This article is contributed by Martina Mascarenhas of PR stationery label Trinco1982 on the occasion of PR x ICT September / October 2024 - Fundraiser and Awareness Raising Campaign in aid of
the Indira Cancer Trust and Sri Lanka's first Paediatric Cancer Palliative Care Centre, Suwa Arana.
All artworks featured are designed by the Author herself and you can shop her range of stationery and lifestyle products in store at PR.
My first brush with cancer was as a child, aged five, when my grandmother was diagnosed with Stage Four Breast Cancer. Up until then, my only association with the word “cancer,” was cancer the crab (an element I integrated into the print I created for PR’s fundraiser for the Indira Cancer Trust here in Sri Lanka – which is the only children’s palliative care centre on the island). Life changed quite quickly then. My grandmother, a smart, sassy lady whose faith kept her going, left us as quickly as her cancer diagnosis arrived. She was 64.
As children often do, I soon put her death behind me and, for some time, life ran its course, until less than a decade later, I lost my uncle to it.
After that, cancer became something that always overshadowed life – it always felt like it was never quite far away.
More recently, in my thirties, cancer is something that has affected many close friends, who thanks to a combination of awareness, preventive health checks, and early detection have managed to kick it in the ass and keep going on. However, it continues to cast it's shadow and takes a toll on them. Some talk of it, while others don’t mention it at all but they do all share one thing in common – that unmaskable fear of having it return, everytime they get a follow on check-up. The other side of it is that it’s never easy, especially to talk to a loved one about it.
What can you say that would change things?
While doing some research for this piece, I came across this text: “Across the world, cancer is among the top three causes of premature deaths among women. Of the 2-3 million women who die prematurely from cancer each year, 65 percent could be averted through primary prevention or early detection strategies, while a further 800, 000 deaths could be averted if all women everywhere could access optimal cancer care,” said the Women, Power and Cancer commission of The Lancet in 2023.
What really stuck out to me here is the impact of primary prevention or early detection. I have my own experiences of this. Every decade I get a mammogram as a preventitive measure. Both times, it has been in Sri Lanka. For anyone who has ever had a mammogram, you know its not an exam that is particularly pleasant. It is in fact, quite painful and embrassing, having your breasts handled by a technician who pretty much squashes it for lack of a better word, to ensure that the mammogram does what it’s supposed to do.
I remember the first time I got one, at 29, and despite having a letter from my gynaecologist, I remember how the radiologist and nurses then yelled at me publicly when it was time to actually get it, about how it isn’t done unless you are over 40 and have had children. A decade later, when I went in to get one just a month ago, I had the same experience. Less yelling perhaps, but everyone at the reception knew my business and the fact that I was a childless 30 something year old who wanted a mammogram.
While being treated as lesser than for choosing to not marry or having children in different parts of the world is something that unfortunately most of us are used to, and while my mortality is much more important to me than some backward cultural norms, this really shook me. Imagine if it were someone who did not have the resources I had, or the thick skin that I have cultivated over time. It literally means that rigid cultural norms over medical professionalism can mean a death sentence for women.
Both experiences were embarassing and painful in equal parts. Thankfully, I am in the all clear for now but all that means is that I will continue my regular preventive health care checks. You can get a less intrusive ultra sound more regularly – but once again, how would you know that, unless you have a good gynaecologist or other reputed health care providers and information resources that tell you so?
While some of us have the resources to access such preventive health care checks, and most of all awareness, not everyone does. The amount of information that comes at you can also be very daunting. The other side of this is also how little awareness women and girls in the Global South have in terms of our bodies, owing to poverty, a lack of education, therein a lack of access to resources, and repressive cultural and societal norms that restrict our own agency when its comes to our own bodies; the list is endless.
When it comes to breast cancer, self examination is often one of the first steps in terms of early detection. In Sri Lanka, a school based study conducted in 2013, that assessed awareness of breast cancer awareness of adolescent girls, found that of 859 adolescent girls interviewed, approximately 146 knew how to perform self-examination, while about 80 knew of currently available breast cancer screening services. The study also found that knowledge was significantly better among students who had a relative with breast cancer.
A more recent study conducted in schools in Kandy in 2023,a decade later, among 406 school girls between the ages of 13-18 in randomly selected schools in the Kandy district, showed that while almost half were aware of early detection, less than 40 knew aboout the steps of a self-examination. Results also indicate that those from rural communities had less awareness. I haven’t conducted a thorough analysis on this nor am I a medical professional, but as someone who is at risk and so who keeps an eye out, what does stand out when accessing various sources of information is that prevention and awareness needs to be built into school programming. Funnily enough, I don’t ever recall being informed about it while at school. I am grateful to my grandmother, who made it her mission to educate me as much as she could during her short lifetime, and whose death forever marked me with the notion of preventive checks and awareness.
The big C has touched all of us in some way. These experiences are not mine alone, and there are many more stories to be told, and information resources to be shared that could utlimately save lives through awareness, prevention and early detection.
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