Patients over politics: Sudanese breast cancer clinic that beat sanctions

Khartoum clinic has persuaded US to lift ban on medical equipment but many other challenges remain

For many women living in Sudan, breast cancer means certain death. Treatment is too expensive or they simply feel too embarrassed to seek help.

But until recently, yet another obstacle was seriously hampering efforts to cut breast cancer deaths in Sudan. Since the early 1990s, the country has been on the US blacklist for state sponsors of terrorism imposed for human rights violations and for harbouring Osama Bin Laden.

Even the Khartoum Breast Care Centre (KBCC), the Horn of Africas first and only dedicated breast cancer clinic, has been hit by the sanctions, with a ban on international money transfers and the restriction on imports of medical equipment and spare parts.

Founded by British-trained Sudanese radiologist Dr Hania Fadl, the KBCC offers hi-tech digital mammography screening for a fraction of the usual price elsewhere. Since it opened in 2010, it has treated more the 18,000 patients from across the region and has received widespread acclaim and international support.

Using private funds and a $14m donation from the charitable foundation run by her ex-husband, Sudanese-British businessman Mo Ibrahim, Fadl has managed its 11-year development from start to finish.

However, the US sanctions meant the centre was unable to buy and maintain crucial diagnostic machinery. In February 2014, it decided to begin a year-long application process for a US Office of Foreign Assets Control (Ofac) exemption, which would make it easier to maintain its General Electric digital mammography machine.

Dr
Dr David Lawis, medical director of KBCC. Photograph: Yassir Bukhari/Elephant Media

During the application process the machine broke down. It ended up being out of action for 10 weeks. The clinic was paralysed, with doctors forced to use alternative screening methods. The problem is the poor women. You do ultrasounds and biopsies but an ultrasound is not an internationally approved screening modality, Fadl says. There are patients and I have to do something, even if theyll put me in jail. I cant let them wait and risk that their cancers spread.

After heavy campaigning and several trips to Washington by Fadl to meet members of Congress, Ofac eventually issued a blanket licence exempting all medical equipment in Sudan from sanctions.

The result was a welcome surprise to doctors at the KBCC, who say the move is a milestone for Sudanese healthcare in that it has put the needs of patients above international politics.

All of our equipment in the clinic is from a US company, General Electric, as are the majority of advanced medical machines in Sudan. For there to be an exemption from sanctions, our lives as doctors will be much easier and the lives our patients will drastically change, says Dr David Lawis, medical director of the KBCC.

Lawis says access to radiotherapy remains a huge issue, with just two machines in the country. One, in Khartoum a hospital, has been broken for about seven months. The second is in Madani hospital, two hours drive from Khartoum.

Anyone who can afford to pay for treatment abroad usually leaves Sudan to get radiotherapy, but the blanket Ofac licence has the potential to change this. People wont have to leave their country to get the treatment they deserve, says Lawis.

Word of mouth

Other challenges remain, however, and Fadl says the battle to educate and inform women about self-examination and the local availability of affordable treatment is the next healthcare frontier.

We did a little survey to ask the women how they heard about us. We found that the most effective, at 49%, was word of mouth. We are still a tribal community: we trust relatives, friends and neighbours who tell us I went to that place and it is good. We dont have that culture of research on the internet, says Fadl.

This was the case for 60-year-old Sudanese patient Fatma Abdelmajid, who regularly takes a six-hour bus from Atbara in north-east Sudan to Khartoum for treatment after a local doctor told her that one of Atbaras boys worked at the KBCC clinic.

Women
Women wait to be seen at the KBCC. Photograph: Yassir Bukhari/Elephant Media

The mentality around breast cancer here is absolutely wrong. When you tell women in the village that youve been diagnosed, they are so disturbed as if youre about to drop dead in front of them. Its really sad, says Abdelmajid.

They tell you, go to a fakeeh [spiritual healer], who will give you herbs and spiritual remedies to treat you. Ignorance is rife and I really hope and pray that women will come to the centre at least for a simple checkup.

While the Sudanese health ministry keeps no full records, Lawis says that breast cancer accounts for approximately 35% of all cancer cases among Sudanese women. An estimated 60% of the 2,000 women diagnosed with breast cancer who die each year could have survived if given proper care.

Fadl strongly believes that stories like Abdelmajids will help end the taboo that often stops women from seeking a diagnosis. A woman who has the experience of being treated should tell her stories, to new patients here at the centre and women in their villages. The best thing is to have these examples and success stories, she says.

Fadl, who lives above the centre in Khartoum, patrols the corridors every day, greeting patients. If I just walk downstairs and see the patients, see their kindness and deep gratitude, I just cant help but want to help them. Sudanese women deserve everything I do really and truly. I cant tell you enough.

Read more: https://www.theguardian.com/world/2016/oct/01/patients-over-politics-sudanese-breast-cancer-clinic-that-beat-sanctions

‘Go smoke free. Stay pretty the health campaigns that havent heard of feminism

From superficial smoking campaigns to ads that attempt to make breast cancer sexy, public health advice for women has got a long way to go…

Hear that sound, all you women of a childbearing age? Its time, running out. Soon your eggs will be past their prime and you will no longer be of any use to society. Even if youre hot! Just ask the Italian government, which recently launched an advertising campaign urging women to get a move on with their baby-making. One poster showed a woman brandishing an hourglass with the caption: Beauty has no age. But fertility does. Feminism: it has come so far.

The ill-conceived ads, launched ahead of Italys first national Fertility Day, were not well received and the campaign has been pulled. Its 2016 and women feel as if they should be treated as more than glorified incubators. Who knew? There were also some suggestions that maybe the government should focus less on reminding women about their ovaries and more on trying to fix issues such as unemployment, paid maternity leave and poor childcare provisions.

Italys fertility publicity may not have worked as intended but it has done a good job of advertising the extent to which womens bodies are still carefully controlled under the guise of public health advice. So, to ensure you are all up to speed with the latest developments on how to safely operate your lady-body, here are a few more examples of campaigns demonstrating an unhealthy interest in womens health.

Booze and babies

Mixing alcohol with oestrogen, women are frequently told, is a recipe for disaster. Drinking will get us raped and/or give us herpes for starters. And if thats not enough to get you to put that glass of merlot down, then wont you think of the unborn children? Earlier this year, Americas Center for Disease Control and Prevention caused widespread ire when it basically said that fertile women shouldnt be drinking unless they were on birth control. A press release explained: Alcohol can permanently harm a developing baby before a woman knows she is pregnant. About half of all pregnancies in the United States are unplanned, and even if planned, most women wont know they are pregnant for the first month or so, when they might still be drinking. The risk is real. Why take the chance?

Ive also heard that walking down the street puts you in danger of getting struck by a car. The risk is real. Of course, I dont mean to underplay foetal alcohol syndrome, but this advice seems to greatly underplay womens common sense. Whats more, its based on highly dubious evidence. A number of studies have shown that light and occasional drinking poses little risk to pregnant women, or their foetuses. In any case, the most frustrating thing about the constant flow of moralising about women and drink is how one-sided it is. Theres been very little health advice to men, after all, about how that one sip of Stella is going to turn you into a rapist with raging syphilis.

Making breast cancer sexy again

Save
Save Second Base T-shirt. Photograph: Save Second Base

Breast cancer is the most common cancer in women worldwide, so it makes sense that a large amount of womens health advice centres on our breasts. What makes less sense, however, is just how fixated on breasts these health campaigns often are. There have been a slew of provocative awareness campaigns centred on messages such as Save Second Base and Save the Ta Tas, for example.

And if breast cancer campaigns arent drowning in tired innuendo about, giggle, boobs, giggle, then they tend not to think further than pink. Indeed, Breast Cancer Action has even coined the term pinkwashing. It defines a pinkwasher as a company or organisation that claims to care about breast cancer by promoting a pink ribbon product, but at the same time produces, manufactures and/or sells products that are linked to the disease.

Superficial smoking campaigns

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Go smoke free. Stay pretty a Queensland government anti-smoking campaign. Photograph: http://ifyousmoke.initiatives.qld.gov.au/

Women only care about their looks, right? You would certainly think so judging by some of the anti-smoking campaigns. An Australian campaign called Your Futures Not Pretty, for example, explains to young female smokers that if they dont put down the cigarettes they might as well kiss their futures (based on men finding them attractive, obviously) goodbye: Go smoke free. Stay pretty. Women are invited to upload a pic to the Future You Smoking Booth and see how old and horrible you could look if you keep smoking. Its a shocking transformation. Being old and female dont let it happen to you!

The dangers of beer goggles

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A Tennessee anti-drink and drive campaign. Photograph: John Partipilo/AP

Even public health campaigns aimed at men seem fixated on passing judgment on a womans appearance. Last year The Highway Safety Office of Tennessee had to apologise over a campaign that warned men about the dangers of drinking and driving through irreverent messages on beer coasters. For example: Buy a drink for a marginally good-looking girl, only to find out shes chatty, clingy and your bosss daughter. Imagine, guys, after drunkenly crashing your car you could wake up to find yourself with horrible injuries and the terrible realisation that youd made out with an ugly girl!

The campaign you havent seen yet

More egregious than any of these campaigns are the ones that dont exist yet. While a large amount of energy is expended on moralising about womens bodies, there is still a shocking lack of research around many womens health issues. For instance, nobody knows exactly how harmful tampons might be because there has been very little research done. Ridiculous as it may seem, this would appear to come down to simple squeamishness and embarrassment society has made menstruation so taboo that science doesnt want to go near it. (The research that has been done has largely been funded by tampon companies, who one imagines arent entirely unbiased.)

Whats more, much medical research still focuses on men and neglects to properly control for female-specific differences. I know, its depressing, right? Still, Im going to have to advise you not to take solace in a glass of wine, particularly if youre not on birth control. Its for your own good.

Read more: https://www.theguardian.com/lifeandstyle/womens-blog/2016/sep/08/go-smoke-free-stay-pretty-the-health-campaigns-that-havent-heard-of-feminism

What it’s like to survive cancer, by those who have done it | Guardian readers and Sarah Marsh

As research shows more people than ever are alive decades after diagnosis, we speak to five people about life after treatment

The chances of surviving cancer are much greater than ever before. In a study published by the charity Macmillan Cancer Support it was found that people are now twice as likely to live at least 10 years after being diagnosed than they were 35 years ago.

Five people shared with us their cancer remission stories and what they learned from the experience.

Stephen Evans, 63, Abu Dhabi: Having come so close to death, I now realise life is short

Stephen
Stephen Evans in 2012

I was surprised by how accepting I was when told I had cancer in 2011. The diagnosis came only a couple of years after my father had suddenly succumbed to lung cancer. At one point I came very close to death as a consequence of leukopoenia, a reduction in the number of white cells in the blood, rather than the cancer itself. Having come so close to losing my life, I now realise life is short and nothing is certain.

My first dose of chemotherapy was dreadful. The oncologist and nurses warned me it would be, but it was still a shock. I felt hot, and nauseous and thrashed about in pain. I wouldve fallen off the bed if the nurses hadnt been hanging on to me. However, after that one episode, ongoing chemotherapy caused me no further problems. In fact, the whole treatment programme was so well managed that eventually I just went back to work and pretty much lived normally.

Ive been in remission since 2014 and I feel pretty good. The cancer may return one day, but Im ready for it I know the symptoms and Im confident prompt treatment will see me OK once more.

Finding out my cancer was gone was not the dramatic moment one might imagine because I could feel I was getting back to normal. I have a clinical background and so I viewed the whole thing quite analytically. When my oncologist told me I now needed only annual check-ups I just went back to normal living like it was no big deal. Its funny really.

Rebecca Palmer, 36, Colchester: One minute I was looking for baby clothing and the next wigs

Becky
Photograph: Becky Palmer

Id gone from being pregnant to having cancer in the space of a matter of weeks one minute I was looking for baby clothing online and the next wigs. I simply didnt have time to be ill and it was a mighty inconvenience to my lovely life.

I had a molar pregnancy a type of gestational trophoblastic tumour that happens when the normal fertilisation of an egg goes wrong. To get cancer as a result of a miscarriage seemed so surreal to me, it actually made the whole thing seem like a very bizarre dream.

Six months of chemo followed and with the help of my husband and incredible nurses and doctors I got through it. My cancer has a very high survival rate, so I wasnt hugely surprised to go into remission. It was the only outcome I expected and I simply wanted to get back to my normal life.

Becky

Im not sure the whole experience taught me anything. I rather suspect Im supposed to say something poignant about life and I am bloody grateful to be here but cancer itself is just a bad bit of my past and has no particular impact on my present. I now have three children and I dont have the time or inclination to give cancer any more of my life.

Robert Barden, 58, Portland: Im still on the road to remission, but feeling positive helps

Robert
Photograph: Robert Barden

I found out that I had lung cancer in the summer of 2011. I was terrified when I heard the news as my stepfather and grandmother both died of it. After the initial shock, I went into a state of denial. Then, I felt determined: I was not going to let my wife and daughters watch me die from this.

Surgery started just a couple weeks after my diagnosis. My lung was collapsed, and there was no time to waste. They removed the lower lobe of my left lung. That was followed by a month of daily radiation treatments, due to a positive test on one of the lymph nodes. It was emotionally draining to realise that I was not out of the woods with surgery alone, but this prepared me for the battle to come. The following two years were met with recurrent tumours requiring the inevitable chemo treatments and more surgery, the last two-and-a-half years ago.

Im still on the road to remission. Ive recently graduated to six month scans, as opposed to three monthly ones, so the prognosis is cautiously optimistic until I reach the five-year mark. But Im halfway there and feel great about it.

Ive learned that a positive attitude and sense of humour is sometimes the only thing that will get you through the day. There were many times when all we could do was laugh or cry, and we most often chose to laugh.

Tom, 43, Hertfordshire: The surgeon said removing my testicle was like getting a Malteser out of the bag

Id known I had testicular cancer before the diagnosis. The lump had been there for months, stubbornly refusing to go away and, by the time I actually mustered the courage to take it to the doctor, the testicle was at least twice normal size. There were only so many possibilities in terms of what was wrong with me and blind optimism has never been my strong point. It was almost a relief to have it confirmed. I had a weekend between diagnosis on the Friday and finding out that the cancer hadnt spread. I spent most of it drunk.

You either learn to laugh at humiliating situations or youll have to crawl under a rock and die of shame somewhere. Before my operation, I had an entire class of medical students have a feel of my diseased nut so that theyd recognise it in future. I dont know how anyone cant see the funny side of that.

I had an orchidectomy, a surgical procedure to remove one testicle. I made the surgeon write on my left leg which ball I was having off, complete with an arrow pointing at the offending gonad. She was the same woman who had charmingly told me what a simple operation it was, like getting the last Malteser out of the bag.

After that, I had the option of one big dose of chemo to be sure. I took it, as I figured it would give me peace of mind. If Id known how it felt, I might not have done. At the risk of stating the obvious, chemo is not pleasant.

Its been over 10 years since I was diagnosed. My life has changed in lots of ways and I wonder if the cancer had something to do with it. I became far more reckless afterwards. Im not sure whether that was as a sort of life is short reaction to what happened. Whatever caused it, that period led to the break-up of my relationship. I cant blame the cancer, but it feels like it was a catalyst. Or it might just be a convenient excuse for my own bloody awful behaviour.

Either way, Ive remarried now and I hardly ever think about the cancer any more. Its still good for the odd comic anecdote here and there, but thats about it.

Kathy, 65, Lancashire: Remission felt like the end of a journey I never thought Id complete

Radiologist
When the cancer came back 12 years later, I opted for a bilateral mastectomy. Photograph: Rui Vieira/PA

The first time I heard the words I wanted to run away rather than face up to what was happening. The doctor was cold, clinical and didnt seem to understand why I was so terrified the nurse tried to tell me that people did survive but nothing made any sense at that point. I just thought, Im going to die.

My bloke, my sister and best friend got me through it. When the cancer came back 12 years later, I opted for a bilateral mastectomy and had both breasts removed. I had bilateral reconstruction with muscle taken from my abdomen during a nine-hour operation. Unfortunately, I haemorrhaged in the recovery room and it took a further two hours to control the bleeding. The reconstruction was wrecked from that point on. Following surgery I had six rounds of chemotherapy, followed by radiotherapy.

When I found out I was in remission it felt like I had finally got to the end of a journey I never thought Id complete. I felt a huge mix of relief and exhaustion. My experience taught me that there are so many brilliant, kind, supportive people in my life, and out there generally. As time goes by Ive realised that if youre here, there may be reasons for that. It sounds like a cliche, but I believe people should live for the moment. Do what you want to do, be where you want to be, and spend time with those who matter to you.

  • Some names have been changed.

Read more: https://www.theguardian.com/commentisfree/2016/aug/03/what-its-like-to-survive-cancer-by-those-who-have-been-given-the-all-clear

Mother With Breast Cancer Announces Last Day Of Breastfeeding In A Beautiful Way

Every mother has her own timeline when it comes to breastfeeding.

Some decide on nursing for a couple months, many months, and some even decide to donate their milk.

New mother Natasha Fogarty had planned to breastfeed for a year, until she received heartbreakingnews that altered her plans. While she was pregnant, Fogarty found a lump on her right side, but dismissed it as an abnormal change due to hormones.

She then gave birth and began to breastfeed her son Milo, but still was aware of the unwavering lump.

She decided to visit anobstetrician who performed a biopsy and discovered that she had Stage 2breast cancer.Through shock and tears, Fogarty scheduled to get a single mastectomy as quickly as possible.

The news was even more bitter because it meant that she would no longer be able to breastfeed her baby.

Though she is currently facing a very difficult ordeal, she still honored her last time breastfeeding withamazingphotos and an emotional post on Breastfeeding Mama Talk.

Check below to read her statement about breastfeeding for the last time, coupled with powerful photos of her and her family.

[H/T: Cosmopolitan]

Click

Natasha Fogarty posted on Facebook:

“My breastfeeding story stopped just Sunday. There are heavy tears in my eyes.”

“I was diagnosed with Stage 2 breast cancer and I am only 29 years old. I had to have a single mastectomy.”

“I wanted and planned to breastfeed for a year. Unfortunately, to save my life, I had to stop. I want any other mom out there going through this to stay strong and positive.”

“I am so blessed to have three breastmilk donors in my life that are giving for free.”

“Sunday, I decided to have a photo shoot to remember my last day breastfeeding. 2:05 a.m. on Monday, as my son fell asleep on my boob, I was sad, but it was peaceful.”

“I was lucky to be able to cherish the last week of our breastfeeding journey. Oh and I dyed my hair pink because I will destroy this cancer!”

“And if you are going through breast cancer, too, and need a shoulder and someone to talk to, I am here! ThanksBreastfeeding Mama Talk!”

Her words may be a bit mournful, but they also emulate her strength and ability to empathize with and inspire others who are going through hard times!

If you love Fogarty’s words and believe in the power of positivity, make sure to SHARE this story with friends and family on Facebook.

Read more: http://www.littlethings.com/mother-announces-last-day-of-breastfeeding/

What You Have to Know About Breast MRI

New Questions About Breast MRI

Women may also help themselves with healthy habits that might help breast cancer prevention, including regular moderate exercise, keeping a healthful weight, and avoBreast-MRI-Breast-MRI-exam-Orange-County-Murrieta-1024x610iding excessive alcohol. Generally, acquiring a wholesome diet and way of life reduces an individual’s chance of growing cancer. Factors that might help breast cancer prevention include breast feeding, keeping a wholesome weight, and normal exercise. Factors which have shown a rise in breast cancer include overweight, hormone therapy, and heightened alcohol consumption. Furthermore, a wholesome diet that has the proper levels of vitamins and minerals is, in addition, vital to the patient battling metastatic breast cancer. Now you know of a number of the benefits of the nutritious diet for patients experiencing metastatic breast cancer, ask your physician or even a certified dietitian for more detailed information.

It’s an incredibly hard day in virtually any woman’s life if she’s found positive for breast cancer. Breast cancer causes are hard to pinpoint. A tumor within the breast never ought to be taken lightly. In that way, an individual can help reduce the likelihood of stage 4 colon cancer forming.

Chemotherapy Treatment

Chemotherapy often uses a mix of drugs (often called anti-cancer” drugs) to kill cancer cells, though just one drug might be used too.  Cancer cells are absolutely just a symptom of the poor diet and also to cure your cancer you need to change your diet plan. Patients afflicted by metastatic breast cancer need to go for much more treatments to battle the illness. From the most up-to-date research in the area of medicine it really is evident there are lots of patients that are suffering from the painful state of brain tumor. Their opinion shouldn’t be taken lightly as they’ll do all they can to offer you the most effective treatment alternatives and support so as to help fight off the disease.

There are special tests that may be made on biopsy samples that may tell whether it’s a melanoma another form of cancer. There are numerous types of Non-Small Cell lung cancer and every type is related to a uniquely different sort of cancer cells. However, if there are just a few cancer cells, this isn’t always true. In this specific article, we’ll only discuss primary breast cancer.

Symptoms are sometimes not present, but might consist of difficulty swallowing, a complete sensation within the abdomen, blockage of the digestive tract or pain within the abdominal area. When the headaches were in the primary stage, they may be preventable, but when the disease enters a severe stage, they’re unstoppable and may even spend the patient’s daily life. Treatments including hormonal therapy and targeted therapy can also be done as a way to avert possible breast cancer metastasis  and also to stop specific hormones from fueling cancer growth.