Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan

Abstract

Background Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment. Methods In this process 45 women (age = 18–50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan. Results An inductive approach was used to analyze the data which resulted in the emergence of eight subthemes under the umbrella of three major themes that delineate individual, socio-cultural and structural barriers to seek screening and treatment of breast cancer in Punjab. Individual barriers included lack of awareness, hesitance in accepting social support, and spiritual healing. The identified socio-cultural factors included feminine sensitivity, stigmatization, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hinder screening and treatment. Conclusions These barriers can be addressed through raising awareness and community mobilization about breast-self exam and treatment. The healthcare system should also pay attention to socio-psychological and cultural factors impeding women's access to available health facilities.

Invasive Lobular Carcinoma in Premenopausal Woman: A Delayed Diagnosis Due to Socio-Cultural Factors Prevalent in Pakistan

“…Religious misconceptions and myths are prevalent in Pakistan due to high illiteracy rates. People follow twisted religious versions and associate crisis and illness with God’s will and believe that only God can cure the disease [ 9 ]. As a consequence, people consult religious healers instead of visiting specialized physicians and this results in treatment delays [ 10 ].…”

“…If a woman is diagnosed with breast cancer, friends and acquaintances keep a distance and view her as a bad and unlucky woman who is inflicted punishment by God for her bad deeds. The young woman hides their disease due to fear of social rejection and married women due to fear of divorce from their husband [ 9 ].…”

“…In Pakistan, there are fewer cancer screening and treatment facilities and patients usually avoid treatment due to poverty. The social structure of Pakistan provides fewer opportunities for women to be financially independent and make them rely on their husband’s wealth which leads to financial insecurity and delays in expensive breast treatment [ 9 ]. There are few studies from Pakistan that state that poor economic and financial conditions are significant barriers to breast cancer screening and treatment [ 12 , 13 ].…”

Promocija zdravlja i komponente socijalnog marketinga u funkciji ranog otkrivanja raka dojke

“…Ali, ovo nije uključivalo lekare u privatnom zdravstvenom sektoru. Za naredne kampanje podizanja svesti o raku dojke i programe sekundarne prevencije veoma je važno da se identifikuju i istraže barijere koje sprečavaju žene da traže blagovremeni skrining, kao što su psihološke, socio-kulturalne i strukturalne barijere [17].…”

Efficacy of linking Breast Awareness Clinics in Gynecology and Obstetrics departments: A pilot project in Zubaida Bani Wing, Fazle-Omar Hospital, Chenab Nagar, Pakistan

“…Some of these factors are lack of knowledge about symptoms of BC, lack of awareness about its screening, hesitation in contributing to screening programs, fear of disease, scarce financial resources, social, religious, and cultural views. [8][9][10] The regular Breast Self-Examination (BSE) has been mentioned by various previous authors as a substantial to enable the women to notify any changes in the mammary tissues and report during clinical visits. 11,12 If performed correctly and regularly, BSE is a simple, confidential, and harmless method for self-detection of breast lumps in the early stages.…”