Breast cancer: Screen early, live longer

When you are told that you have breast cancer, it is devastating news and the treatment can be a traumatising experience. But I want tell people that it does not mean you are going to die; most people are scared of going for breast cancer checkups and testing, which is so dangerous. These are the words of 55-year-old Evelyn Kamagaju Rutagwenda, a breast cancer survivor. Unlike Kamagaju not many people survive breast cancer because of fear to go for early testing. As Rwanda joins the rest of the world to mark the Breast Cancer Awareness Month, the problem of breast cancer continues to take a toll on the country’s health sector. Sensitisation and awareness remain a big challenge, with many cases of cancer which could be treated in early stages, not being detected early enough. Most people realise they have breast cancer when it has advanced and in delicate stages to treat. According to the World Health Organisation, the Breast Cancer Awareness Month marked in countries across the world every October, helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of the disease. It’s in this same spirit that Rwanda also carries out extensive breast cancer awareness in October to advocate for an early breast cancer checkup amongst men and women. Philippa Kibugu, the founder of Breast Cancer Initiative East Africa (BCIEA) Inc, says that promoting the early detection of breast cancer and its related benefits to treatment can be achieved through advocating for awareness and education. “Our primary focus at BCIEA is to increase the awareness of cancer as a disease because many women in Rwanda detect breast cancer at a later stage because of lack of knowledge and awareness. Through out our initiative, we talk about the disease, signs and symptoms but mainly stress the importance of early detection,” Kibugu explains. Breast Cancer Initiative East Africa (BCIEA) is a non-profit organisation dedicated to take the lead in the advancement of breast cancer surveillance and increase survival rates. “Besides our brand being “Early detection is the best protection,” we do empower women to love themselves and their bodies. Our main Kinyarwanda slogan for the breast cancer awareness campaign is “Ikunde, Imenye, Isuzumishe,” which can be literally translated as “Love yourself and go for medical checkups,” we offer support, research and make sure that the patients do not face breast cancer fearfully and helplessly alone,” Kibugu emphasises. “During the campaigns we demonstrate breast cancer self examinations as well as visual pictures and testimonies from breast cancer survivors and we replace fear with hope and let women know that breast cancer is not a death sentence. “We also do clinical breast exams, for example on September 29th, 2013 when we had the ‘Ulinzi Walk’ Ulinzi which is a Swahili word meaning ‘protect’, 156 participants were examined. Out of those, four abnormal lumps were detected and out of the four, the three were later confirmed to be breast cancer. We do follow-ups when breast cancer is detected,” Kibugu reveals. However, Kibugu who is also a breast cancer survivor says that they are limited by how much they can do because of lack of funding but they are collaborating with many stakeholders especially the Midwives Association in Rwanda. According to the Ministry of Health, between 2007 and 2013, at least 4,615 people were infected with different types of cancer in the country, the most common one being breast cancer, constituting 15.8 per cent, according to latest Ministry of Health statistics on cancer epidemiology. The Cervix uteri stood at 15.6 per cent while stomach cancer was at 9.1 per cent and uterus 5.5 per cent. But stomach cancer was the most prevalent among men, standing at 11.7 per cent, followed by prostate at 9.4 per cent. Men not spared While most people generally associate breast cancer with women, men are also susceptible and experts say they should also carry out early screening for male breast cancer. Dr. Leonard Kayonde, the Director of Cancer Diseases Unit at the Rwanda Biomedical Centre (RBC), notes that four per cent of the breast cancer victims are men. “Breast cancer cases that we have are about 450 and they have been detected in the laboratories. Four per cent of these cancer victims are men. The problem is that in men, breast cancer spreads really fast compared to women,” Dr Kayonde explains. He further advises that during the breast cancer awareness campaigns, the misconceptions that men don’t get breast cancer should be addressed and demystified. “Breast cancer awareness campaigns should be for both men and women so that they can know the signs and symptoms as well as the benefits that come with early detection. They all have to seek immediate medical assistance in case they suspect or detect any signs. Early detection helps in knowing which type of cancer it is and which medical assistance the person is supposed to get,” Dr Kayonde says. Although there are still several challenges like shortage of cancer experts and facilities in Rwanda, the main challenge has been the misconception about the disease from the people or patients. “We have discovered that there are still many people especially in rural areas who get breast cancer and start thinking that they were bewitched. These victims spend so much time seeking help from traditional witch doctors that by the time they come to seek medical help, its already too late and the cancer is in advanced stages. “But that has not stopped us from continuously informing them as well as promoting healthy living. We are educating Rwandans on eating healthy and avoiding dangerous behaviours like smoking and alcohol consumption. They need to exercise regularly too,” Dr Kayonde reveals. He adds, “Breast cancer can be cured especially if it’s detected early. I advise everyone to go for a checkup and also do a self examination.” The testimony of a breast cancer survivor 55-year-old Evelyn Kamagaju Rutagwenda is the President of Conquer Breast Cancer Association in Rwanda and a breast cancer survivor. “When you are told that you have cancer, it is devastating news and the treatment can be a traumatising experience. But I want tell people that it does not mean you are going to die; they performed a mastectomy on my left breast, but you can’t notice. “I feel perfect and I know my example should hopefully encourage other people. Most people are scared of going for breast cancer checkups and testing, which is so dangerous,” Rutagwenda says. She adds that her husband’s support during and after the treatment helped her a lot. “I had the support of my husband all through because he came a day after the surgery in South Africa and my family members kept calling me. My children were very scared but I told them I would be fine and everything was okay. I also had help from my friend who had been diagnosed with breast cancer in 1999, she talked to me regularly and I thanked God for all the support because it gave me more strength,” Rutagwenda narrates. She also reveals that she was inspired to start the Conquer Breast Cancer Association in Rwanda when she came back based on the support she got from a similar association of women breast cancer survivors while in South Africa. The group is called Reach To recovery. She says, “I picked good pieces of information from this group that kept me pushing through the whole treatment. This information didn’t let me go into depression or have any negative thoughts. You meet people who have gone through the same experience; they tell you how you can push through and how to communicate with the family. “We have seen cases where even within the family; some husbands may not be that understanding or think you are dying anyway. We would like to get to the stage where we talk to people and show them that everything will be okay and also be supportive to the people undergoing the treatment.” The Conquer Breast Cancer Association meets once a month and they provide support to breast cancer patients and survivors and their families. Rutagwenda is a retired civil servant who worked as Auditor General of the Government of Rwanda.