Breast cancer in Gaza

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Published: 26 Nov 2018
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Shaymaa Al Waheidi - King's College London, London, UK

Shaymaa Al Waheidi speaks to ecancer at the CCLMIC meeting at the Royal Society of Medicine in London, UK.

She discusses the breast cancer survival rates in Gaza, and why this is very low compared to other parts of the world.

Al Waheidi also gives a brief outline of her experience in Gaza, and what she learnt from being there in terms of lack of medicine, but also the problems with supportive care.

Today I gave a talk about breast cancer in Gaza and why the breast cancer survival rate is very low compared to other countries in the Middle East and also almost unrecognisable when it’s compared to countries in the West. I also talked about the fact that the incidence is lower in Gaza but the main problem is breast cancer survival is around 50%. This is mainly because of the lack of treatment facilities in Gaza and also the improper diagnostic facilities. In Gaza we don’t have radiotherapy, for example, chemotherapy is available but intermittently. There are no cancer surgeons who specialise in breast cancer in Gaza and there are no nurses specialised for cancer patients.

There is also a problem in terms of referral outside the country to access radiotherapy that is needed for breast cancer cases in Gaza. Because of the permits issued by the Israeli government and also the Egyptian government for our borders in the south where people in general and patients mainly struggle to access needed treatment outside the country. Also doctors find difficulties to get out of the country to access training and also international volunteers and experts are facing difficulties to come to the country and provided needed training or perform surgeries in the Strip.

So what are the difficulties involved?

According to the WHO, Gaza hospitals had run out of 500 essential medicines and that is 40% of the medications needed in the Palestinian health stock.

What were the key points from your presentation?

The main points were lack of availability of treatment, mainly radiotherapy and chemotherapy. Breast cancer survival is very low and how we can best improve it in societies like Gaza. I also gave a brief description of my experience in Gaza during my data collection period for my PhD study because I’m studying how I can improve breast cancer survival in Gaza. I reflected on the experience I had with women with breast cancer in Gaza, how they engaged with me, how they expressed their difficulties in terms of lack of privacy, for example, in the hospitals; the lack of time they spend with their oncologists; there are no female oncologists in Gaza; issues related to stigma, fear, embarrassment associated with the disease also. I also reflected on the lack of coordination between the hospitals for cancer care in Gaza and how they have different classification systems and recording systems for the medical files. Because of this we faced many difficulties to collect data that we needed. I also talked a bit about the issue of paper-based medical records, there are no computerised records in Gaza and because of this we also faced many difficulties

What’s the future looking like for the treatment of breast cancer in Gaza?

That’s a very tricky question because, first of all, we need to get the diagnosis right for breast cancer cases in Gaza. Most women, according to available evidence, they are diagnosed with very late stages of the disease and this is related to factors such as stigma, fear and embarrassment associated with breast cancer. So awareness of symptoms of breast cancer in Gaza should be the first approach and encouraging women to seek healthcare services when they notice changes in their breasts or any symptoms of the disease.

In terms of treatment we need to push more the international communities to help access of treatment to people in Gaza and encourage more international organisations to support chemotherapy availability and also affordability for people in Gaza.

When will you next be based there?

My next visit to Gaza will be next year, August 2019, and I hope to learn more about breast cancer in Gaza and to get a chance to meet more women diagnosed with the disease and just to learn more about it from them.