Exploring Possible Causes for Delays Seeking Medical Treatment Among Indonesian Women With Breast Cancer

Abstract

Objective: This study aimed to explore the underlying causes for the delays seeking medical treatment experienced by Indonesian women with breast cancer and what kinds of non-medical treatment were pursued instead.Methods: This study used qualitative methods with in-depth interviews among 20 participants to reveal the causes of delaying medical treatment by patients with breast cancer. Subjects were chosen from women diagnosed with breast cancer who had delayed their medical treatment for various reasons and were currently undergoing medical treatment at a hospital.Results: The underlying causes for the delay of medical treatment were varied, including psychological reasons (fear of surgery, being worried about adverse effects of the medicine, making troubles to the other people, afraid of losing breast, or losing husband); lack of knowledge about cancer (unfamiliar with the symptoms of cancer, possible cancer cure by nutritious food, more trust in alternative medicine, myth, participant’s husband did not approve her surgery, only rely on prayer, forgot if she was sick); factors deriving from health service system (limited facilities, a false diagnosis, queue rooms/radiotherapy/for hospitalization, the radiotherapy equipment was out of service, patient unable to walk, high out-of-pocket cost, and doctors were not communicative). During time delay, some patients have also sought non-medical treatment with herbal medicines, non-herbal medicines, and non-conventional treatment (laser, reiki, acupuncture, and vest treatments).Conclusion: Many factors affect the delay of medical care among patients with breast cancer. Often, these delays influence the patients to seek alternative treatments.

Delays in the presentation and diagnosis of women with breast cancer in Yogyakarta, Indonesia: A retrospective observational study

“…In a local publication, initially consulting with non-medical practitioners for breast-related complaints and consuming non-medical treatments have also been associated with diagnosis and treatment delays [ 14 ]. Observed by qualitative studies, a lack of awareness and knowledge of cancer, cancer beliefs, treatment beliefs, financial problems, emotional burden, paternalistic style of communication, and unmet information needs are related to psychosocial and cultural reasons for patient delay [ 15 , 21 , 22 ].…”

“…To date, research focusing on delays in presentation and diagnosis for patients with breast cancer [ 15 , 22 , 23 ] in Indonesia have included qualitative studies [ 15 , 23 , 24 ], including a study undertaken in Yogyakarta, the region in which this study is focused [ 21 ]. There is very limited research quantifying factors affecting delays in Indonesia [ 14 , 15 ], with none exploring factors in Yogyakarta.…”

Lag time, high-risk histopathological features, metastasis, and survival interrelation in retinoblastoma: a perspective from lower-middle income country

“…Several factors might influence the longer lag time for the patients with retinoblastoma in Indonesia. The extensive belief in alternative medicines and extended delay until symptoms get worse were the most reported motives in delays for seeking medical treatment in Indonesia [52][53] . Moreover, a major treatment-related delay also occurred due to direct non-medical expenses such as transportation and accommodation for the patient's caregivers [54][55][56] .…”

Cancer and the Politics of Care

“…The moral stigma projected at women affected by cervical cancer can be differentiated from the fear surrounding other prominent cancers in Indonesia, such as breast and lung cancer. While cancers in general are feared in the popular imaginary, both because they often lead to death and because their treatment is understood to be brutal (Sunarsih et al 2018), other cancers do not immediately attract moral condemnation because they are not associated with immorality and promiscuity; 2 only HIV and other sexually transmissible diseases share this level of moral stigma (Newland et al 2021;Waluyo et al 2015;Waluyo, Nurachmah and Rosakawati 2006). The discrepancy in stigma between cervical cancer and other cancers drives inequalities between different cancers, in terms of the degree of care afforded to women and their associated social suffering.…”