While breast cancer is the most common female cancer in the Middle East, many of those affected do not seek medical care. A recent study in the Lancet Oncology found that breast cancer appears in Arab women on average at least 10 years earlier than it does in women in Europe or the United States. Yet when the disease is first discovered, Arab women are found to have a more advanced stage of the disease with larger tumours.
Historically, the region has shown extremely high rates of late presentation – the obstacles facing breast cancer awareness in the Middle East range from lack of access to healthcare in rural areas to the social stigmas against breast cancer screening and the lack of awareness about the disease. Many women do not win their battle with the disease as a result. Those who do seek treatment are often faced with issues including social ostracism and abandonment by family members.
After a self-diagnosis of breast cancer in 2006, Dr Samia al-Amoudi found herself living this truth. An obstetrician, gynaecologist and assistant professor at King Abdulaziz University in Jeddah, Saudi Arabia, Dr al-Amoudi felt the need to speak out about breast cancer while undergoing chemotherapy. “Being just a doctor in a clinic wouldn’t be enough,” says al-Amoudi. “Being a physician and a patient, I felt it was my responsibility and duty to do something – to break the silence.”
She brought the issue into a public forum with her weekly column in Al Mafinah newspaper and regular TV appearances, detailing her struggle with the disease and the importance of early examinations. While going through treatment, her daughter also wrote about her feelings in a book, which al-Amoudi took to schools “to break the taboo of breast cancer, and bring issues to a younger generation.”
“My life has changed a lot, but I have found a new one,” says al-Amoudi, whose efforts to raise awareness of breast cancer have seen her listed on the Power 100 Saudi Arabia list, not to mention onetime US Secretary of State Condoleezza Rice declaring her one of the most courageous women in the world.
Breast cancer rates in the Middle East are actually lower than in the western world. But mortality rates in the Arab world are much higher. According to the World Health Organisation, this is because the region lacks a culture of regular breast cancer screening and therefore, early detection of the disease. “There is a stigma attached to the illness,” says al-Amoudi. Women are terrified of the possibility of a mastectomy and what outcomes this could have, and many worry that their husbands will leave them. “Breaking the silence was not easy in a closed conservative community; many would refuse screening out of fear of knowing they have cancer, because they feel it means sentence of death. This is why my focus was on the new generation is so important. They need to become ambassadors to spread the word and encourage their families [to be aware].”
Despite these challenges, many say that awareness campaigns are having a positive impact in the region. “al-Amoudi’s courage as a single mother and healthcare professional undergoing treatment have inspired countless women to change the way they think about the disease,” says one breast cancer survivor in Jeddah. “The number of women asking for (breast cancer) screening is increasing. There is a tremendous change since 2006,” says al-Amoudi.
In addition to inspiring countless Arab women to have early examinations, al-Amoudi wrote the first book in Saudi Arabia about breast cancer for women who suffer from hearing difficulties, and this year also penned her memoir – a bitter sweet milestone as it also coincided with another breast cancer diagnosis, which Al Amoudi also survived. She’s now working on a project dedicated to women’s’ health empowerment and the rights of breast cancer patients. “I don’t want to see women suffering the way I did. Early detection is the answer. If you don’t want to do it for yourself, do it for your families.”