It’s still one of the leading cause of cancer deaths
Breast cancer has existed for over 3,500 years, but it was only in the late 1800s when doctors really did something about one of the most common cancers in the world. In 1882, the first radical mastectomy was performed by William Halsted, and this surgery became the operation standard for the next 50 years. In 1895, the first X-ray was taken, which eventually led to what we all refer to now as mammograms that are low-dose X-rays.
Since the 19th century, much progress has been made to help women get well from breast cancer, but there is still much work to be done. For the local landscape, Manila Bulletin interviews broadcast journalist and documentary filmmaker Kara Magsanoc-Alikpala on the current status of breast cancer in our country. Concurrently, she is also the founding president of the ICanServe Foundation, vice president of the Cancer Coalition Philippines, and board member of the Philippine Alliance of Patient Organizations.
To start off, breast cancer in the Philippines remain the top cancer in 2020. Thirty-one percent of new cases (153,751 reports) are under the breast cancer category, with 92,606 reported deaths. Prevalent cases within the five-year range is 354,398. This is based on the reports shown on the website of the World Health Organization.
With the ongoing pandemic, it is a sad truth that things have been getting worse. “Many have delayed their cancer treatments or regular check-ups for fear of COVID-19 in the hospitals. Last year, one of the biggest barriers was lack of transportation when the lockdown also banned public transportation. Of course, in general, people have gone broke and hungry in the pandemic and cancer treatments or regular maintenance checkups are no longer a priority. The Philippine Society of Medical Oncology, in an informal survey among their members last year, said that 73.91 percent of their patients deteriorated or died due to delays attributed to COVID-19. This is very alarming, and that’s why we cannot delay paying attention to breast cancer cases and promoting early detection despite COVID-19,” explains Alikpala.
Even before the pandemic, ICanServe has been reaching out with their barangay-based breast cancer program, promoting early detection, access to accurate diagnosis, timely treatments, and patient navigation. “We do this in collaboration with the local government unit, particularly the city,” Alikpala says. The city, in turn, provides free or affordable diagnostics, treatment, and survivorship care.
With these free services, more women get to go for checkups, eventually getting help with early detention and treatments. This program is still ongoing with partners in Marikina, Panabo, Taguig, Muntinlupa, and Tagum.
For this month, ICanServe also has OKtober. “It’s a breast cancer forum and free clinic every October nationwide. They also have Silver Linings where breast cancer patients and survivors get together via a forum to help each other with their own personal journeys.
Aside from her role in ICanServe, Alikpala is also the co-founder of Cancer Coalition Philippines. It is composed of ICanServe Foundation, Project Brave Kids, Cancer Warriors, Carewell, the Philippine Cancer Society, Philippine Society of Medical Oncology, and Philippine Society of Oncology. “We banded together in 2016 to create a draft law on cancer and pitched it to Congress,” she says.
From the get go, the overriding spirit was no one would be left behind. We must help patients with any stage of cancer, and any kind of cancer.—Kara Magsanoc-Alikpala
All cancer patient advocates, these groups of people know all too well how patients and their loved ones have suffered because of cancer—not enough information and knowledge for possible preventive measures, not to have access to specialized medical facilities, discrimination against those who are undergoing treatment, post-treatment, and more so for those who have stage 4 cancers. “People tend to talk about them as if they were the living dead,” laments Alikpala.
There are just some of the reasons that brought the groups together to work on the Cancer Law. “From the get go, the overriding spirit was no one would be left behind. We must help patients with any stage of cancer, and any kind of cancer,” explains Alikpala. This includes, not only the poor, but working and middle classes, especially those who would run out of money during their treatment journey. “We agreed to go for the moon and the stars,” says Alikpala who observed that each organization has leveled up their programs. “But we’ve all reached the point where we need the national government to step in.” They could only do so much, and they knew that they needed to work with the Department of Health to beat cancer in all forms and stages.
Seventy-three cancer-related bills have been proposed to the Congress in the last 12 years. “Efforts in the past focused on one element of the cancer issue: infrastructure, a particular cancer, cancer awareness, screening, financing, but none that was integrated, comprehensive covering all cancers, the continuum of care of a patient’s journey from prevention, diagnosis, palliative, treatment, survivorship to hospice care and improving and upgrading the entire cancer ecosystem,” explains Alikpala. For the first time, the Cancer Coalition Philippines was able to propose one that eventually became a law that was signed on Feb. 13, 2019.
The Department of Health’s website explains what the Republic Act 11215 or the National Integrated Cancer Control Act (NICCA) is all about. It “aims to expand PhilHealth packages for Filipinos diagnosed with cancer and mandates the establishment of the Philippine Cancer Center to ensure access to cancer care services and medicines.” Cancer Assistance Fund will also be set up to complement the Universal Health Care Act.
Through the NIICCA, which is the first in Southeast Asia, it is with hope that the country can help work on the United Nations Sustainable Development goal number 3.4, that is to reduce non-communicable diseases by 30 percent in 2030. “Ultimately, the Filipinos will be among the healthiest people in Southeast Asia by 2022 and in Asia by 2040,” says Secretary Francisco T. Duque III.
Going back to breast cancer, Alikpala added that they are set to establish Patient Power Philippines. “It’s a platform for all breast cancer patient leaders of breast cancer patients groups in the country. Together, we want to elevate each other’s advocacy, share information, best practices, and breakthroughs and shape a united front and voice,” she says.