Detecting cancer early can save your life
It has been more than two years now since *Pamela Jackson's doctor detected a lump in her breast and suggested she get a mammogram, but the 59-year-old household worker is yet to follow through on this advice.
"He said there was a lump and I should go and get it tested to find out if it was cancerous," she said.
But Jackson, who did a mammogram just a year before her physician's assessment, insisted there was no need to get the screening test, which doctors warn could make the difference between life and death for those with cancer.
"There was another doctor who told me I could do it myself, and she told me what I could do when I go to the bathroom or a lie down, or whatever, and I did it and I didn't feel anything, really," she told The Sunday Gleaner.
"You can self-test it and don't feel anything there. I did that test (mammogram), and believe me, it was hot [painful], and that kind of turn me off, honestly," added Jackson, who witnessed first hand the devastating impact of cancer from nursing her cousin, who was diagnosed with lung cancer a year ago. He died recently.
Despite several education campaigns to amplify the message that early detection saves lives, executive director of the Jamaica Cancer Society (JCS) Yulit Gordon finds that the number of women who are being screened is nowhere near where it should be. The JCS screens about 10,000 persons annually for breast cancer, although the number of Jamaican women between the ages of 40 and 75 years who need access to mammography screening currently stands at 400,000.
"For Jamaica to have the level of impact that is needed to reduce the incidence of and mortality to this disease, we need to be screening, as a country, approximately 40,000 women annually," she said.
"The major barriers that prevent most Jamaican women from accessing mammograms are the psychological barrier of fear, financial barrier of cost, geographical barrier of access."
Gordon said the not-for-profit organisation has expanded its health promotion programmes to include cancer survivors who share their stories in the hope of inspiring and motivating more women to face their fears.
"We have had media personalities here that have videotaped themselves getting it [mammogram] done just to show that while it can be discomforting for some women because of the nature of their breasts, it is not painful, and it is not a lengthy process either. It is just a couple minutes that can give you a lifetime with your family," Gordon stated.
Mammograms are currently not offered at public health care facilities, and so a woman can expect to pay as much as $15,000 to access one privately. However, the JCS has tried to make the cost less of a burden by asking women to contribute $3,500 for a mammogram at their facility.
Dr Deria Cornwall, who has worked extensively with cancer patients in her capacity as a radiologist, is just as concerned about the reluctance of many Jamaicans to be screened regularly for cancer.
"We need to get people screened to pick up the cancer early because in Jamaica, we are picking up cancers late," she said.
"A lot of people wait until they go to the doctor before they get screened and we tell people like women who are over 40, once you reach the age, you don't need to go to a doctor to get permission to go and do your mammogram," explained the radiologist, who lamented the fact that some people wait until they feel a lump before they get screened.
Although the struggle to get women screened exists, Gordon is pleased that there has been a vast improvement in the number of men coming forward to be screened for prostate cancer. There was a 250 per cent increase in the number of men screened for prostate cancer between 2010 and 2015.
According to Jamaica's Cancer Registry, the most common cancers in women are breast, cervical, and colon cancer, while in men it is prostate, lung, and colon. Fortunately, the last report from the registry showed a decrease in the incidences of both lung and cancer of the cervix and the figures are expected to dip lower with the continued reduction in the use of tobacco and the increase in Pap smears for cervical cancer screening.
While the World Health Organisation has predicted that new cancer cases would rise from 14 million annually in 2012 to 22 million within the next two decades, it is not known how many persons have been diagnosed with cancer in Jamaica in recent times. The last cancer incident report for Jamaica was published in 2010 and only covered cases in Kingston and St Andrew between 2003 and 2007. During that five-year period, 4,981 cases were recorded.
According to data provided by the National Health Fund, more than 21,000 Jamaicans are currently being assisted by the Fund (NHF) to get treatment for cancer. The NHF provides drug subsidies for those with breasts and prostate cancer. The Fund also subsidises the cost for breast cancer receptor studies, which is a diagnostic procedure used by clinicians to determine the type of treatment therapy that is appropriate for each patient. The NHF has spent approximately $2.6 billion in cancer treatment subsidy since 2003.