Breast cancer treatment limited in public hospitals

Staff busy with a patient during surgery at the new Khayelitsha Breast Oncology Clinic. Photo supplied.

October every year is breast cancer awareness month but public health services to treat it still fall short of need.

Breast cancer is the leading cancer diagnosed in women in South Africa. According to the National Cancer Registry of 2014, 1 in 27 women are at risk of being diagnosed in their lifetime.

Despite the government talk about the Fourth Industrial Revolution (4IR), the South African health system is only able to assist women at a some of its hospitals with proper screening and therapy. In some cases endocrine treatments are also used.

With the public health system in dire straits, according to Maria Streicher from Paarl hospital, they see no more than nine patients per week for mammograms. “To date in the current calendar year, only 180 patients have been seen for mammograms. There are no chemotherapy or radiation therapies available at Paarl hospital. In most cases patients are referred to Tygerberg hospital for chemotherapy or radiation therapies,” she said.

Women in poor and rural communities in the province access breast diagnostic services through their local clinics.

According to the provincial Department of Health, the only hospitals in the Cape Town Metro West that have breast clinics are Mitchells Plain, Groote Schuur and Tygerberg. The doctors at these hospitals are in the process of establishing a clinic at Khayelitsha hospital.

Portia Masiza (29), a cancer survivor from Mbekweni, Paarl, comes from a family with a history of breast cancer. So when she discovered a lump four years ago, she went to her nearest clinic. She was diagnosed with cancer and was referred to Tygerberg hospital where it was confirmed as stage one. She had to travel between Mbekweni and Cape Town and used public transport.

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She underwent six months of chemotherapy and then radiation therapy for nine days. This was followed by a year-long regime of an injection, Zoladex, that kills the hormone cells in the body while reducing the chance of the cancer in her breast changing. “For the past four years I have been on Tamoxifen and next year I will finish my course,” Masiza said.

She advises black women to always do self-examination on a regular basis: “If you don’t know how to do self-examine go to your nearest clinic.”

With strong words she concluded the interview by saying that women especially must stop with “bazothini abantu/what will people say” syndrome.

Sithembiso Magubane, Principal Communications Officer for Khayelitsha Hospital, confirms that the hospital does not have mammograms for a breast clinic currently. “Patients requiring this service are usually referred to Tygerberg Hospital. The hospital this year did three breast cancer surgeries that were part of Mandela Day,” Magubane said.

He reiterated the importance of self-examination and the need for women to consult a healthcare practitioner at their nearest clinic if they suspect or notice any lump or mass.

The Western Cape Health Department states that it is vital for women to do monthly breast self-examination. Two days after the last day of your period is an important screening method. Women over the age of 45 should consider going for a regular mammogram. Younger women have denser breast tissue and can benefit more from an ultrasound examination. 

In South Africa, there is no law or act that stipulates that women must be screened for breast cancer. It is compulsory in the United Kingdom where screening has to be done every three years, and in the United States and Sweden every one to two years (depending on the age of the woman), and in Uruguay every year.

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