Dr Tendai Zuze
Health Matters
FOR many women, a diagnosis of breast cancer feels like the world has suddenly come to an end.
Thoughts immediately turn to death, losing a breast, leaving children behind and the financial burden of treatment.
Some women become so frightened that they struggle to accept the diagnosis, while others avoid seeking medical attention because they fear what they might be told.
These fears are understandable, particularly in Zimbabwe, where accessing specialist cancer treatment can be difficult and expensive.
However, there is an important message we need to share, a diagnosis of breast cancer is not a death sentence. There are treatment options, and many women can be successfully treated, particularly when the disease is detected early.
The outcome depends on the type of cancer, its stage at diagnosis, the patient’s general health and how the cancer responds to treatment.
Even when the disease has spread beyond the breast, treatment may still control its progression, relieve symptoms and prolong life. The important thing is not to lose hope before exploring the available options.
Treatment usually begins with confirming the diagnosis through a biopsy and determining the extent and characteristics of the cancer. This information guides the treatment plan. Surgery is one of the main options and may involve removing the tumour and some surrounding breast tissue or removing the entire breast in a procedure called a mastectomy. Although the thought of losing a breast can be devastating, it is important to remember that breast cancer treatment is about saving lives and that a mastectomy does not take away a woman’s dignity or worth. Where available and appropriate, breast reconstruction or an external breast prosthesis can help women regain confidence after surgery.
Other patients may require chemotherapy, which uses medicines to destroy cancer cells or stop them from multiplying. Chemotherapy can be given before surgery to shrink a tumour or afterwards to reduce the risk of the cancer returning. Radiotherapy uses targeted radiation to destroy cancer cells in a particular area and is often recommended after breast-conserving surgery, and in some cases after mastectomy. Hormone therapy, including medicines such as tamoxifen, is effective for certain hormone sensitive breast cancers. Not every patient needs all these treatments. The combination depends on the individual diagnosis and the treatment team’s assessment.
Zimbabwe has established cancer treatment services, including at Parirenyatwa Group of Hospitals and Sally Mugabe Central Hospital in Harare, as well as Mpilo Central Hospital and other referral facilities.
Chemotherapy, cancer surgery, radiotherapy and hormone based treatments form part of the country’s cancer care services, although access to particular treatments and medicines varies.
For someone living in Mutare, Chipinge, Buhera, Chimanimani or a more remote part of Manicaland, the journey to treatment can be particularly challenging.
A patient may need to travel to Harare or another referral centre for specialist consultations, investigations or radiotherapy. The cost of transport, accommodation, food, medicines and repeated hospital visits can quickly become overwhelming, especially when the patient is unable to work or the family depends on a single income.
One of the greatest dangers is delaying treatment. A woman may discover a lump, but decide to wait until it becomes painful. Another may notice that her nipple has changed shape or that the skin over her breast has become dimpled but postpone visiting a clinic because she is frightened.
Others may spend months trying different remedies before seeking medical attention.
Breast cancer does not always cause pain, particularly in its early stages. Waiting for pain, a large lump or an open wound before seeking help can allow the disease to progress. As cancer advances, it may spread to lymph nodes and organs such as the bones, liver, lungs or brain. At that stage, treatment can become more complex, more costly and less likely to achieve a cure.
Although not every breast cancer progresses at the same rate, no one can reliably determine how safe it is to wait without proper medical assessment.
This is why any new breast lump, unexplained change in breast shape, skin dimpling, nipple inversion or unusual nipple discharge should be assessed promptly. Most breast changes are not cancer, but it is not possible to establish that with certainty simply by feeling the lump or observing it at home. Early assessment gives patients the best opportunity to understand what is happening and consider appropriate treatment before valuable time is lost.
Another challenge in our communities is the use of herbal preparations and faith based remedies as alternatives to conventional cancer treatment. Prayer can provide comfort, courage and emotional strength during a difficult period. Church members, traditional community networks, relatives and friends can offer invaluable support with appointments, childcare, transport and the daily demands of treatment. Patients should not feel that they must abandon their faith to receive medical care. Spiritual support and evidence based treatment can coexist.
The danger arises when someone is advised to stop prescribed treatment, reject surgery or postpone chemotherapy because a herbal preparation, prayer session or traditional remedy is claimed to cure the cancer. There is no reliable scientific evidence that herbal mixtures or faith based practices alone can cure breast cancer or replace established cancer treatments. Some herbal products can also interfere with cancer medicines or cause liver and kidney damage. Patients should disclose any herbs, supplements or traditional preparations they use to their treating clinicians.
This month, let us replace fear and stigma with knowledge and hope. Breast cancer is a serious disease, but a diagnosis does not mean that life is over. Treatment options exist, support is available, and early action can make a meaningful difference.
For more on breast cancer awareness, contact [email protected]
Breast cancer diagnosis is not the end of the world
