Breast Cancer continues to be one of the widest killers in the Kingdom of women. In spite of ongoing efforts, women (and their families) still need to be better educated and aware of the need for regular checkups, self-exams and be pro-active rather than reactive in the fight against breast cancer. I wrote several earlier posts about cancer in the Kingdom and breast cancer:
http://delhi4cats.wordpress.com/2007/10/23/laura-bush-breast-cancer-awareness/
http://delhi4cats.wordpress.com/2007/10/18/cancer-in-the-kingdom/
I do not wish to repeat what I have already written but will share additional observations I have recently learned as related to breast cancer. While an uphill climb continues to make women in the Kingdom proactive for preventing breast cancer such as self-exams, regular checkups and mammograms, it is not only the women who have to better educated on prevention of the disease but the society to include health care establishments which have to change their patterns as well. For example, I know a woman who is proactive and due to a family history with cancer, will routinely do self-exams as well as receive yearly mammograms. However one time she did discover a lump in one of her breasts. The attending doctor completed a mammogram request stating a lump had been identified and the mammogram should be done on a priority basis.
Now what exactly is the definition of priority? According to the American Heritage Dictionary: pri·or·i·ty
<!–[if !supportLists]–>1. <!–[endif]–>Precedence, especially established by order of importance or urgency.
<!–[if !supportLists]–>2. <!–[endif]–>
<!–[if !supportLists]–>a. <!–[endif]–>An established right to precedence.
<!–[if !supportLists]–>b. <!–[endif]–>An authoritative rating that establishes such precedence.
<!–[if !supportLists]–>3. <!–[endif]–>A preceding or coming earlier in time.
<!–[if !supportLists]–>4. <!–[endif]–>Something afforded or deserving prior attention.
I see the words importance, urgency, right to precedence…. Yet when this woman went to the diagnostic imaging department of a well-known hospital with this request from the doctor, she was advised it would take 4-6 months before she could be given an appointment for a mammogram. Naturally she was shocked and outraged and ensured that the department realized a lump had been detected in her breast and that 4-6 months could make a big difference in her prognosis. Their response was they were very sorry and understood her urgency and that perhaps she might want to visit a private clinic where perhaps she could have an appointment sooner.
Now the woman’s health care program and medical files were with this major hospital so her preference was to get treated where she was entitled to treatment. Also going to a private clinic would require paying a hefty fee too.
To cut to the chase here, the woman did get her appointment but only after using Wasta. She was fortunate to know some doctors in established positions at the institution who made calls on her behalf so she could be seen and given the mammogram. And yes, she learned that she will require immediate surgery.
But what about the average individual? What about the Bedu woman who is likely already timid about coming to a doctor for such a personal and sensitive matter? Chances are if she were told to wait 4-6 months she likely would not come back at all.
Breast cancer still remains a subject which many Saudi women (and particularly tribal and bedu) are ashamed to talk about. A young woman who has not been educated will be afraid and ashamed to point out that she may have a problem. She would likely go to great lengths to conceal it as she would believe herself to be defected. Continual efforts must take place to educate the women and their families to be proactive. Good health is one of our most precious gifts. Don’t lose it.
Filed under: America, culture, gender, Saudi Arabia, Saudi culture, Saudi customs, travel, Uncategorized
Thank goodness your friend had ‘WASTA’ and had everything arranged. Yes, the average woman probably would turn away and never go back until it was too late. Women, in general, sense something is wrong, but many times are afraid to go in. This sad treatment will only make matters worse.
In Orlando, Florida, at ORMC, each Wednesday morning, a woman can make an appointment to have a mammogram…then a sonagram if needed, see the radiologist right then who will tell you if there is anything needed, and then there is a surgeon there to speak to and set up an appointment if that is necessary. A cancer specialist doctor in Orlando told me that these Wednesdays save about 6 to 8 months for most patients (by the time they have all their appointments and readings done) and can mean the difference between life and death for those who actually have/find cancer and get treated right away. Something needs to change in KSA…..and quick!
I agree American2Saudi. Learning of the “system” just reinforces that breast cancer awareness is not only about educating the women!!!!
Breast Cancer remains the number one killer of women in the Kingdom and sadly, until awareness and availability for prompt care exist, it will likely remain the number one killer.
I just wish to add to my previous comment, the care and facilities are here in the Kingdom. Good care, expert care, state-of-the-art equipment and facilities exist. The issue is of getting through to these resources in time.
What is the medical/health care insurance like in the Kingdom? Are you aware of the difficulties of the American system opposed to the Canadian one? Which would prefer? Do you have a preference of health care initiatives from the presidential candidates? Does Saudis carry national health insurance etc? Is it privately owned? Do they have to option to go abroad for their healthcare?
Medical/health care insurance is available but spotty in the Kingdom. It really depends who one is working for, where one is from, nationalities…some employers provide health insurance, some do not. Private plans are available but probably like many places, costly.
Don’t get me started on the American system…it continues to worsen. While one may have to wait longer for care here in KSA once the care is provided, it is first class and one does not feel rushed or “depersonalized.”
Some Saudis will go abroad for certain kinds of health care treatment. Excellent doctors are here but they may choose to go abroad due to the purpose of treatment or simply prefering the more amenable surroundings if a long stay is required in a hospital.
On the other hand, if one has Siamese twins which need separated, this is the best place in the world to come to and this is an area where the Kingdom excels. All separations have been done as acts of humanitarism.
[...] GruntDoc wrote an interesting post today onHere’s a quick excerptBreast Cancer continues to be one of the widest killers in the Kingdom of women. In spite of ongoing efforts, women (and their families) still need to be better educated and aware of the need for regular checkups, self-exams and be … [...]
Interesting article. What I can’t understand is why is breast cancer so prevalent now?
Is there any scientific reason for the increase we’ve seen worldwide?
Interesting article. What I can’t understand is why is breast cancer so prevalent now?
Is there any scientific reason for the increase we’ve seen worldwide?
I cannot explain for a worldwide increase but I shared my views in the article on why I think it is so prevalent in KSA. I’m certainly more than ready to be very vocal on this topic since proper and timely exams can indeed make the difference between life and death. On these issues there is no excuse for a head in the sand.
I thought I felt a lumpy thing a few years ago and was checked out the next day. Was nothing btw.
It’s in my family too. And three of my best friends are recovering or still dealing with surgery.
I wonder if it is a sudden surge, or rather that it is recognised and diagnosed now.
Especially with breastcancer timely treatment really does mean the difference between life and death!
The American system may, indeed, continue to get worse, but the difference in treatment (I believe) is not about American/nonAmerican, but about public/private health care. Public– that means national– care has a reputation for just the kinds of delays this woman would have faced had she not used wasta.
Here in America, my father loved his VA hospital (which gives excellent treatment, when you get it), but it sent him to the end of the line for every diagnostic procedure he needed. His cancer treatment was delayed by months. Finally, we compelled him to go to a private (that means expensive) facility.
There, within one day, he received every procedure he needed, and was placed on a chemo/radiation regimen, which probably extended his life by months, if not a year.
Interestingly, he was also placed in a clinical trial to evaluate the efficacy of migrating the breast cancer protocal to bladder cancer. The decisive factor in the kind of treatment a breast cancer patient needed was whether the patient was positive for the gene (protein) HER-2neu.
Positiive breast cancer patients had a poorer prognosis. The gene is also found in bladder cancer. My father was positive.
In the Kingdom I believe part of the difference is public versus private but also educational awareness remains an issue too.
In the US it is not only public versus private but what kind of insurance one has as well. I am not an advocate of the US health care system in regards to insurance and to a degree, handling of patients. The state-of-the-art and the expertise is there certainly but I see the patient becoming more and more a commodity (depending on insurance) and treated like a number rather than an individual.
Well, the insurance business is an absolute mess, but even within that system, the public/private dichotomy can be seen in the difference between HMOs and traditional insurance.
As for education, yes, that’s always an issue, especially re: private parts of the body.
I must mention, though, that I was never treated as an individual during my visits to clinics in the Kingdom, except at KFSH. I dreaded going to any doctor after I could no longer go to KFSH. We (my family) became either a commodity or a bother, depending upon the facility. Unless things have changed since I’ve been gone, I daresay one must have a thick skin to get treatment there.
Getting back on subject, have you seen an awareness of the more aggressive nature of breast cancer when positive for the HER-2neu gene?
In fact our modern world has so many marvellous technical methods in healthcare – but few people get them when they really need.
So if you are a “normal” patient, you may be dead when you get your appointment. And breast cancer is indeed nothing for waiting …
But this is the same story, wherever you go in our modern “civilization”. People with money still have a better health care. Thats a fact.
Marahm, I can say that my experiences (as a patient) in regards to health care in the Kingdom have been very positive. I feel I am treated as an individual and given significantly more time with a physician than what one would receive in the States.
When you are referring to the HER-2neu gene, is this one of the two genes when conducting the Brac 1 and Brac 2 test? If so, these tests are conducted in the Kingdom. I’m not a medical professional so I cannot comment more than that.
I was impressed with the Saudi hospitals seperating siamese twins on a humanitarian basis.
Also, the U.S. medical system is absolutely wonderful—if you have the funds to pay for it, or have an excellent health insurance, which may, or may not cover all the expenses.
It’s good to hear you’re in good hands over there.
And actually, it is not “Saudi hospitals” separating the Siamese twins but specifically National Guard Health Affairs in Riyadh. It’s undertakings in this area have been incredible.
I will agree Janice that if one has the funds, the US healthcare system is excellent.
If KFSH has maintained its reputation for cutting edge medical technology, I would expect that it (as well as other hospitals) in the Kingdom does test for this gene.
I do not know about the Brac 1 and Brac 2 tests. I do not know much about cancer, as my only experience with it has been with my father’s illness.
Well, now that I am back online, this post was very personal. I can say that the Kingdom has excellent care and treatment — ONCE the appointments are made.
King Faisal Specialist Hospital, National Guard Health Affairs, Military Hospital, Defense Forces Hospital, King Khalid University Hospital, King Khalid Eye Hospital are all excellent institutions. They are each known for their individual specialities.
Cancer would likely be King Faisal but that does not mean in any way the care and treatment at the others is less. I was treated at National Guard Health Affairs and cannot say enough positive about the care, the compassion, the professionalism and treatment. If one has to undertake such care and treatment in the Kingdom, do not be alarmed because it is taking place in KSA.
On a closing note, I strongly strongly urge ALL women, GET REGULAR MAMMOGRAMS!!! I found a lump doing a self exam but at the same time, when I had the mammogram, other areas were detected which could only be identified via a mammogram. Regular mammograms and check ups can and do mean a significant difference in prognosis and options.