Breast cancer is the leading cancer in the Philippines with over 25,000 new cases every year, according to Globocan 2018. There is no national breast cancer screening program, and government help through the Philippine Health Insurance Corporation is limited to cases in the early stages. A cancer diagnosis plunges 73% of low- and middle-income families into financial catastrophe, mostly within a year of cancer treatment.
Kara Magsanoc-Alikpala, founding president of ICANSERVE Foundation, presented preliminary results of an ongoing project at the World Cancer Congress (WCC), held October 2-4, 2018, in Kuala Lumpur, Malaysia. She spoke in the session, “Understanding patient needs and building communities for better advocacy: the cancer and NCD (non-communicable disease) experiences” organized by the NCD Alliance (Switzerland), Union for International Cancer Control (UICC), which also organized the WCC, and Rethink Breast Cancer (Canada).
Though a grant from UICC and Pfizer under the Seeding Progress and Resources for the Cancer Community (SPARC) Metastatic Breast Cancer (MBC) Challenge, ICANSERVE is creating a resource guide for women with breast cancer of all stages. Breast cancer is said to be metastatic when it has spread to another part of the body.
Called “Ignite Hope”, ICANSERVE’s project under SPARC first identified the needs of women with MBC, crafted a patient navigation curriculum, and trained patient navigators in four partner-cities to attend to the needs of MBC patients. Breast cancer can come back in another part of the body months or years after the original diagnosis and treatment. According to the non-profit breastcancer.org, nearly 30% of women diagnosed with early-stage breast cancer will develop metastatic breast cancer.
Ignite Hope’s research into the profile of women with MBC found that women only did breast self-examination (BSE) occasionally. Early breast cancer detection guidelines encourage women to do BSE every month beginning the age of 20. At age 30, women should undergo annual clinical breast examination or CBE, in addition to monthly BSE. And at age 40, women should continue monthly BSE, annual CBE and get a baseline mammogram.
Those in low- and middle-income families delayed medical consultation by months to a year, either because of work or because they didn’t know where to go. They took pain medicines intermittently, had to stop working because they were in pain or feeling weak, and spent time applying for financial aid due to the high cost of medication.
Two respondents took herbal medicine because it was cheaper, but later found that the cancer had spread to the bones. Breast cancer commonly spreads to the liver, brain, bones and lungs.
Patient navigators trained under the project visited government funding agencies and hospitals as part of the course. They found that the time from diagnosis to first treatment is from 42 to 60 days. Among the causes of delay were waiting for laboratory results, getting a surgery schedule, having few chemotherapy facilities, and the limited financial capacity of patients. Low- and middle-income patients use up all their savings, beg and borrow from family and friends, and apply with government agencies to fund their treatment.
Carmen Auste, managing director of Cancer Warriors Foundation, Inc. and vice president of Child Cancer International served as ICANSERVE mentor for the SPARC grant.
Magsanoc-Alikpala is co-chair of Cancer Coalition Philippines, which has been working to get the National Integrated Cancer Control Act enacted. If passed, the landmark legislation will address the various gaps in the cancer care continuum and integrate solutions from prevention, detection, correct diagnosis, treatment, survivorship and palliative care.
“We’ve been working on it (cancer bill) for nearly two years and inputted provisions for support care services for women with MBC. We still need help from national government to support efforts on local levels, as most of them say it (cancer treatment) is something they have difficulty providing. We’ve barely scratched the surface of the surface of the surface of the problem, but we believe with your (SPARC, UICC) help, we are planting seeds. And so far this is where we’re at, and we’d like to think we’ve been true to the title of our program, ‘Ignite Hope’,” said Magsanoc-Alikpala at the WCC session. -Carla Paras-Sison
*This article was first published in Manila Bulletin on October 23, 2018 (page C-3). View a video of presentation on the ICANSERVE channel on YouTube.