Breast Cancer: Beyond Pink October

A t one minute past midnight on 1st November, imagine a woman in Ntui, in the Centre Region. She touches her breast while bathing and feels a small lump. Hard and painless. She has seen the pink ribbons all through October. She heard the radio jingles. But now October is gone. The free tents are gone. The doctors who came for campaign are gone. Her fear has just started. Where does she go? Who will show her the road? How much will she pay? That is the question we do not like to answer. For 31 days, the world shouts about breast cancer. We decorate buildings pink. We wear pink t-shirts and organise awareness walks. Then what? After we switch off the pink lights, what happens in the other 11 months? Many women under their beautiful dresses are carrying a breast that has reached an advanced stage of cancer, some do not even know. Even for those who know, they do not have money to commence treatment. Every October, ministries, banks, hospitals, private companies, all dress in pink. The cost of mammograms drops to as low as 5,000 FCFA. Social media is full of pink ribbons. These things matter. They make women go for check-up. They break some taboos. They bring a serious disease into national talk. But visibility does not mean continuity. A disease that kills every month cannot be fought with one month of good­ will. And there is another side we must not forget. For some men, October becomes an excuse for crude jokes. They turn awareness into sexual enter­ tainment. This is not funny. It trivialises suffering. It dis­ tracts. Beyond the pink decorations, reality is not colourful. According to GLOBOCAN 2022, Cameroon recorded about 4,207 new breast cancer cases and 2,285 deaths. Behind each number is a woman. Her chance to survive does not only depend on medicine, but on where she lives, when it was detected and what she can afford. Women in Cameroon do not die more because their cancer is different. They die more because they are diagnosed late. Recent hospital studies from Yaounde and Douala General Hospitals, as well as Yaounde Teaching Hospital, show that over 70 per cent of women arrive at Stage 3 or Stage 4. Stage 3 means the tumour is big, it has spread to lymph nodes, skin has changed, breast is deformed. Stage 4 means cancer has al­ ready gone to bones, lungs, liver. At that stage, you do not treat to cure. You treat to prolong a few months. In high-in­ come countries, it is the opposite. 70 per cent arrive at Stage 1 and 2. In Cameroon, 70 per cent arrive at Stage 3 and 4. Why? It is not because Cameroonian women are ignorant. It is because awareness campaigns only come one month per year. There are 11 months of silence. In Oc­ tober, every media talks about breast cancer. You hear “palpate.” You see pink. You are scared but motivated. You hear women saying “I will go for screening”. In November, silence. No more radio spots. No pink slogan. People go back to school fees, rent, market. The fear fades. You hear some saying "Next year I will do screening. “Those 11 months of silence create deadly delays. There is the delay to recognise danger. When you only hear about breast cancer in October, you think it is an October disease. You hardly connect a painless lump in February to cancer. But if we talked all year, a woman who feels a lump in February would immediately think “This could be cancer, I heard about it last week.” There is also the delay to decide to go. Some women still need permission from husband, money and someone to keep children. If awareness is permanent, husband also heard the message, community supports. If it is only October, in March she is alone to convince family that she needs 100,000 FCFA for biopsy. There is also the delay to get correct care. She decides in April to go to a district hos­ pital, but nurse has no clear path, no mammography, no re­ ferral. She is told “come back.” By the time she reaches Yaounde or Douala, it is Stage 3. Medics reveal that when women arrive ...