Breast cancer survivors urge women in the Middle East to seek timely screening

In Arab countries, breast cancer is the most frequently diagnosed form of the disease, which is why every October is Breast Cancer Awareness Month. (AFP/File Photo)
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Updated 25 October 2020
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Breast cancer survivors urge women in the Middle East to seek timely screening

  • Every October, Breast Cancer Awareness Month tells women not to neglect checkups
  • In Arab countries, breast cancer is the most frequently diagnosed form of the disease

DUBAI: Breast cancer is the most common form of the illness diagnosed in women worldwide. If caught early, the prognosis for survival is reassuringly high. But a lack of awareness, common myths and fear of bad news causes far too many women to delay getting checked.

In Arab countries, breast cancer is the most frequently diagnosed form of the disease. One recent study found 17.7 to 19 percent of all new cancer cases across the region in 2018 were breast cancer diagnoses.

That is why every October is Breast Cancer Awareness Month, when experts meet to discuss the latest treatments, charities raise awareness and private clinics offer special discounts on tests and screenings.

Cancer survivors are frequently asked to share their experiences, whether in small private groups or at large public gatherings, and the distinctive pink ribbon synonymous with the cause proliferates on blouses and lapels the world over.

While pandemic restrictions have forced many events online, this year has been no exception. And the message is getting across. Oncologists, surgeons, radiologists and other medical practitioners in the field are often fully booked this time of year.

“I think the essence is to try and get the whole world to just refocus,” Dr. Millicent Alache Bello, a renowned breast surgeon at King’s College Hospital in Dubai, told Arab News.

 

“It is important all through the year that breast education and breast awareness continues. However, a specific month for people to just refocus and take stock is vital.”

Women are recommended to begin getting annual mammograms from the age of 40, when the likelihood of developing breast cancer increases.

“In this part of the world, screening is not something done nationally. Screening is done ad hoc, meaning people go when they feel like it,” said Bello.

In the UK, general practitioners working for the taxpayer-funded National Health Service keep detailed medical records on every patient and remind them when they are due to receive a screening exam. This is not the case in Arab countries, where health services are insurance-based.

King’s College Hospital in Dubai wants to imitate the British system and to begin reminding its patients when they are due a check-up. It has already started compiling patient data and will soon offer mammograms at a cost of AED 350 ($95).

 

Routine check-ups and on-time screenings pay off. “The point where a woman feels a lump in her breast is not the point when the breast cancer started,” Bello warned. “Sometimes, it started before that period, anything up to 12, 14 or 24 months earlier.”

That is why it is so important to get screened regularly before the trouble signs emerge.

Catherine, a British cancer survivor in her 40s, says she used to be disciplined with her screening appointments, often getting tested twice a year. But after having children, she began neglecting her checks. It was during this six-year window that she developed a lump.

“I was so busy being a mom, I just forgot about myself,” Catherine told Arab News. By the time she was diagnosed, the tumor in one of her breasts already measured eight centimeters in diameter.

After a double mastectomy, the pathology report showed her other breast also contained three cancerous lumps. “I was very pragmatic about it. I didn’t feel this massive emotional connection to my breasts. If they try to kill me, they have to go,” she said.

Women should not make the same mistake and neglect their health, she says, even when other life pressures take over. Now Catherine devotes her time to charity work during Breast Cancer Awareness Month to raise funds and awareness.

Joining her is Ghozlan, an Arab woman and fellow survivor, who says she discovered a lump in her breast while exercising. She traveled to Europe for treatment and opted for reconstruction.

“I am a woman who cares about her femininity and I can’t live without it,” Ghozlan told Arab News, describing her breast implant, which must be replaced every 10 years. “It was not what I expected. It wasn’t a great result but it is better than nothing. I have been through hell, and now I accept what I have. I am living with it, but I have some side effects because of the implant.”

Ghozlan is now anxiously awaiting her next check-up with her doctor in Europe, which had to be pushed back due to coronavirus travel restrictions.

Another woman fundraising for Breast Cancer Awareness Month is Gina, a 58-year-old who, like Catherine, underwent a double mastectomy. Unlike Ghozlan, she was unable to undergo reconstructive surgery.

INNUMBERS

Breast Cancer

* 2.1m Women diagnosed with breast cancer each year.

* 627,000 Estimated breast-cancer deaths in 2018 (WHO).

* 50 Age above which women are most at risk.

* 17.7-19% Share of all cancer cases in Arab world in 2018.

* 20% Drop in mortality due to regular mammograms (WHO).

“Due to my autoimmune disease, the chances of the prosthesis being rejected by my body was very high,” Gina said. “It was not my voluntary choice. It was a shock to me. I must admit, even today, after five years, I have not 100 percent accepted this situation.”

Gina has since resigned from her job to commit herself entirely to charity work.

With the evolution of technology and other scientific advancements, doctors are getting even better at detecting potential problems — faster and more accurately.

The triple assessment — clinical examination, imaging and biopsy — has changed little over recent years, but equipment offering more sensitive scans has developed in leaps and bounds while surgery techniques have become more refined.




Participants take part in the Pink Caravan Ride in Dubai, a UAE breast cancer initiative. (AFP/File Photo)

“It is the oncology, the medicine we give for hemotherapy and the endocrine treatments — they have moved on in quantum leaps, which is fantastic news,” said Bello.

Scientists have come to understand that treatment plans are not always the same for all breast cancer patients and that the most effective surgeries and therapies are unique to the individual.

“No two women have the same breast cancer,” said Bello. “Every woman’s cancer is different because the genetic composition is different. This is why people are doing better now, because the treatment is tailored individually.”

But this can also mean reconstruction surgery is not an option for everyone, and is dependent on body type, the extent of the cancer, the patient’s medical history and personal preference.




A picture taken on October 1, 2020 shows the Eiffel Tower illuminated in pink to mark the start of "Octobre Rose" (Pink October) or Breast Cancer Awareness Month in Paris. (AFP/File Photo)

“Reconstruction is designed to improve your well-being; it is not supposed to interfere with cancer treatment,” Bello said.

High-income countries in Europe and North America appear to have much higher rates of breast cancer largely because screening and early detection are so prevalent. With a more limited testing capacity, the Arab world appears to have a lower rate of cases — but also a high mortality rate.

A retrospective epidemiological study conducted in 2012 found that breast cancer was the leading cause of death among Saudi women.

However, a paper published in 2018 by the Journal of Epidemiology and Global Health said: “Although the incidence of breast cancer in Arab countries is rising, it is still less than the global average and only one-fifth of that in Western Europe.”

But now is not a time for complacency. Breast Cancer Awareness Month is a reminder to all women to get themselves checked and for governments to invest in clinics and vital research.

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Twitter: @jumanaaltamimi


Hamas negotiators arrive in Egypt for Gaza truce talks: media

Updated 04 May 2024
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Hamas negotiators arrive in Egypt for Gaza truce talks: media

  • A top Hamas official earlier accused Israeli Prime Minister Benjamin Netanyahu of trying to derail a proposed Gaza truce

GAZA STRIP, Palestinian Territories/CAIRO: A Hamas delegation arrived Saturday in Egypt for the latest round of talks on a proposed truce and hostage release in Gaza, Egyptian state-linked media Al-Qahera News reported.

Al-Qahera News, linked to Egyptian intelligence services, quoted an unnamed high-ranking source as saying that “there is significant progress in the negotiations” between the Palestinian militant group and Israel, and that the Egyptian mediators have “reached an agreed-upon formula on most points of contention.”

A top Hamas official earlier accused Israeli Prime Minister Benjamin Netanyahu on Friday of trying to derail a proposed Gaza truce and hostage release deal with his threats to keep fighting the Palestinian militant group.

“Netanyahu was the obstructionist of all previous rounds of dialogue... and it is clear that he still is,” senior Hamas official Hossam Badran said by telephone.

Foreign mediators have waited for a Hamas response to a proposal to halt the fighting for 40 days and exchange hostages for Palestinian prisoners, which its chief Ismail Haniyeh has said the group was considering in a “positive spirit.”

A major stumbling block has been that, while Hamas has demanded a lasting ceasefire, Netanyahu has vowed to crush its remaining fighters in the far-southern city of Rafah, which is packed with displaced civilians.

The hawkish prime minister has insisted he will send ground troops into Rafah, despite strong concerns voiced by UN agencies and ally Washington for the safety of the 1.2 million civilians inside the city.

World Health Organization chief Tedros Adhanom Ghebreyesus said the agency was “deeply concerned that a full-scale military operation in Rafah... could lead to a bloodbath.”

“The broken health system would not be able to cope with a surge in casualties and deaths that a Rafah incursion would cause,” an agency statement said.

Badran charged that Netanyahu’s insistence on attacking Rafah was calculated to “thwart any possibility of concluding an agreement” in the negotiations brokered by Egyptian, Qatari and US mediators.

Israeli air strikes killed several more people in Rafah overnight, Palestinian medics and the civil defense agency said.

One bereaved resident, Sanaa Zoorob, said her sister and six of her nieces and nephews were killed.

Two of the children “were found in pieces in their mother’s embrace,” Zoorob said, appealing for “a permanent ceasefire and a full withdrawal from Gaza.”

The war broke out after Hamas’s October 7 attack on Israel resulted in the deaths of more than 1,170 people, mostly civilians, according to an AFP tally of Israeli official figures.

The militants also took some 250 hostages, of whom Israel estimates 128 remain in Gaza.

The army says 35 of them are dead, including 49-year-old Dror Or, a resident of the badly hit kibbutz Beeri, whose death was confirmed by authorities on Friday.

Israel’s devastating retaliatory campaign has killed at least 34,622 people in Gaza, mostly women and children, according to the Hamas-run territory’s health ministry.

Israel has weathered an international backlash over the spiralling death toll.

Pro-Palestinian protests that have rocked US campuses for weeks were more muted Friday after a series of clashes with police, mass arrests and a stern White House directive to restore order.

But similar demonstrations have spread to campuses in Britain, France, Mexico, Australia and elsewhere.

Turkiye announced on Thursday that it was suspending all trade with Israel, valued by the government at $9.5 billion a year.

President Recep Tayyip Erdogan said the move was intended to “force Israel to agree to a ceasefire and increase the amount of humanitarian aid to enter” Gaza.

Yemen’s Iran-backed Houthi rebels, who have carried out months of attacks on merchant shipping in the Red Sea in a costly blow to maritime trade, said they would extend their attacks on Israel-bound shipping to the Mediterranean “immediately.”

Israel’s siege has pushed many of Gaza’s 2.4 million people to the brink of famine.

US pressure has prompted Israel to facilitate more aid deliveries to Gaza, including through the reopened Erez crossing that leads directly into the hardest-hit north.

Food availability has improved “a little bit,” said the World Health Organization’s representative in the Palestinian territories, Rik Peeperkorn.

But he warned that the threat of famine had “absolutely not” gone away.

Five Israeli human rights groups that took Israel to court over restrictions on aid to war-torn Gaza said the state’s insistence that it has met its obligations was “incomprehensible.”

The government had told the supreme court that the steps it had taken went “above and beyond” its obligations under international law.

Gisha and four other Israeli non-profit organizations retorted that the shortages evident inside Gaza indicated “the respondents are not meeting their obligations, not to the required extent nor at the necessary speed.”

The US-based charity World Central Kitchen resumed operations this week, after suspending them in the aftermath of Israeli drone strikes that killed seven of its staff as they unloaded aid in Gaza on April 1.

The group’s kitchen manager Zakria Yahya Abukuwaik said: “We realized after the kitchen closed that many mouths were left hungry.”

World Central Kitchen was involved in an effort earlier this year to establish a new maritime aid corridor to Gaza from Cyprus to help compensate for dwindling deliveries by land from Israel.

The project suffered a new blow Friday when the US military announced high winds had forced troops working to assemble a temporary aid pier off the Gaza coast to relocate to the Israeli port of Ashdod.

“The partially built pier and military vessels involved in its construction have moved to the Port of Ashdod, where assembly will continue, and will be completed prior to the emplacement of the pier in its intended location when sea states subside,” US Central Command said in a statement.

Several Arab and Western governments have also airdropped aid into northern Gaza. Civil defense spokesman Mahmud Basal said one person was killed and several injured when they were hit by falling pallets.


UN official warns famine in northern Gaza is already ‘full-blown’

Updated 04 May 2024
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UN official warns famine in northern Gaza is already ‘full-blown’

  • Israel has killed more than 34,000 Palestinians since Oct. 7 attacks by Hamas
  • There was no immediate comment from Israel, which controls entrance into Gaza

WASHINGTON: A top UN official said Friday that hard-hit northern Gaza was now in “full-blown famine” after more than six months of war between Israel and Hamas and severe Israeli restrictions on food deliveries to the Palestinian territory.
Cindy McCain, the American director of the UN World Food Program, became the most prominent international official so far to declare that trapped civilians in the most cut-off part of Gaza had gone over the brink into famine.
“It’s horror,” McCain told NBC’s “Meet the Press” in an interview to air Sunday. “There is famine — full-blown famine — in the north, and it’s moving its way south.”

Executive Director of the World Food Programme Cindy McCain delivers a speech at the first meeting of the Global School Meals Coalition in Paris on October 18, 2023. (AFP)

She said a ceasefire and a greatly increased flow of aid through land and sea routes was essential to confronting the growing humanitarian catastrophe in Gaza, home to 2.3 million people.
There was no immediate comment from Israel, which controls entrance into Gaza and says it is beginning to allow in more food and other humanitarian aid through land crossings.
The panel that serves as the internationally recognized monitor for food crises said earlier this year that northern Gaza was on the brink of famine and likely to experience it this month. The next update will not come before this summer.
One of the US Agency for International Development’s humanitarian officials in Gaza told The Associated Press that on-the-ground preparations for a new US-led sea route were on track to bring in more food — including treatment for hundreds of thousands of starving children — by early or mid-May. That’s when the American military expects to finish building a floating pier to receive the shipments.
Ramping up the delivery of aid on the planned US-backed sea route will be gradual as aid groups test the distribution and security arrangements for relief workers, the USAID official said.
The official spoke on condition of anonymity over security concerns for work done in a conflict zone. They were some of the agency’s first comments on the status of preparations for the Biden administration’s $320 million Gaza pier project, for which USAID is helping coordinate on-the-ground security and distribution.
At a factory in rural Georgia on Friday, USAID Administrator Samantha Power pointed to the food crises in Gaza and other parts of the world as she announced a $200 million investment aimed at increasing production of emergency nutritional paste for starving children under 5.
Power spoke to factory workers, peanut farmers and local dignitaries sitting among pallets of the paste at the Mana nonprofit in Fitzgerald. It is one of two factories in the US that produces the nutritional food, which is used in clinical settings and made from ground peanuts, powdered milk, sugar and oil, ready to eat in plastic pouches resembling large ketchup packets.
“This effort, this vision meets the moment,” Power said. “And it could not be more timely, more necessary or more important.”
Under pressure from the US and others, Israeli officials in recent weeks have begun slowly reopening some border crossings for relief shipments.
But aid coming through the sea route, once it’s operational, still will serve only a fraction — half a million people — of those who need help in Gaza. Aid organizations including USAID stress that getting more aid through border crossings is essential to staving off famine.
Children under 5 are among the first to die when wars, droughts or other disasters curtail food. Hospital officials in northern Gaza reported the first deaths from hunger in early March and said most of the dead were children.
Power said the UN has called for 400 metric tons of the nutritional paste “in light of the severe hunger that is pervading across Gaza right now, and the severe, acute humanitarian crisis.” USAID expects to provide a quarter of that, she said.
Globally, she said at the Georgia factory, the treatment made there “will save untold lives, millions of lives.”
USAID is coordinating with the World Food Program and other humanitarian partners and governments on security and distribution for the pier project, while US military forces finish building it. President Joe Biden, under pressure to do more to ease the humanitarian catastrophe in Gaza as the US provides military support for Israel, announced the project in early March.
US Central Command said in a statement Friday that offshore assembly of the floating pier has been temporarily paused due to high winds and sea swells, which caused unsafe conditions for soldiers. The partially built pier and the military vessels involved have gone to Israel’s Port of Ashdod, where the work will continue.
A US official said the high seas will delay the installation for several days, possibly until later next week. The official, who spoke on condition of anonymity to discuss operation details, said the pause could last longer if the bad weather continues because military personnel and divers have to get into the water for the final installation.
The struggles this week with the first aid delivery through a newly reopened land corridor into north Gaza underscored the uncertainty about security and the danger still facing relief workers. Israeli settlers blocked the convoy before it crossed Wednesday. Once inside Gaza, the convoy was commandeered by Hamas militants, before UN officials reclaimed it.
In Gaza, the nutritional treatment for starving children is most urgently needed in the northern part of the Palestinian territory. Civilians have been cut off from most aid supplies, bombarded by Israeli airstrikes and driven into hiding by fighting.
Acute malnutrition rates there among children under 5 have surged from 1 percent before the war to 30 percent five months later, the USAID official said. The official called it the fastest such climb in hunger in recent history, more than in grave conflicts and food shortages in Somalia or South Sudan.
One of the few medical facilities still operating in northern Gaza, Kamal Adwan hospital, is besieged by parents bringing in thousands of children with malnutrition for treatment, the official said. Aid officials believe many more starving children remain unseen and in need, with families unable to bring them through fighting and checkpoints for care.
Saving the gravely malnourished children in particular requires both greatly increased deliveries of aid and sustained calm in fighting, the official said, so that aid workers can set up treatment facilities around the territory and families can safely bring children in for the sustained treatment needed.
 

 


The UN warns Sudan’s warring parties that Darfur risks starvation and death if aid is not allowed in

Updated 04 May 2024
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The UN warns Sudan’s warring parties that Darfur risks starvation and death if aid is not allowed in

  • At least 1.7 million people in Darfur were experiencing emergency levels of hunger in December
  • Sudan plunged into chaos in mid-April 2023, when long-simmering tensions between the military and the paramilitary forces broke out into street battles

UNITED NATIONS: The United Nations food agency warned Sudan’s warring parties Friday that there is a serious risk of widespread starvation and death in Darfur and elsewhere in Sudan if they don’t allow humanitarian aid into the vast western region.
Leni Kinzli, the World Food Programme’s regional spokesperson, said at least 1.7 million people in Darfur were experiencing emergency levels of hunger in December, and the number “is expected to be much higher today.”
“Our calls for humanitarian access to conflict hotspots in Sudan have never been more critical,” she told a virtual UN press conference from Nairobi.
Sudan plunged into chaos in mid-April 2023, when long-simmering tensions between its military led by Gen. Abdel Fattah Burhan, and the paramilitary Rapid Support Forces commanded by Mohammed Hamdan Dagalo, broke out into street battles in the capital, Khartoum. Fighting has spread to other parts of the country, especially urban areas and the Darfur region.
The paramilitary forces, known as the RSF, have gained control of most of Darfur and are besieging El Fasher, the only capital in Darfur they don’t hold, where some 500,000 civilians had taken refuge.
Kinzli said WFP’s partners on the ground report that the situation in El Fasher is “extremely dire” and it’s difficult for civilians wanting to flee the reported RSF bombings and shelling to leave.
She said the violence in El Fasher and surrounding North Darfur is exacerbating the critical humanitarian needs in the entire Darfur region, where crop production for staple cereals like wheat, sorghum and millet is 78 percent less than the five-year average.
On top of the impact of escalating violence, Kinzli said, “WFP is concerned that hunger will increase dramatically as the lean season between harvests sets in and people run out of food.” She said a farmer in El Fasher recently told her that her family had already run out of food stocks and is living day-to-day, an indication that the “lean season,” which usually starts in May, started earlier.
Kinzli said she received photos earlier Friday from colleagues on the ground of severely malnourished children in a camp for displaced people in Central Darfur, as well as older people “who have nothing left but skin and bones.”
“Recent reports from our partners indicate that 20 children have died in recent weeks of malnutrition in that IDP camp,” she said.
“People are resorting to consuming grass and peanut shells,” Kinzli said. “And if assistance doesn’t reach them soon, we risk witnessing widespread starvation and death in Darfur and across other conflict-affected areas in Sudan.”
Kinzli called for “a concerted diplomatic effort by the international community to push the warring parties to provide access and safety guarantees” for humanitarian staff and convoys.
“One year of this devastating conflict in Sudan has created an unprecedented hunger catastrophe and threatens to ignite the world’s largest hunger crisis,” she warned. “With almost 28 million people facing food insecurity across Sudan, South Sudan and Chad, the conflict is spilling over and exacerbating the challenges that we’ve already been facing over the last year.”
In March, Sudanese authorities revoked WFP’s permission to deliver aid from neighboring Chad to West Darfur and Central Darfur from the town of Adre, saying that crossing had been used to transfer weapons to the RSF. Kinzli said restrictions from Sudanese authorities in Port Sudan are also preventing WFP from transporting aid via Adre.
Sudanese authorities approved the delivery of aid from the Chadian town of Tina to North Darfur, but Kinzli said WFP can no longer use that route for security reasons because it goes directly into besieged El Fasher.
On Thursday, gunmen in South Darfur killed two drivers for the International Committee of the Red Cross and injured three ICRC staff members. On Friday, UN humanitarian chief Martin Griffith called the killing of aid works “unconscionable.”
Kinzli said the fighting “and endless bureaucratic hurdles” have prevented WFP from delivering aid to over 700,000 people in Darfur ahead of the rainy season when many roads become impassable.
“WFP currently has 8,000 tons of food supplies ready to move in Chad, ready to transport, but is unable to do so because of these constraints,” she said.
“WFP urgently requires unrestricted access and security guarantees to deliver assistance,” she said. “And we must be able to use the Adre border crossing, and move assistance across front lines from Port Sudan in the east to Darfur so we can reach people in this desperate region.”


Hamas ‘only thing standing between the people of Gaza and a ceasefire’: Blinken

Updated 04 May 2024
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Hamas ‘only thing standing between the people of Gaza and a ceasefire’: Blinken

  • ‘We wait to see whether, in effect, they can take yes for an answer on the ceasefire and release of hostages’
  • But official says US cannot support a major military operation going into Rafah
WASHINGTON: US Secretary of State Antony Blinken said Hamas was the only holdup to a Gaza ceasefire as the militants prepared to send a delegation back to Cairo on Saturday for talks.
“We wait to see whether, in effect, they can take yes for an answer on the ceasefire and release of hostages,” Blinken said late Friday.
“The reality in this moment is the only thing standing between the people of Gaza and a ceasefire is Hamas.”
Blinken pointed to difficulties in negotiating with Hamas, which the United States considers a terrorist group and does not engage with directly and which Israel has vowed to eliminate.
“The leaders of Hamas that we’re indirectly engaged with — through the Qataris, through the Egyptians — are, of course, living outside of Gaza,” Blinken said.
“The ultimate decision-makers are the folks who are actually in Gaza itself with whom none of us have direct contact.”
Blinken was addressing a dinner at the McCain Institute’s Sedona Forum in Arizona two days after meeting Israeli Prime Minister Benjamin Netanyahu and other top leaders on his latest visit to the Middle East.
Ahead of his talks with Blinken, Netanyahu vowed to push ahead with an assault on the southern Gaza city of Rafah to root out Hamas regardless of the outcome of negotiations for a temporary ceasefire that would involve the release of hostages.
President Joe Biden’s administration has repeatedly warned Netanyahu’s government against moving on Rafah, where some 1.4 million Palestinians have taken shelter after fleeing the Israeli assault in response to the October 7 attack by Hamas.
Blinken said that Israel, which counts on the United States for military and diplomatic support, has yet to present “a credible plan to genuinely protect the civilians who are in harm’s way” in Rafah.
“Absent such a plan, we can’t support a major military operation going into Rafah because the damage it would do is beyond what’s acceptable,” Blinken said.

France condemns attack on Red Cross in Sudan

Updated 04 May 2024
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France condemns attack on Red Cross in Sudan

PARIS: France on Friday condemned “in the strongest terms” an attack on an International Committee of the Red Cross convoy in war-torn Sudan that killed two staff and injured three others.
“France calls on all parties to the conflict to respect their obligations under international humanitarian law, which obliges them to protect humanitarian and health staff and guarantee complete, safe and unhindered humanitarian access,” said French foreign ministry spokesman Christophe Lemoine.
The ICRC said gunmen killed two drivers and injured three staff in South Darfur on Thursday as they returned from a humanitarian mission.
A brutal conflict between the Sudanese army led by General Abdel Fattah Al-Burhan and the paramilitary Rapid Support Forces of his ex-deputy Mohamed Hamdan Dagalo has torn the country apart for more than a year.
The war has killed tens of thousands of people and forced millions more to flee their homes in what the United Nations has called the “largest displacement crisis in the world.”
It has also triggered acute food shortages and a humanitarian crisis that has left the northeast African country’s people at risk of starvation.