Helen Chen, a Taiwanese-American woman who was diagnosed with breast cancer at the tender age of 27 revealed that she couldn’t believe it because she had always thought of cancer as an “old white man’s disease”.

This idea of cancer as a ‘western’ or ‘white person’s disease’ appears to be detrimentally, highly prevalent – not just in Asian populations in western countries, but also in south and east Asian countries around the world.

The image of breast cancer is generally of a white woman seeking treatment in a state of the art western hospital, whilst loved ones host fundraising events and participate in runs to raise money for the treatment. While this may be true – and these countries are celebrating significant progress in curing women – in Asian countries, the severity and extent of the disease is only worsening.

The problem begins with approaching cancer in a ‘western’ way

Much of the advocacy for screening and early treatment of breast cancer is not geared to Asian sections of the society. For example, they generally rely on the assumption of a certain level of education; but Asian women are more likely to be less educated than their white counterparts.

Often enough, there can be a language barrier, too – especially for those who have recently immigrated to western countries. Women with symptoms of breast cancer may be reluctant to seek help “after 30 years of not being able to speak the language and get their own services,” lamented Betty Guzman, a breast cancer survivor who moved from the Philippines to the United States.

Additionally, breast cancer is often discussed openly as possible in western culture – but the sharing of information can exclude Asian women who do not partake, as they are not used to sharing such personal information.

Perhaps more surprisingly, this western view of the disease affects aid provided to Asian countries. Over the next 20 years, chronic diseases, which include all cancers, will cause a predicted economic loss between USD100 billion and USD2.8 trillion in developing nations, according to scientists at the World Economic Forum.

Stereotypically, people expect malnutrition, natural disasters, water shortages, homelessness and mass breakouts of viral disease to be the biggest public health issues in such nations – but, not cancer. This influences investment in health interventions to diagnose and treat cancer more efficiently and timely. Currently, less than 5% of global spending on cancer is in low-income countries – even though they bear 80% of the global cancer burden.

Lack of knowledge enables cancer to become an unencumbered silent killer

Approaching cancer in this way with Asian women can lead to them having a lack of awareness, and not following up on screening and prevention techniques. A qualitative study of Malaysian cancer patients’ perceptions of cancer screening by the Universiti Sains Malaysia (USM) gathered telling responses to their interview questions.

“I never read about cancer screening before the diagnosis. I just read posters at hospitals, which are usually in the Malay language. It should be written in other languages too, like Tamil or Mandarin. Sometimes, it’s in English which I don’t understand either,” said one.

“Access is a big part of this ― not knowing what kind of access is available. With regards to barriers to screening, some people think, ‘If I don’t feel anything, why do I need to see a doctor?’” echoed Scarlett Lin Gomez, a research scientist at the Cancer Prevention Institute of California.

Follow up can also be difficult. As Dr Rita Ghatak, head of Stanford University’s Aging Adult Services/Geriatric Health Program, explains – there is a tendency for Asian breast cancer patients to lose contact with the complicated network of doctors, expensive specialists, clinics and examiners, which can have a detrimental effect on the continuity of care.

Yet, Asian women are also less likely to follow up on an abnormal mammogram, according to a study by Kim Hanh Nguyen and Dr. Leah Karliner from the University of California. Having evaluated data from more than 50,000 women over a decade, the researchers found that only 57% of Asian women had follow up tests after a month compared to 77% of white women.

Ultimately, these issues lead to a lack of knowledge about the disease and when women begin dying of it, the disease takes on a social stigma. MIMS

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