Women with breast cancer face major obstacles in Haiti

Only « three medical oncologists, two radiation oncologists and four surgical oncologists are practicing in Haiti, » reports Zanmi Lasante

In 2022, the World Health Organization’s International Agency for Research on Cancer reported 13,860 new cases of cancer in Haiti, i.e. 7,028 men and 6,832 women. Among the 5 most common types, breast cancer ranks second with 1,355 cases, all of which occurred in women.

Kettia Jean Pierre Taylor, a former journalist, was diagnosed the same year. « I went to the hospital after I felt unwell, she says. A few months later, the doctor informed me that I had breast cancer. »

Taylor didn’t even have time to digest the news. In addition to informing her that she was sick, the doctor also told her that she needed emergency surgery because her cancer was already at stage three, the penultimate of the four stages of breast cancer.

In other words, the cancer was beginning to spread to areas other than where it had originated. And in Taylor’s case, it managed to reach her armpits.

To stop the progression of the disease, an operation was therefore necessary. The medical team prescribed chemotherapy, a cancer treatment that causes undesirable side effects such as intense and persistent fatigue, vomiting, weight loss, anemia, etc. « It was horrible, » Taylor says. « I felt like the treatment was even worse than the disease. It literally knocked me down. »

However, this mother remains grateful. When she found out about her cancer, she had just moved to Canada, fleeing the gang war in Haiti. The health system is heavily impacted by the climate of insecurity that is raging in the country.

The Peace University Hospital (HUP) is currently the only public centre still functioning in Port-au-Prince. And according to what its medical director, Jean Philippe Lerbourg, reported to AyiboPost, the HUP is not able to receive the number of patients who flock to it due to the dysfunction of other hospitals.

In this context, Kettia Jean Pierre Taylor confides that if she had stayed in Haiti, she would never have gone to the hospital for a simple illness. « As I was already doing, » she says, « I would have continued to take painkillers when I felt any pain. »

In hindsight, the thirty-year-old believes that some of her pain could very well have been related to her cancer. But still, she would never have made the connection if she had stayed in the country. « I would have thought it more a result of the stress caused by the situation in the country, » she says.

There are no symptoms in 15-20% of breast cancer cases, says gynecologist Joseph Vilaime Alexis. In order for the victim to know if they have cancer, they need to have a mammogram. This is a breast cancer screening test that the Canadian Cancer Society recommends that women between the ages of 40 and 74 take every two years.

The association does not deem the mammogram necessary for young women. On the other hand, from the age of 25, a woman must have her breasts examined by a general practitioner or a gynecologist, on an annual basis, preferably at the end of her reproductive cycle.

According to studies, it is normal for breasts to change because they are made up of different types of cells. These cells change regularly when, for example, a woman is menstruating, pregnant, or breastfeeding. What you have to watch for are abnormal changes.

This is the case when the cells grow until they form a mass that may indicate the presence of cysts or tumors. If it is not properly managed and becomes uncontrollable, this mass can develop into cancer. And depending on the cells in which it develops, a different type of cancer emerges. For example, carcinoma can be found in any cell in the breast, while Paget’s disease is located in the nipple and looks like an infection.

Thus, every woman should see a doctor as soon as they notice a discharge from the nipple without compression, a lump in the armpit, pain in the breast, or any other abnormality. Because the sooner they go to the hospital, the sooner they will be taken care of. And their chances of recovery will be greater.

Thus, every woman should see a doctor as soon as they notice a discharge from the nipple without compression, a lump in the armpit, pain in the breast, or any other abnormality.

In the healing process, the type of cancer as well as its stage are very important. If the person delays being diagnosed, the cancer will have time to progress, attack other organs in the body, and recur.

In some cases, it is the capacity of hospitals to care for the sick that poses a problem. Very few centers in Haiti provide cancer care. In fact, only « three medical oncologists, two radiation oncologists and four surgical oncologists practice in Haiti, » reports Zanmi Lasante (Partners In Health), an institution providing health care outside the Haitian government. And all these specialists work in the private sector.

To remedy this, Zanmi Lasante established an official oncology program at the University Hospital of Mirebalais (HUM) in 2013. As a result, a large part of the impoverished population can benefit from free CT scans and other specialized care. As such, the HUM was able to perform 1,600 biopsies, 40% of which were related to breast cancer, in 2015. And in 2018, it was able to treat 570 people with different types of cancer.

Even though there are effective methods to fight cancer, gynecologist Joseph Vilaime Alexis encourages a responsible attitude. All women should be examined from the age of 25. Self-examination is at the top of the list of recommendations.

On the last day of their period, a woman can feel their breasts to detect if there is a lump forming. Palpation can be done when soaping in the shower, standing in front of a mirror with one hand above the head, or lying on your back.

In addition, a healthy and balanced diet, regular physical activity, non-consumption of alcohol, sleeping well, and not smoking… are all methods that reduce the risk of cancer. Some women with a family history of breast cancer are more likely to get breast cancer. But many others develop breast cancer without any predisposition.

This is now the case of Kettia Jean Pierre Taylor. She says she is satisfied with the results of her chemotherapy, but still needs to take medication and undergo psychotherapy. « These sessions helped me keep my spirits up, she says. Because, as doctors are aware of, many people end up committing suicide when they have cancer, even after successful treatment. »

From her host country, Kettia asks women to remain attentive to the messages and changes in their bodies. As for those who have cancer or have already had it, she reminds them that they no longer have anything to fear in their lives because « fighting cancer is really what we call a fight. »

By Rebecca Bruny and Widlore Mérancourt

Cover image: A woman performing a breast self-examination, a crucial procedure for the early detection of breast cancer. | © AUFEMININ

Watch this video from AyiboPost to learn more about breast cancer: