BREAST cancer, according to a study published by the World Health Organization (WHO), accounts for almost 30 per cent of all female cancer patients in Guyana. Globally, it is often termed as the world’s most prevalent cancer, with 2.3 million women diagnosed and 685,000 dying of the disease in 2020 alone.

Also, by the end of last year, there were 7.8 million women living with breast cancer after being diagnosed in the past five years; Guyana has dozens of them still battling to survive, and fortunately, they have several living and breathing examples that their fight can be won.

Over the past couple of years, the Guyana Chronicle has featured many such persons who have been brave enough to tell their stories, and give us an insight into their scars.

One such person is Ms. Hermanetta Andrews, who spoke with the Guyana Chronicle in 2019. At that time, she was a nurse attached to the Beacon Foundation. She told this publication then that four years had elapsed during which she did not maintain her routine health check-ups, at least until 2016. “I went to the Cancer Institute [of Guyana] and I did my mammogram first and the doctor told me that they saw suspicious cells,” Andrews recalled.

She told this newspaper that she then proceeded to consult her “personal doctor” who ordered another round of tests which only confirmed her fear – the authenticity of the first diagnosis.
“The tests came back with the same results. At that time, I said, ‘well this has to be real’. I was hoping beyond hope that at the second examination… I’d have [had] a different result,” Andrews related.

Having realised that she was a potential cancer patient, Andrews said she was hit with a gush of unexplainable emotions. “No one word could explain the emotions and the feelings I was feeling. It was everything you [could think]. I’m also a Christian, so, I took it to the Lord. I prayed, I fasted.

Two weeks would elapse and Ms. Andrews returned to her doctor’s office for a biopsy, the results of which marked the beginning of a long, painful road to beating cancer and recovering both physically and mentally from its devastation.

In sharing her story, Andrews had encouraged women to “listen to your bodies.” She continued, “If you wake up [one] morning and feeling not your best, just think about what can be wrong… If you feel a pain that should not have been there, follow it up. Your body tells you so [many] things and we need to listen to it. Sometimes, we feel … pain and we say, ‘oh, this will go away just now’, but your body is telling you something and you must listen to it.”

STRESS LESS
Another resilient breast cancer survivor is Roxanne ‘Ann’ Singh, who shared her inspiring journey with the Guyana Chronicle’s Telesha Ramnarine. The 53-year-old mother to four daughters, has been a breast cancer survivor for just a few years; she has since joined the Guyana Cancer Foundation Survivors Club.

In her 2020 interview with Ms. Ramnarine, Singh recalled how the sharp pain she felt in her breast was enough for her to know something was wrong. She immediately made an appointment for a medical screening at the Cancer Institute of Guyana. But soon after the pain disappeared, Singh cancelled her appointment thinking that the pain was a one-off discomfort and that all was well. Soon enough, the vague lump in her breast began to grow larger and larger, and eventually, Singh knew that she had to see a doctor. She did an ultrasound which showed possible “malignant findings”; this led to a biopsy.

“Finally, after two full weeks of sleepless nights, I received a call that my results were ready. Since I have no family history of cancer, I took the results to my doctor with high hopes of all being well, but my wall of hope came crashing down when the doctor said the results were positive.” Singh told the Guyana Chronicle previously.

Like Ms. Andrews, the bad news also hit Singh like a ball of indescribable pain. “I felt so many emotions all at once. I was shocked, numb for a few seconds, I couldn’t process what was being said to me. My tears started flowing and I couldn’t think about anything else; it felt like the end of the world for me,” Singh noted.

As the story is told, Singh managed to compose herself just in time to embark on a long list of treatments and procedures that were critical for her survival. She did a surgery, followed by a partial mastectomy, and then began her eight sessions of chemotherapy, followed by 25 sessions of radiation therapy. She was later prescribed a five-year hormonal treatment.

Even with all the pain and fatigue, Singh said losing her hair was particularly devastating, as it served as a constant reminder of all that was going on in body. “It was more of a personal challenge, even though I had a lot of support from family and friends. I knew so much, yet so little about cancer. My anxiety level was always high and I guess fear was actually my biggest challenge; not knowing if, how or when I will recover. The struggle for survival was real. I was mentally and emotionally drained,” Singh shared in her interview with Ms. Ramnarine.

Even though she is cancer-free, Singh said that her life will never be the same again. As a matter of fact, she is now far more health-conscious than she ever was.

“Now, my well-being is my number one priority. I continue to eat well. My diet has changed drastically; no meat, no dairy products, no sugar, no soda, etc. I am using lots of fruits, vegetables and beans and I drink only herbal and green teas. I do daily exercises and keep my stress level down,” Singh related.

She went further to note that the critical support of her family and friends really impacted her overall recovery. Her advice to cancer patients is to stay positive, even on the darkest of days. “It is the most important thing that you can do; worrying only worsens your health. There will be days where it seems like things will never get better, but you will get through it,” she advised, comfortingly.

CANCER AND COVID-19
More than just facing painful and intense treatments and therapies, cancer patients now have the added worry of the novel coronavirus. They have to fear visits from family and friends; visits to the doctors’ office, and even going outside for a breath of fresh air.

This is of deep concern for cancer survivor, Rosaline Clarke, who lost her sister, brother and uncle from cancer. In an interview with Vishani Ragobeer, Clarke explained how she was on family vacation in the United States when she first felt a striking pain in her left breast. In a typical Guyanese manner, Clarke sought to rationalise her pain; she reasoned that it was due to her handling of an extra suitcase which contained Guyanese delicacies for her family. But, as the story is told by Ms. Ragobeer, it was not.

While on vacation, Clarke learnt that another sister had secretly been battling breast cancer. It was this that prompted her to get tested as soon as she returned home to Guyana. “I said ‘you’re a child of God, don’t tek this thing on’ and so I came home and went to the [Guyana Responsible Parenthood Association] and got it checked out,” Rosaline recollected.

A lump was detected in her breast and a mammogram and ultrasound would reveal, six weeks later, that Clarke herself was a cancer patient. Clarke described the wait as being “agonising”.

Nonetheless, Clarke said that when the news was confirmed, she immediately agreed to a mastectomy. “I tell them right away to take off the breast, because I don’t want to wait for it to get to no big stage and then I gotta do chemotherapy and radiation because those are not nice,” Clarke said.

Although cancer-free, Clarke is still undergoing steady check-ups to monitor the cyst that has developed in her right breast.

Meanwhile, having survived a long, tedious recovery process, Ms. Clarke is concerned about the potentially deadly impact that COVID-19 has had on cancer patients who are already battling for their lives each and every day.

As it is, persons with co-morbidities (meaning persons with more than one disease or condition present at the same time) are more vulnerable to the novel coronavirus (COVID-19). Moreover, older persons are even more vulnerable to the severe symptoms that come with the disease.

At age 62, Clarke, who had cancer and is hypertensive, would be especially vulnerable to the virus and therefore has to take all the added precautions to stay safe. This means that she has to limit physical contact, remain indoors as much as possible, and follow all COVID-19 regulations when venturing outside.

Clarke, in her interview with Ms. Ragobeer, expressed her displeasure with the frivolous manner in which many Guyanese treat the coronavirus. “I think people are not taking COVID-19 seriously and they’re only going to take it seriously when it hits close to home; to somebody they love or so,” she lamented.

The World Health Organization (WHO) has said that survival of breast cancer for at least 5 years after diagnosis ranges from more than 90 per cent in high-income countries, to 66 per cent in India and 40 per cent in South Africa. Given the rate at which the disease has been killing women, the WHO’s Global Breast Cancer Initiative (GBCI) has endeavoured to reduce global breast cancer mortality by 2.5 per cent, thereby averting 2.5 million breast cancer deaths globally between 2020 and 2040.

“The three pillars toward achieving these objectives are: health promotion for early detection; timely diagnosis, and comprehensive breast cancer management,” the WHO said.
For the mission under these pillars to be achieved, WHO recognised that public education needs to be combined with health worker education about the signs and symptoms of early breast cancer so that women can be referred to diagnostic services as required.