Breast cancer stories are not necessarily simple ones, but they are ones breast cancer advocates know well. Regardless of where in the world we live, each of us know so many women who have shared their breast cancer story with us.
The shock and dismay that women feel when they first hear the words, “You have breast cancer” is universal. But what happens next is not so universal.
For those living in high-income countries, breast cancer is more likely to be diagnosed at an early stage. Early detection and best practice treatment and care mean these women will benefit from an overall five-year survival rate of 80-90%. But for those women in low- and middle-income countries (LMIC), the diagnostic pathway is very different, with the majority of women likely to present to a healthcare facility with advanced disease. Many of these women will have access to very few treatment options, meaning their overall five-year survival rate may be as low as 15% with the prospect of a poor quality of life.
Breast cancer is the most common cancer in women worldwide, and affects more than 1.5 million women each year. Over the next decade, over 16 million women will receive a breast cancer diagnosis, and approximately 1/3 of these women will develop advanced diseases.
Low-resource settings face an increasing and disproportionate share of the disease burden, and the stark difference in outcome is attributed to a lack of awareness, early detection, and timely access to quality treatment and care.
Again, this is a story that breast cancer advocates know too well, and evolves in much the same way if the breast cancer patient is a man. What advocates may not know, however, is that there is now a cancer resolution that supports advocates’ needs with government commitments.
On May 30th, 2017, health leaders from across the world reaffirmed cancer control as a critical health and development priority as they adopted a new cancer resolution at the 70th World Health Assembly in Geneva. The 2017 resolution provides cancer-specific guidance to Member States across the care continuum, including commitments for improved prevention, early detection, treatment and care for all cancers.
Efforts were particularly made to capture multidisciplinary approaches from prevention to palliative care so as to support and acknowledge the various pathways to optimal outcomes for all people at risk.
This resolution, in addition to the update of evidenced, cost-effective interventions in Appendix 3 of the Global Action Plan on NCDs, stresses the importance of partnership, referrals, centres of excellence and evidence-based research – all of which support advocates’ efforts in their settings to improve access to and quality of care.
Evidence shows that women in LMICs are likely to be diagnosed with advanced stage breast cancer. However, we have seen that it is possible to shift the stage at which women are diagnosed with breast cancer, thereby improving treatment outcomes. Advocates must lobby for early detection of cancers like breast cancer, and for improved health literacy of women in at-risk age groups through awareness of their breast health. The cancer resolution supports the development, implementation and monitoring of early detection programmes based on common cancers, as does Appendix 3, which recommends screening with mammograms for women between the ages of 50 and 69 every two years, due to its links to timely detection, diagnosis and treatment of breast cancer.
All patients with breast cancer must be provided with clear treatment plans that offer affordable and accessible treatment and care based on prognosis and tailored to the setting. The cancer resolution supports the development and implementation of evidence-based protocols for cancer management, with particular emphasis on networks to create centres of excellence, and referrals through the health system, from primary healthcare through to tertiary. The cancer resolution also promotes the availability and affordability of quality, safe and effective medicines for cancer, as well as greater investment in essential cancer diagnostic and core treatment modalities, including surgery and radiation.
It is expected that over five million women will present with advanced stage breast cancer over the next ten years. In addition to early detection programmes, we must support women living with metastatic disease, and ensure their quality of life. The cancer resolution holds countries to commitments in the provision of pain relief and palliative care, and the facilitation of psychosocial counselling and support for breast cancer patients and their families.
This cancer resolution is a crucial tool for breast cancer advocates. It is a way for all advocates to use universal messaging to lobby for improved patient outcomes, whether it is the metastatic breast cancer patient, the patient whose breast cancer was caught early, or the aging woman with the growing breast cancer risk. We know these breast cancer stories all too well, and it’s time we change them.
Please note that the cancer resolution applies to all cancers across the cancer control continuum, and what is presented here are only a few examples of what is included in the cancer resolution.
Feel free to get in touch with UICC’s Advocacy team to learn more on how you can leverage the cancer resolution to serve your national cancer control targets.