Raising cancer awareness to achieve earlier diagnosis for patients in Myanmar

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Published: 4 Sep 2023
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Prof Yin Yin Htun - President, Shwe Yaung Hnin Si Cancer Foundation, Myanmar

Prof Yin Yin Htun speaks to ecancer at SEABCS 2023 about the Shwe Yaung Hnin Si Cancer Foundation, which aims to raise cancer awareness to achieve earlier diagnosis for patients in Myanmar.

The Shwe Yaung Hnin Si Cancer Foundation's vision is that all those in need will have access to the best cancer care and support available, through effective health education, emotional support and possible financial assistance.

In the pre-covid period, the foundation offered cancer education awareness outreach programmes, talks on common cancers such as breast, cervical and oral and on-site screening programmes run by expert volunteers. In the post-covid era, they have moved their talks and symposiums online.

Prof Htun explains in Myanmar one of the main challenges of raising cancer awareness is that people tend avoid approaching the topic. Another challenge the foundation is working toward improving is the accessibility of cancer awareness tools for people in hard to reach areas.

She concludes by focusing on the future plans for the foundation.

I’m extremely glad to be back in Huế which was the first to host the South-East Asia Breast Cancer Symposium back in 2016. From this event it inspired and enabled us to hold the second South-East Asia Breast Cancer Symposium in our country, Myanmar, in 2017. I would like to continue talking about our foundation which is the non-profit organisation dedicated to cancer awareness among the people of Myanmar which is of the utmost importance to get earlier diagnosis for the better outcomes. 

What we do mainly is the advocacy and empowering people, for example empowering women to do breast self-examination manually because are a LMIC country and we don’t have any organised screening programme. But we are helping out to be able to access to the mammogram free of charge at times. Also we are focussing on the patient advocacy, patient engagement and patient support as well.

What current programmes or events are you working on?

To achieve our objectives and strategies, most importantly we do have education, cancer awareness outreach programmes, pre-COVID era and going to the hard to reach areas, giving talks on the common cancers like breast, cervical cancer, colorectal cancers and oral cancers. Also we do helping with the on-site screening programmes – for example, we do according to the WHO Surviving Cancer VIA screening and if the woman is assessed to be positive we would do cryotherapy on site for the past nearly ten years. 

For the oral screening in our country it’s common because we have betel chewers. So we can also detect the precancerous lesions. We integrated for breast, cervix and oral on-site at the same time with the expert volunteers from our foundation. Also we integrated with the non-communicable diseases like measuring BMI, measuring blood pressure, blood sugar, and we would offer testing for hepatitis B, the hepatits antigen blood test.

So that is in the pre-COVID era but during COVID and the post-COVID era, like in any parts of the world, we had to go virtual. So we are doing online health education and cancer awareness talks, symposiums, train operative courses etc. We are a UICC member, full member, and so we would do World Cancer Day activities since 2015 when we became a full-time member. We achieved the World Cancer Day Spirit Award finalist in 2018 together with the Poland and Cyprus organisations. That time the winner was the Pink and Blue organisation from Nigeria. We would use the World Cancer Day themes like ‘We can. I can’, ‘I am and I will’ and now we are ongoing activities for the Closer Care campaign from the UICC each World Cancer Day.

Another thing is collaboration and cooperation is the key to success. So we are collaborating with the WHO, UICC Global Focus on Cancer and also with the other international partners and local partners as well. Also we would like to do research activities and we would present it in the World Cancer Congresses and have been published, some of the papers, in the Journal of Global Oncology as well. So we are trying our best, despite challenges and barriers.

What are the difficulties in raising awareness of cancer in Myanmar?

Awareness is the key to early detection but even that awareness is the challenge. Because, in our country, the main challenge is the people tend to have traditional medicine and, simply, they don’t want to hear about the cancer word. So if you are going to talk about awareness only on cancer, if you want to find early enough cancers, they will not be happy enough. So we do this barrier by doing other NCDs like hypertension, diabetes, etc. so they are willing to come forward. Then we will talk about cancer and education as well as do some breast self-examination teaching and, as I mentioned, cervical cancer screening as well.

Another thing is we have some hard-to-reach areas so the accessibility is not that strong, and the resources, the trained human resources, with our own languages, we need cancer education materials, we are trying to do that. And the media, we are using various platforms from the TV channels, through the radio; radio can reach throughout the whole country but it’s just audio. For the digital media and the IT, most young people have smartphones so we are reaching out from that era to overcome that.  And each and every project unit costs and funding, so that is also a barrier.

How is the foundation funded?

Our foundation, whichever activities you do, we have actually open [inaudible]. Everything free of charge – daycare, chemotherapy service – for the breast cancer patients and the colorectal cancer patients. It’s been now eight years and we’ve treated 100,000 patients, everything free of charge up until now. 

So, where has the funding come from? It is from the Myanmar people, they are interested in [inaudible] and they would like to donate for whenever their birthdays or for commemoration days and many from the cancer families. We would put the money in the bank and then only the interest we are going to use. But, surprisingly, our foundation has been founded for nearly ten years; by December we are going to celebrate our tenth anniversary. From the very seed money it has been sixty times raised by now. So from the local organisations we have and for the fundraising, whenever we go to the community events we will do some fundraising, something like a funfair. We are raising awareness, in other words, they would like to donate more.

What are the common cancer types in Myanmar?

Like in every part of the world, in women breast is number one and cervical cancer is there. For the men lung is still number one. In our country, because of the betel, alcohol and tobacco, oral cancer is coming up. Also because in our country there is hepatitis B and hepatitis C so we are seeing liver cancer patients as well. Stomach is also quite high as well as colorectal cancers.

Does Myanmar have an HPV vaccination scheme?

With the aid of GAVI for the nine to eleven years girls the cervical vaccine has been put for the schoolgirls, pre-COVID era. We have to welcome the single dose cervical vaccine so that the expenses will be low for the out-of-pocket families.

What future plans does the foundation have?

Our mission is dedicated to improve awareness among the people of Myanmar so we would like improvements in the cancer awareness programmes. We are focussing on the family focus cancer prevention and early detection because in Myanmar, our Asian people, the family model is towards the extended family members looking after the grandparents and the children and relatives. 

Another thing, we are focussing for the next generation young people so that they will become the emerging volunteer leaders. So we have to create the interest of the young people to do volunteering work. Because in our foundation we all are volunteers, we don’t have any paid, salaried staff. So we are focussing on the family focus and young volunteers for the sustainability of our foundation. So we are doing that.

Thank you so much for organising for this interview for ecancer and the organising committee of the 2023 South-East Asia Breast Cancer Symposium. Our foundation is looking forward to learn more and to do more collaboration work for the people of, not only our country, for the region as well as we wish everyone free of cancer. That’s it, thank you so much.