Have changes in lifestyles in the region over the last decades contributed to an increase in breast cancer?
Certainly, our diets are becoming more westernized and minimal physical activity, are all factors that contribute to ones quality of health. You also have to take into consideration that women are now having children much later in life; in their late 20’s or early 30’s.  The use of Hormone Replacement Therapy may also be a cause for this rise in incidence rates within Arab countries, but more research is definitely required. 

What factors may increase ones risk of developing breast cancer?
To date, the most significant risk factors are age and gender. Women are much more likely to develop breast cancer than men. In Arab countries you’re also seeing the incidence in breast cancer occurring in women at a much younger age. The median age of women who acquire breast cancer in the Middle East is 45-52 years. That is 10 years earlier than in Western women, which is pretty astounding. Also keep in mind that if a mother or sister has it, the person is twice as likely to get it as well. If both have it, then she is three times as likely to be diagnosed with cancer. Despite this most cases of breast cancer in Saudi society occur in women with few or no known risk factors.

Is the government or private sector doing its part to raise awareness of the disease?
Unfortunately, nationally we are still quite scattered. That is why earlier this year the Ministry of Health held numerous meetings in order to start developing a national screening program in collaboration with health institutions and some nongovernmental sources. There are still some issues that need to be ironed out to establish a proper comprehensive national program. There are also philanthropists in the private sector who have taken the initiative to help their community, such as the Abdullatif Center, which was fully donated by Shaik Mohammed Al Abdullatif Al Abdullatif, and despite being a charity center, it has adopted international standards, and offers free services for early detection of breast, cervix, colon and prostate cancers. 

Have you noticed a specific cultural stigma attached to breast cancer in Saudi Arabia?
There are definitely obstacles facing women here, as this is a male dominated society. To begin with there is the basic challenge of facilitating transportation to hospitals. Then there are the cultural challenges as well.  There is a perception that women who take care of themselves are selfish, as well as this passive belief that everything should be left in God’s hands.  This is especially true for uneducated women, who also believe diagnosis may affect the stability of their married life. However, that being said, I have witnessed a major change in women’s mentalities about taking care of oneself, as well as a change in the male attitude towards this matter.

Do women here perceive treatment as a viable option, or are the cosmetic consequences too significant?
Let me just start off by saying that the treatment of all cancers for Saudi patients is free by law. All options are available, but because patients are usually presented in the more advanced stages of the cancer, their options are greatly limited.

All women fear the idea of a Mastectomy—not just in the Arab world.  A woman’s breasts are viewed as part of her female identity, and this is a universal feeling. In my personal experience, older Arab women tend to be more accepting of their fate and more willing to choose mastectomy as a treatment option as they believe it was God ‘s will to have cancer, and thus, treat it accordingly. But the new generation is definitely different and they often opt for the more conservative treatment plan, if their cancer stage allows for it.

Why is it important to have screening centers?
It is important in order to save lives! It’s not just the lives of the women who have the breast cancer, but also the lives and wellbeing of the families who are indirectly affected by the disease. Breast cancer screening has been shown to reduce breast cancer mortality by 30%, while early detection by mammogram improves the survival rate by more than 95%. That is a significant number to consider.

Mammography can detect cancer two years earlier than detection by self-examination or even by a trained physician. Therefore, the presence of screening centers helps to facilitate that early detection. I can really see it making a difference and I encourage all ladies to go and get checked! It is simple practice and every month it doesn’t take more than 20 minutes to examine your breasts. Annually it only requires one visit to the screening center, but it could save your life.

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