DEIR AL-BALAH, Gaza Strip, Palestine – “I always encourage the women I know to do a self-examination and regular screenings,” Intisar, 55, told UNFPA. She is a breast cancer survivor from Deir al-Balah in the Gaza Strip, and her outspokenness about the topic is a rarity in her community.
The incidence of breast cancer has been increasing in Palestine in recent years – partly due to growing awareness and detection, but also because of lifestyle and dietary habits related to poverty. It is the most prevalent cancer among Palestinian women, accounting for 32 per cent of cancer diagnoses in the West Bank and 18 per cent of those in the Gaza Strip.
Breast cancer is most treatable when detected early. Unfortunately, more than 60 per cent of breast cancer cases in Palestine are found at a late stage, reducing the chance of survival.
Women with breast cancer also face serious stigma.
In Palestine, it is widely understood that vulnerability to breast cancer can be hereditary. As a result, some women avoid getting screened because they fear a breast cancer diagnosis could affect their daughters’ marriage prospects. Women with breast cancer have also faced gender-based violence and abandonment. A recent UNFPA study showed that breast cancer stigma is a major cause of delayed detection and treatment.
Intisar was fortunate to have the support of her family when she received her breast cancer diagnosis in 2016. But the social stigma left her feeling depressed and isolated.
A ray of hope
UNFPA works with the Ministry of Health to improve detection and treatment efforts, and coordinates a breast cancer working group.
Working with Augusta Victoria Hospital and the Palestinian Medical Relief Society, and with funding from the Government of Japan, UNFPA has deployed a mobile breast cancer screening clinic to marginalized communities in the West Bank.
UNFPA also works closely with the Culture and Free Thought Association (CFTA) and the Campaign for the Children of Palestine to support breast cancer patients in Gaza. After Intisar received chemotherapy, she started to visit the CFTA for services.
There, she received a wig, dignity kits with hygiene products, hormone therapy, vitamins, medication and financial assistance. The association also helped her receive a mastectomy operation and prostheses. CFTA also provided psychosocial support, recreational activities and group outings.
“I met women who became my real friends,” Intisar recalled.
These services, as well as community awareness sessions, are supported by UNFPA with funding from the Government of Japan. Awareness is essential, experts say.
“The aim is to increase awareness on the importance of early diagnosis for breast cancer for both women and men,” said Firyal Thabet, director of the Women Health Centre at CFTA.
“We do this by online campaigns, radio coverage, and by involving mosques, hair salons and taxi companies. Now we see more and more women and men coming to our centre for screening.”
“Do not give up”
Swift access to treatment services is also crucial. A recent evaluation of UNFPA’s projects on breast cancer found that, among the project’s clients, the average time from diagnosis to initiation of treatment fell from 6 months to 7 days between 2016 and 2018.
Still, some treatment options remain out of reach.
Intisar needed to receive radiotherapy, but no such services were available in Gaza. CFTA helped her obtain a permit from the Israeli authorities to receive treatment at Augusta Victoria Hospital in East Jerusalem, but her permit application was rejected five times before she was finally granted permission.
In 2018, almost 40 per cent of Israeli permit applications for Palestinian patients to exit the Gaza Strip to receive treatment in the West Bank or Jerusalem were rejected or delayed. About a quarter of these applications were for cancer care.
Today, Intisar is a leading advocate for early detection and a peer supporter at CFTA. She also counsels women and girls about the topic in her community. “Breast cancer is a start of a new life and not the end of your life,” she tells them. “Do not give up.”
She is also refusing to give up.
A year ago, doctors found a small cancerous tumour on her lung. She is again undergoing chemotherapy.
“I am hopeful that I will recover again,” she said, “with the help of God and those around me.”