BEIRUT: Patients across the region are needlessly dying from treatable cases of cancer due to fear, taboos and a lack of knowledge about the disease, according to doctors.
“There is public information that people need to know about but they do not, because there is a fear of knowing,” Dr. Joseph Kattan, head of the Oncology and Hematology Department at Hotel Dieu de France University Hospital, explained to The Daily Star.
“In Lebanon, people are not aware [of the symptoms of cancer] because there are very few who have medicinal information.”
The problem is that many symptoms of cancer are non-specific, according to Dr. Nagi Saghir, professor of oncology at the American University of Beirut and director of the Breast Center of Excellence at AUB Medical Center.
Many of the warning signs are no different from those of any other illness – such as bloating, fever, chronic pain, redness, inflammation, weight loss, bleeding, indigestion, and unusual bowel movements.
The telling difference is that the symptoms of cancer tend to be persistent, which should be the first indicator to consult a doctor.
Regardless of how “common” the symptom appears to be, Kattan explained, “people need to be aware that any symptom that lasts longer than it should is an alarm bell. ... It could be cancer.”
The delay could, and often does, make matters worse – the earlier cancer is detected, the better patient’s prognosis.
“People should know that the earlier they catch the cancer, the better the chance of survival,” said Kattan.
Saghir echoed Kattan’s comments, stressing that “if the cancer is discovered early, it could be cured.”
The more common and cost-beneficial screen tests in Lebanon include mammograms to detect breast cancer, the Prostate-Specific Antigen test for prostate cancer, the Papanicolaou (Pap) smear for cervical cancer, and a colonoscopy for colon cancer.
When it comes to cancer, however, many tend to delay going to their physicians even if they suspect they may have it, partly out of fear and partly out of denial.
“We suffer from this issue here more than in other countries,” said Kattan. “Usually it’s worrying that drives you to go see a doctor, but in this case, it is this worry and this fear that makes the person not go.”
Due to a lack of understanding, combined with suspicions that surround the disease – still largely a taboo in the Middle East – most individuals simply don’t want to know if they have cancer.
“People are afraid, there is still a ... stigma that if I have cancer, I will die,” Saghir explained. “They have misconceptions that cancer means death, but it’s not true, we keep telling people that it is not the case.”
The socioeconomic status of a country has a significant effect on both the level of public awareness about the disease and the readiness of patients to consult a doctor and begin a course of treatment, a large part of which comes down to the expensive fees.
“We don’t have a policy [in Lebanon] that obliges anyone to go to a doctor,” said Dr. Khaled Ibrahim, a consultant in hematology and oncology and clinical assistant professor of medicine.
Medical experts agreed that Lebanon needs to encourage people to have annual checkups, especially for anyone over 40 years of age, while individuals themselves need to examine their bodies for any conspicuous changes and consult doctors about them.
But while experts agreed that initiatives to increase public knowledge of the various types of cancer and remove the associated stigma were desperately needed, Lebanon is not completely behind the curve.
In the Middle East, campaigns about breast cancer have proved quite successful in encouraging women to undergo mammograms, and in Lebanon this has increased the number of early detections of the disease , according to Kattan.
Breast cancer is the most common type of cancer among women in Lebanon, and prostate cancer is the most common among men. Another common form is lung cancer, most probably as a result of smoking cigarettes and nargileh, Kattan added.
Symptoms of breast cancer include asymmetry in the breasts, skin changes and an inverted nipple. Symptoms of prostate cancer are more difficult to detect, and are similar to those associated with urinary infections or kidney stones. Symptoms of lung cancer include persistent coughing, shortness of breath, and a sudden hoarseness. Most individuals mistakenly attribute this to smoking and do not resort to consulting a physician, Saghir warned.
A change in bowel activity may also signal a tumor in the bowel, which carries symptoms like constipation and diarrhea, or an alternation between both, he said, adding that “many people don’t know this.”
Ibrahim also pointed to a particularly significant delay in consulting a doctor among women who have ovarian cancer, which allows the disease to progress to an advanced and much more dangerous stage.