameroon

FOSTER DAUGHTER GOT MARRIED THIS WEEKEND AND I FINISHED WRITING MY 200,000 WORD NOVEL…SO, THIS IS AN EXTRA ENCORE. THANKS!

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in December of 2016.

In the 1980s, I traveled with an organization to West Africa. I spent three months in Cameroon, so I still follow news about the country. Recently it seemed a natural extension of my reading about Breast Cancer to check the stats regarding the disease in that country.

I found this: “Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.”

OMG! This is truly horrifying. Where we – justifiably – celebrate the survival of American breast cancer victims, the mortality rate of the women in Cameroon is THREE TIMES ours.

What’s being done? How can we help?

The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need.” (Emphasis mine)

Why should this matter to you? Why should the matter to me?

I COULD wallow in guilt. That would be both easy and satisfying! Instead, I’ve decided I’m going to take a character I’ve created in a science fiction short story, and send him on a few adventures. Most likely, he’ll be travelling with a hard-thinking woman who will become his perfect match. They’ve already started out rebuilding the educational infrastructure of Liberia in the future middle of this century. I’m thinking the two of them need to make a trip to Cameroon. Separately – where they’ll meet and butt heads.

The driving issue will be breast cancer education, diagnosis, and treatment in these three West African countries that hold a special place in my heart. From the sale of the stories, I’ll donate the money to breast cancer research in those places…

As for current work going on there, there does seem to be movement and as you’d expect, it’s in the area of EDUCATION AND AWARENESS. “A recent review using the most recent data available for the entire continent showed that breast cancer was the most commonly diagnosed cancer among women in 2008. There were an estimated 92,600 cases…breast cancer recently overtook cervical cancer as the most commonly diagnosed cancer in several countries in sub-Saharan Africa, including Nigeria, Chad, Sudan, Cameroon, Central African Republic, Niger, Namibia, Congo, Kenya, and Somalia. This change was attributed to increases in the prevalence of breast cancer risk factors associated with urbanization and economic development, such as earlier menarche, later childbearing, having fewer children, obesity, and increased awareness and detection.”

As well, “Worldwide, breast cancer mostly occurs after the age of 50 years. The situation is different in our context where it occurs at a relatively younger age, 46 years. The majority of these cases in our setting are diagnosed at advanced stages of the disease because of difficulties in access to health care among other factors, underscoring the importance of early diagnosis through screening. According to the WHO, breast cancer is responsible for 25% of cancer deaths in the world with the majority of these deaths occurring in the developing countries. Although incidence of breast cancer is lowest in African countries, survival rates are also lowest. The majority of breast cancer deaths, 69%, occur in developing countries.”

A ray of hope? Run for a Cure, Africa has this as its mission: “To Win the fight against breast cancer in Africa by erasing societal stigmas; providing affordable breast cancer screenings, and creating more access to quality breast care. Their vision is to “…turn the current 90% breast cancer mortality rate in Africa into the 99% survival rate.”

So…the fight goes on in places most of us have never heard of. Hallelujah!

Resource: http://file.scirp.org/pdf/ABCR_2015033017061944.pdf, http://allafrica.com/stories/201607181336.html, http://file.scirp.org/pdf/OJOG_2016110715230808.pdf, http://us8.campaign-archive1.com/?u=9921334c92e792139971fa508&id=22224a0179&e=7c62834bc7
Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

ENCORE #160! – BREAST CANCER: Nigeria

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in November of 2016.

Most people don’t know that for most of 1984, I was in the West African countries of Nigeria, Cameroon, and Liberia.

I got to thinking this morning when I noticed that some of my blog entries have taken a new direction, that I can pretty much talk about whatever I want to talk about.

So, it got me to wondering: what are the breast cancer facts, figures, and treatment in these three developing countries and what does it have to do with me – or you? Two of them have recent histories rife with coup d’etat, civil war, and mass exodus. One of them has had the same president for 34 years.

What have they accomplished for women’s health in relation to breast cancer – and why would it matter to us in the US?

Nigeria: Well…here was study conducted in 1992. That’s almost a quarter century old… (https://www.ncbi.nlm.nih.gov/pubmed/1393468). There DOES seem to be a current drive to help the women in Nigeria and that is what you’ll find below.

“BACKGROUND: In most resource-constrained settings like Nigeria, breast self-examination self-breast examination (BSE) is culturally acceptable, religious friendly and attracts no cost. Women's knowledge and beliefs about breast cancer and its management may contribute significantly to medical help-seeking behaviours. This study aimed to assess knowledge and beliefs of BSE among market women.

METHODS: A descriptive cross-sectional study was conducted among 603 market women in Ibadan, Nigeria (Ibadan is a major city with a heavy Western influence. This is not necessarily representative of MOST women in Nigeria). Data was collected using semi-structured interviews and analyzed using descriptive and analytic statistical methods.

RESULTS: The mean age of the respondents was 34.6±9.3 years with 40% of the women aged between 30-39years. The proportion of married women was 339 (68.5%) with 425 (70.8%) respondents reporting that they do not know how to perform BSE. However, 372 (61.7%) women strongly agreed that BSE is a method of screening for breast cancer. Highest proportion 219 (36.3%) reported that the best time for a woman to perform BSE was 'anytime'. Most of the respondents believed breast cancer is a dangerous disease that kills fast and requires a lot of money for treatment. (Emphasis mine)

CONCLUSION: More efforts are needed in creating awareness and advocacy campaigns in the grassroots in order to detect early breast cancer and enhance prevention strategies that would reduce the burden of breast cancer in Nigeria. - See more at: http://www.cancerindex.org/Nigeria#sthash.vxdUxdCI.dpuf”

The conclusion: “The vast majority of deaths from malignancies occur in sub-Saharan Africa primarily as a result of lack of public awareness of cancer and how it is diagnosed and treated in the setting of a severe lack of resources (physical and personnel) to actually diagnose tumors. To correct this massive health disparity, a plan of action is required across the continent of Africa to bring diagnostic medicine into the modern era and connect patients with the care they desperately need.” http://www.cancerindex.org/Nigeria#sthash.vxdUxdCI.dpuf

Why should this matter to you? Why should the matter to me?

I COULD wallow in guilt. That would be both easy and satisfying! Instead, I’ve decided I’m going to take a character I’ve created in a science fiction short story, and send him on a few adventures. Most likely, he’ll be travelling with a hard-thinking woman who will become his perfect match. They’ve already started out rebuilding the educational infrastructure of Liberia in the future middle of this century. I’m thinking the two of them need to make a trip to Nigeria. Separately – where they’ll meet and butt heads.

The driving issue will be breast cancer education, diagnosis, and treatment in these three West African countries that hold a special place in my heart. From the sale of the stories, I’ll donate the money to breast cancer research in those places…

UPDATE: The story I wrote shifted to Liberia and at this time, I have been unable to sell it…

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg