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drugs only because of the fact they have not enough money for the prescription charges - campaigners warns.

According to Charity Breast Cancer Care, 42% of breast cancer patients, which is almost a half, had financial problems as they were forced to pay prescriptions charges for their medicine.
Patients ill with cancer do not receive treatment with vital drugs only because of the fact they have not enough money for the prescription charges - campaigners warns.
According to Charity Breast Cancer Care, 42% of breast cancer patients, which is almost a half, had financial problems as they were forced to pay prescriptions charges for their medicine.
In England and Scotland 164 women participated in the survey and 15% of them declared they had not taken the drugs to hold the recurrence of the cancer simply because the cost of it was too high.
Breast Cancer Care has introduced a campaign - Prescription for Change - and is trying to influence on the Government to cancel prescription charges for cancer treatment. Those people who fulfil certain medical conditions (e.g. diabetes and those who suffer from some kinds of epilepsy) already receive free prescriptions.
The survey, conducted by the charity, discovered that the yearly cost of prescriptions for patients ill with breast cancer started from around “90 and finished in about hundreds of pounds! Obviously, the heaviest costs had patients who were forced to take a number of medicine for several years” e.g. those put on a treatment courses lasting up to 10 years.
The charity stated that the financial hardship could hit patients suffering from advanced or terminal phases of cancer, who might be forced to quit work and live on a lower earnings.
Breast Cancer Care’s chief executive, Christine Fogg, stated: “Thankfully more people with cancer are now surviving than ever before but many are now being treated long term which comes at a price. Prescription charges, on top of all the added costs that can come with cancer can place enormous strain on individuals and families. After 40 years it’s time for change. The Government must commit to an urgent review of the current list of exemptions. No-one should ever be forced to pay prescription charges for what may be life-saving treatment.””>Patients ill with cancer do not receive treatment with vital drugs only because of the fact they have not enough money for the prescription charges - campaigners warns.
According to Charity Breast Cancer Care, 42% of breast cancer patients, which is almost a half, had financial problems as they were forced to pay prescriptions charges for their medicine.
Patients ill with cancer do not receive treatment with vital drugs only because of the fact they have not enough money for the prescription charges - campaigners warns.
According to Charity Breast Cancer Care, 42% of breast cancer patients, which is almost a half, had financial problems as they were forced to pay prescriptions charges for their medicine.
In England and Scotland 164 women participated in the survey and 15% of them declared they had not taken the drugs to hold the recurrence of the cancer simply because the cost of it was too high.
Breast Cancer Care has introduced a campaign - Prescription for Change - and is trying to influence on the Government to cancel prescription charges for cancer treatment. Those people who fulfil certain medical conditions (e.g. diabetes and those who suffer from some kinds of epilepsy) already receive free prescriptions.
The survey, conducted by the charity, discovered that the yearly cost of prescriptions for patients ill with breast cancer started from around “90 and finished in about hundreds of pounds! Obviously, the heaviest costs had patients who were forced to take a number of medicine for several years” e.g. those put on a treatment courses lasting up to 10 years.
The charity stated that the financial hardship could hit patients suffering from advanced or terminal phases of cancer, who might be forced to quit work and live on a lower earnings.
Breast Cancer Care’s chief executive, Christine Fogg, stated: “Thankfully more people with cancer are now surviving than ever before but many are now being treated long term which comes at a price. Prescription charges, on top of all the added costs that can come with cancer can place enormous strain on individuals and families. After 40 years it’s time for change. The Government must commit to an urgent review of the current list of exemptions. No-one should ever be forced to pay prescription charges for what may be life-saving treatment.”

by PAUL DOUGLAS

October is National Breast Cancer Awareness Month - the perfect opportunity and the perfect excuse to promote breast cancer awareness in your workplace.
But to increase awareness you first have to get people’s attention, and one of the best ways to make people stand up and take notice is through planning a memorable and distinct awareness campaign.

First off - decorate. Pink is the color of breast cancer awareness, but it’s not just a matter of ribbons. Start with your own cubicle or office. Infuse a refreshing blush into the earthy oranges of autumn. Whether your style calls for tulle and taffeta, tissue and bows or construction paper and crayons, brighten up your work space with soft shades of pink. And check with your supervisors to see if you can decorate other parts of the office: windows, doorways, the lunchroom or the reception area. The more pink, the better, and encourage your co-workers to decorate too.

The next step is to provide information. Find out if you can set up a breast cancer resource center in the workplace. A desk, a bulletin board, a section of wall - the nature of the space matters less than its visibility and accessibility. Decorate this area too, but more important here is the availability of informative and supportive material. Fill the space with posters and pamphlets. Provide contact details for local breast cancer resources, including support groups and mammography facilities.

You may even want to dedicate the space in honor of a breast cancer survivor, or in memory of someone who has had breast cancer. The company’s intranet is another good location for this kind of recognition or memorial space. You could put up a page where employees can share their stories and experiences, or post messages in honor of breast cancer patients they have known. Your business could even have breast cancer awareness messages printed on its pay stubs or promotional material for the month.

Every great awareness campaign needs an event, so don’t forget to plan something special to catch people’s notice and get them involved. Get a speaker in for a lunch and learn - a breast cancer survivor or activist, or a health care worker from a local cancer treatment center or mammography facility. Plan a pink themed day; make it Hawaiian or beach wear so everyone can dress down for a donation, and cap it off with a rose-colored meal, like a pink potluck lunch.

The basic steps involved in raising breast cancer awareness at your workplace this month may be fairly standard but the creativity lies in details, and there’s no limit where your imagination can take you. Make this month - and this issue - one to remember.

by KRISTEN KELLY

African-American women with breast cancer were more likely to have larger, later-stage tumors that were more difficult to treat and also had lower survival rates than Hispanic and Caucasian women who received the same treatment in two independent series of clinical trials examined by researchers from The University of Texas M. D. Anderson Cancer Center.

The analysis published on line Oct. 23 by Cancer, a peer-reviewed journal of the American Cancer Society, indicates that race is associated with unfavorable tumor biology, which, along with other factors, likely contributes to the lower rate of breast cancer survival among African-Americans.

“These findings should prompt additional research on how we can improve outcomes for African-American patients by understanding and addressing tumor biology,” says first author Wendy Woodward, M.D., Ph.D., assistant professor of radiation oncology at M. D. Anderson. “It’s important to identify unique features in different populations and subgroups of all women with breast cancer so we can understand a woman’s risk and factors that affect her care on an individual level.”

African-American women are less likely than Caucasian women to have breast cancer but are more likely to die from it. Many factors have been implicated in this disparity, the researchers note, including access to health care and screening, differing treatments, socioeconomic status and racial bias.

By examining two series of clinical trials in which treatment was specified and rigorously followed for all patients, the research team minimized biases related to access to care and type of treatment, two variables that often confound analysis of the issue.

Between 1975 and 2000, 2,140 breast cancer patients were treated in two prospective series of clinical trials at M. D. Anderson involving use of the chemotherapy doxorubicin before and after a radical or modified radical mastectomy.

Of the total patients, 1,590 were Caucasian, 300 were Hispanic, and 250 were African-American, with racial categories based on self-reporting by the patients. In both trials, African-American women received at least as many cycles of chemotherapy as did Hispanics and Caucasians.

In the clinical trial for post-operative chemotherapy, the 10-year overall survival rate for African-Americans was 52 percent. For Hispanics and Caucasians it was 62 percent.

More African-American women came to the trial with later stage disease (24 percent compared with 18 percent of Hispanics and 16 percent of Caucasians) and tumors greater than 5 centimeters (22 percent compared with 13 percent each for Hispanic and Caucasians). African-Americans were more likely to have tumors that were estrogen-receptor negative, which are considered more difficult to treat (41 percent compared with 32 percent for Hispanics and 33 percent for Caucasians).

The trial of pre-operative chemotherapy showed similar results, with African-American 10-year survival rate of 40 percent, compared with 56 percent for Hispanics and 54 percent for Caucasians. As in the post-operative trial, higher percentages of African-Americans came to the trial with later-stage disease, larger tumors, and estrogen-receptor negative disease.

A multivariable analysis that took into account age, estrogen receptor-negative status, primary tumor size, and whether the disease had spread to the lymph nodes, showed that African-American race is an independent factor in reduced overall survival rate.

The researchers note they could not take into account factors that might have influenced the patients’ care before they entered the clinical trials. And their analysis did not include socioeconomic factors because that information was not available for patients. However, they doubt socioeconomic factors could fully explain differences in survival rate because Hispanic and African-American women have similar socioeconomic status in M. D. Anderson’s patient referral area.

“We interpret these data as suggesting that intrinsic biological differences in the disease and response to treatment among racial groups contributed to the poorer overall survival rates seen in the African-American cohorts,” the researchers conclude.

“It’s important to note that African-Americans, and people in all self-reported racial groups, are genetically and culturally diverse,” Woodward says. “Not all African-American women will have worse survival prospects for breast cancer, but there are probably subsets of patients for whom we could be doing something better.

“The tools and technology are emerging that will allow us to understand how one person’s tumors differ from another and how we can more effectively assign people to treatments,” Woodward says.

Elderly patients with breast cancer who received care in a community hospital setting may have been under-diagnosed, under-staged and under-treated, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.

The number of older breast cancer patients has increased along with overall elderly population, according to background information in the article. About half of breast cancer patients are older than 65 years and 35 percent are older than 70; 77 percent of breast cancer deaths occur in women older than 55. Choosing the appropriate treatment for older patients is a challenge, because many have other serious illnesses in addition to their cancer that may threaten their health and shorten their lives. Questions remain about the best screening protocols for elderly women, as well. Some current guidelines suggest that women stop having mammograms at age 70, while others provide no upper limit.

David A. Litvak, M.D., then of Michigan State University, Lansing, and now at Kaiser Permanente Medical Center, Orange County, Calif., and Rajeev Arora, M.D., used a tumor registry database to identify 354 women age 70 or older who were diagnosed with breast cancer between 1992 and 2002 at a community hospital. The researchers studied the group of women as a whole and also divided them into three age groups for analysis: ages 70 to 74 (136 patients), 75 to 79 (115 patients) and 80 or older (103 patients).

Overall, 46 percent of the patients came to their physician with breast cancer that could be felt during a physical examination. Although 72 percent of all the women and 60 percent of those age 80 and older had mammograms, they were mainly used to verify the results of the physical exam–mammograms uncovered previously undetected breast cancer in only 54 percent of the patients, including 38 percent of those 80 years or older. More than 70 percent of patients were in the early stages of cancer, stages I and II, at diagnosis, but evaluation of the lymph nodes to thoroughly assess the cancer’s progression was omitted in 36 percent of the cases (56 percent of those in women 80 or older).

About half of the women received breast-conserving surgery; however, rates of chemotherapy, radiation and hormonal therapy were lower than would be expected and were lowest among the oldest women. For example, 12 percent of all patients, 19 percent of those age 70 to 74 and 5 percent of those older than 80 underwent chemotherapy. “We also noted omissions of treatment in patients with indications for adjuvant [combination] treatment,” including those whose cancer had spread to the their lymph nodes or who had estrogen receptor-positive tumors, the authors write. “All together, 70 patients (20 percent) had positive lymph nodes. Of these patients, 29 percent received chemotherapy. Moreover, only 17 percent of patients age 80 years or older received chemotherapy in the presence of lymph node disease, significantly less than the 70- to 74-year age group.”

Although the results of this study do not confirm that these diagnosis and treatment patterns in older women lead to worse health, other evidence suggests this is the case, they continue. “Contrary to many physicians’ beliefs, the data suggest that fit older patients derive the same benefits from treatment as do their younger counterparts,” the authors conclude. “The cornerstone of treatment of older breast cancer patients is an adequate geriatric assessment that helps estimate life expectancy and predict tolerance of treatment. Treatment strategies then ought to be individualized based on this assessment.” Screening guidelines should also be customized to the patient; those who expect to live more than five additional years should continue having mammograms, they write.

OCTOBER is Breast Cancer Awareness Month. What is the message during the month? Breast lumps are very common in women but some of these lumps can be dangerous. In most cases when such lumps are identified, they are removed and examined by the doctor to determine whether they are cancerous or not.

When found cancerous the immediate advise is to undergo the treatment
A diagnosis of cancer often elicits feelings of shock, fear and despair. This is not surprising because cancer is one of the killer diseases.

In Uganda, it is estimated that 85 percent of the breast cancer patients die within two-three years after the treatment. So being diagnosed with breast cancer is assumed to be synonymous with a death sentence. This attitude is partly due to low levels of awareness about cancer in general, and breast cancer in particular, which results in late reporting to health workers. These scary statistics do in turn contribute to the fear and despair exhibited by the patients, their families and friends.

For example, in Uganda one of the most commonly used methods of treating breast cancer is mastectomy (cutting off the affected breasts), which is usually followed by radiotherapy (burning of the cancer area with X-ray) and chemotherapy (treating using anti-cancer drugs). Like any treatment, there are side effects. In the case of chemotherapy, there is often the loss of hair, discolouring of the nails and sometimes loss of appetite and vomiting. These conditions disappear after treatment.

However, because of low levels of awareness, many newly diagnosed patients lose time before accepting to undertake treatment. The notion of having one breast or none makes patients go from one doctor to another in search of another opinion. If the second opinion is the same, it may be accepted at a price; the cancer may have spread to other parts of the body and difficult to stop.

The social environment can be equally scary. Some friends and relatives do not help the situation. They advise the patient not to have mastectomy and instead take them to herbalists, prayer groups and sometimes witch doctors. They tell married patients that their husbands will desert them. The unmarried ones are told that no man will marry them if they undergo mastectomy. Some clan leaders advise that such treatment will spell a curse on the clan such that their girls and boys will have difficulty finding suitors. They will be considered as outcasts.

The above fears and stigma are understandable in our circumstances where, in addition to low levels of awareness, the health system is not adequately equipped to handle breast cancer. For example, the few available facilities such as mammography machines, a functional radiotherapy centre and chemotherapy centre are all based in Kampala. In addition, cancer is not a priority like HIV/AIDs and malaria. These inadequacies therefore require women to be vigilant and play their part so as to help in reducing the incidence of death due to breast cancer.

Let all women be watchful over their breasts and do routine breast self examination every month. Get to know the size, shape and feel of your breasts. In that way any unusual lumps can be felt. In addition, let women take interest in seeking information related to the health of breasts. For example, women above 40 years of age should have a mammography every year. A mammography is an X-ray that can detect breast cancer before the lump is even obvious. It is currently the best way of detecting breast cancer.

Friends and relatives should give support to their loved ones who have been diagnosed with breast cancer. Encourage them to undergo treatment. Mastectomy and other modes do not deter one from conceiving and having a baby after. Remember that early detection and treatment improves your chances of living longer and resuming your usual activities.