A Global Focus on Breast Cancer
Published: October 21, 2013
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To the Editor:
“Poverty and Stigma Give an Edge to Disease” (“The Cancer Divide” series, front page, Oct. 16) illustrates how inadequate cancer care is in Uganda and many other African countries. In fact, at least 19 African countries have absolutely no radiotherapy facilities.
Cancers that are increasingly treatable in developed countries are all too often fatal in developing countries. I have seen the outstanding work many African medical professionals are doing against impossible odds to fight cancer. They, and the patients they are doing their best to help, urgently need support.
This crisis must be addressed with a multipronged international effort to build awareness, develop and equip diagnosis and treatment centers, and train medical professionals.
The International Atomic Energy Agency, together with the World Health Organization, is playing its part by helping to make radiotherapy, medical physics, nuclear medicine and imaging services available to fight cancer in developing countries. But our efforts are just a drop in a vast ocean of human suffering.
The world needs to mobilize its resources against cancer in the same systematic way that it did against AIDS to reduce the incidence of tragic stories like those told so poignantly by your reporter.
YUKIYA AMANO
Director General
International Atomic Energy Agency
Vienna, Oct. 16, 2013
Director General
International Atomic Energy Agency
Vienna, Oct. 16, 2013
To the Editor:
The article about breast cancer in Africa discusses some of the problems as noncontagious diseases are finally being recognized in emerging countries.
In November 2007, I brought an international group of breast cancer specialists to Nairobi, Kenya, to present a weeklong program on breast cancer before a group of physicians, technologists and breast cancer survivors who are now advocates. At the conclusion, we advised them not to do routine mammography screening before surgery, oncology and radiation therapy services were also improved. But we discovered that the first step should be education, of men as well as women.
Several female advocates told us of returning home after breast surgery and being shunned by their husbands as well as prevented from seeing their children. They said most women avoided cancer screening or help for breast problems. They feared being shunned and separated from their families.
My experience with women of the favelas (shanty towns) of Brazil has demonstrated the importance of education before offering breast services for the less educated and less informed.
We should remember that it was not so long ago that a woman who received a diagnosis of breast cancer in the United States felt that it was a stigma and told almost no one.
PHILIP B. KIVITZ
San Francisco, Oct. 16, 2013
San Francisco, Oct. 16, 2013
The writer, medical director of Breast Evaluation Centers International, is an adjunct clinical professor of radiology at Stanford.
To the Editor:
Thanks to The New York Times for restoring real meaning to the “awareness” in Breast Cancer Awareness Month. For far too many Octobers, meaningful conversation has been drowned out by the tidal wave of pink-ribbon products and illuminations of landmarks (like the Empire State Building), none of which have furthered our understanding of the disease one bit.
The sad tale of woeful shortages and high mortality rates in Uganda and elsewhere highlights the benefits of our relative affluence, and credits American initiatives that are trying to share our anticancer resources with colleagues in Africa. But it should also draw attention to the consequences, for breast cancer patients, of economic and geographic inequalities.
These, of course, persist here as well as in Africa even if they are less dramatic and less visible. Unequal access to top-quality medical care costs lives everywhere.
ELLEN LEOPOLD
Cambridge, Mass., Oct. 16, 2013
Cambridge, Mass., Oct. 16, 2013
The writer is the author of “A Darker Ribbon: Breast Cancer, Women and Their Doctors in the Twentieth Century.”
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