Survey: Malaysians Still Ignorant About Advanced Breast Cancer

Advanced breast cancer is actually treatable, but not preventable because it’s unpredictable.

KUALA LUMPUR, Sept 27 — A survey revealed that most Malaysians know little to nothing about advanced breast cancer, holding misconceptions like the disease is not treatable and patients don’t live long.

The online survey of 306 respondents — which was run last month by the Breast Cancer Welfare Association Malaysia (BCWA) and supported by Pfizer Malaysia — found that 86 per cent mistakenly believed that stage 4 breast cancer is preventable, while 62 per cent wrongly perceived that the disease cannot be treated.

“The belief that mBC (metastatic breast cancer) is both preventable and untreatable is pervasive in our country,” BCWA president Ranjit Kaur told a media briefing last Wednesday, referring to advanced or Stage 4 breast cancer.

“It is true that mBC is incurable at the moment. But, there are many approaches to treating mBC and new treatments are being tested every day,” she said. “Patients can have many more years of life with the right kind of treatment.”

The BCWA survey also showed 61 per cent of respondents mistakenly believed that advanced breast cancer is caused by late detection, while 33 per cent wrongly attributed the disease to unhealthy life choices.

Ranjit stressed that advanced breast cancer is not a “moral failing”.

“Early detection and a healthy lifestyle can help reduce the risk of mBC developing, but it cannot be prevented,” she said.

“We need to have more empathy for mBC patients and stop blaming them for the unpredictable progression of their disease.”

Breast Cancer Welfare Association Malaysia (BCWA) president Ranjit Kaur

According to the breast cancer survivor, 20 to 30 per cent of breast cancer patients will see their disease progress to Stage 4, no matter the measures taken.

Universiti Malaya professor emeritus Dr Yip Cheng-Har speaks at a media briefing on September 25, 2019 in Kuala Lumpur.

Universiti Malay professor emeritus Dr Yip Cheng-Har said the Health Ministry does not pay for expensive drugs.

“We’re very good at preventive and primary health services, but tertiary health services is really quite expensive. If you have a pot of money, are you going to spend more on tertiary or primary? That is a difficult question to answer,” Dr Yip told the media briefing.

She said medicines, if available, were the most important when it came to advanced breast cancer, giving the example of a friend who has been living for 10 years with the disease but spent RM2 million on treatment.

According to Dr Yip, breast cancer patients who can relapse into Stage 4 include 10 per cent of stage 1 patients, 20 per cent of stage 2, and 40 to 50 per cent of stage 3.

“It’s fairly unpredictable. I’ve had patients with stage 1 breast cancer whom I thought will survive and live, but they come back with metastatic breast cancer in a few years.”

Breast cancer, unlike colorectal cancer, can fall into relapse even after five years, said Dr Yip.

“Colorectal cancer, after five years don’t relapse, you’re considered cured. For breast cancer, forever you’re on follow up.”

Some stage 4 breast cancer patients, she said, stop treatment because it’s too expensive, as some drugs can cost RM20,000 per cycle.

“They’ll say why should I spend all that money, that money is better spent on my family when I die.”

Pfizer Malaysia country medical lead Dr Jerusha Naidoo said Pfizer’s patient assistance programme EMBRACE subsidises half the cost of palbociclib, a targeted therapy drug that is not available in Malaysian public hospitals, for HR positive or HER2 negative advanced breast cancer patients.

Palbociclib is priced between RM13,000 and RM15,000 a month; patients on the EMBRACE programme only pay 50 per cent of the price.

Between 100 and 200 patients are currently on the EMBRACE programme that is not tied to one’s income, according to Dr Jerusha. The patient assistance programme is open to all hospitals with oncologists or breast surgeons.

“Pfizer is committed to supporting mBC patients throughout their treatment journey, including financial needs. That is why we are launching the EMBRACE programme today, to put effective treatments in the hands of those who need it so that patients can live their lives to the fullest,” said Dr Jerusha.

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