The major challenges of Haitian women facing breast cancer

Only “three medical oncologists, two radiation oncologists and four surgical oncologists practice in Haiti,” reports Zanmi Lasante

The World Health Organization’s International Agency for Research on Cancer reports 13,860 new cases of cancer in Haiti, or 7,028 men and 6,832 women in 2022. Among the five most common types, breast cancer ranks second with 1,355 cases, all in women.

Kettia Jean Pierre Taylor, a former journalist, was diagnosed the same year. “I went to the hospital after feeling unwell,” she says. “A few months later, the doctor told me I had breast cancer.”

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

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

To stop the progression of the disease, surgery was necessary. The medical team prescribed chemotherapy, a type of cancer treatment that causes unwanted side effects such as intense and persistent fatigue, vomiting, weight loss, anemia, etc. “It was horrible,” Taylor says. “I felt like the treatment was worse than the disease. It just knocked me out.”

Yet the mother remains grateful. When she learned about her cancer, she had just moved to Canada, fleeing gang warfare in Haiti. The health system is heavily impacted by the climate of insecurity that prevails in the country.

The University Hospital La Paix (HUP) is currently the only public center still functional 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 because of the dysfunction of other hospitals.

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

Looking back, the 30-year-old believes that some of her pain could very well have been linked to her cancer. But she would never have made the connection if she had stayed in the country. “I would have thought it was more a result of the stress caused by the situation in the country,” she says.

There are no symptoms in 15 to 20% of breast cancer cases, says gynecologist Joseph Vilaime Alexis. For the victim to know that she has cancer, she must 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 have every two years.

The association does not consider mammography 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, every year, preferably at the end of her reproductive cycle.

According to studies, it is normal for the breast to change because it is made up of different types of cells. These cells change regularly when, for example, a woman has her period, is pregnant, or is breastfeeding. What you need to watch out for are abnormal changes.

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

Therefore, every woman should see a doctor as soon as she notices a discharge from the nipple without being compressed, a lump in the armpit, pain in the breast, or any other abnormality. Because the sooner she goes to the hospital, the sooner she will be taken care of. And her chances of recovery will be greater.

Therefore, any woman should see a doctor as soon as she notices nipple discharge without compression, a mass in the armpit, breast pain, or any other abnormality.

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

In some cases, it is the capacity of hospitals to care for patients that is lacking. 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), a health care provider outside the Haitian government. And all of these specialists work in the private sector.

To address this, Zanmi Lasante established an official oncology program at the Mirebalais University Hospital (HUM) in 2013. Thanks to this, a large part of the impoverished population can benefit from free scans and other specialized care. Thus, 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.

Although there are effective methods against cancer, gynecologist Joseph Vilaime Alexis encourages a responsible attitude. All women should seek medical attention from the age of 25. Self-examination is at the top of the list of recommendations.

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

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

This is the case today for Kettia Jean Pierre Taylor. She says she is satisfied with the results of her chemotherapy, but she still has to take medication and attend psychotherapy sessions. “These sessions helped me keep my spirits up,” she says. “Because, as doctors know, 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 had it, she reminds them that they no longer have anything to fear in their lives because “fighting cancer is truly what we call a fight.”

Par Rebecca Bruny et Widlore Merancourt

Cover image: A woman performing a breast self-examination or self-palpation, a crucial step in the early detection of breast cancer. | © SHUTTERSTOCK

Watch this AyiboPost video to learn more about breast cancer: