Today #19Oct, International Day of the Fight against Breast Cancer, from lapatilla.com we are supporting this cause through various special publications to raise awareness about this terrible disease.
By La Patilla
Oct 19, 2022
According to data from the World Cancer Observatory, between 3,000 and 3,500 women died of breast cancer in Venezuela in 2020, that is, about nine women per day. This mortality statistic is probably much lower than the real number, since it is based on a model that does not consider the serious setbacks in the country’s public healthcare system in recent years.
Although it is well known that breast cancer does not distinguish skin color, social class, religion or political preference, when it occurs in a country with a complex humanitarian crisis like Venezuela, it can be much worse for the patient and her family.
In the midst of a shortage of drugs, deficiencies in the public healthcare system, including the lack of advanced equipment, many suffer a true tragedy to receive their treatments.
Among the many cancer patients in Monagas State, there is the case of Yaritza Figueroa, who since 2014 has waged an arduous battle against this disease. In the first stage, she received nine chemotherapy sessions, thanks to the salary of her husband, she was able to cover the expenses in a clinic. Despite the fact that she was set to undergo reconstructive surgery of breast once the chemotherapies were over, she never had the surgery since she was unable to raise enough money for this purpose.
Four years passed, and in 2018 the breast cancer reappeared but much more aggressive. In the midst of the country’s critical economic situation, she was unable to carry out any type of examination or pay for consultations. Ms. Figueroa recounts that she thus arrived in 2020 with an overexposed tumor combined with an infection, for which she had to be hospitalized for 22 days.
“Through churches and many relatives, little by little I was able to cover the treatment with antibiotics. I was discharged, went to the hospital surgery department and was sent to see a clinical oncologist. It was a private doctor’s appointment, since in the hospital appointments have a waiting time of four months, but mine was an emergency. One of the in-law‘s of my sister offered to help me, he sent her the money to pay for the appointment and the first thing the doctor told me was that she needed urgent chemotherapy, because she could die. She had no money and the doctor told me that it didn’t matter, that I could pay in installments, but I couldn’t leave without the chemo,” said Figueroa.
She added that at that time she only had six grams of hemoglobin, as she had suffered three strokes. Prudently, the specialist only applied the drug that was going to shrink the tumor. From abroad, several friends of her relatives sent her money to pay for the second chemotherapy. “Fortunately, the medicines were given to me for free at the Ivss.”
“All medical exams, tomographies, echographies, among others, were paid for and we had to sell almost all our belongings, such as furniture, clothes, refrigerator, decorations, tents, dining set, things that we did not use and that were kept almost new. We were left with almost nothing, the cancer ate everything. In 2014, on average, my husband was able to cover all the expenses, not anymore,” comments the patient sadly.
Currently, she fights against a bacterium called staphylococcus coagulase, for which she has a daily expense of 20 dollars to buy gloves, gauze, compresses, hydrogen peroxide, antiallergic adhesive and 0.9 physiological solution. Sometimes, because she does not have the money for this specific treatment, she cannot perform it, which causes her to crash.
Psychological Help is Essential
For the clinical psychologist, Nilda Salazar, professional help and emotional support from the family is essential for the patient with breast cancer. She points out that it is a very hard experience that the patient associates with death, so she recommends that the person have an optimistic mentality, focus on treatments. Despite being a deadly disease, it has many options for survival through treatment.
“It is very important that the person remains positive as much as possible, to open emotionally to receive support from their relatives. Talking about her fears, anxieties. That helps to have a lot of relief and well-being, because there are those who close themselves off so as not to worry their relatives. They must understand that at that moment, they are the most important thing and their relatives will understand it,” explains the professional.
She adds that adversities should not unnerve us, such as the concern of not getting medication, to always believe that all the possibilities might not be exhausted, that is, seek all possible help, including selling goods.
“You have to understand and accept the reasons why that sacrifice is being made, because it is about health, about saving a life. It’s like when a father sacrifices everything for a son, it should be seen that way,” says Salazar.
She reiterates that it is critical to adopt a positive attitude towards the disease, to cultivate a sense of humor. She indicates that there is research showing that cancer patients subjected to several hours of humorous videos, the “natural killer” cells increased in quantity. These are the cells of the immune system that fight against those that are cancerous.
“It is inevitable that during recovery or during the process, the patient goes through depressive processes. That is why there should always be psychological support and emotional support from family or friends. They can’t lock themselves up, don’t pretend that everything is fine, look for a friend, a sister, cry, because you’re going to feel better. That liberates,” comments the specialist.
“Depression Is a Ticking Time Bomb”
Graduated from the Universidad de Oriente, Lusymar Taly has a degree in Human Resources. She is a broadcaster and a single mother. Two years ago she was diagnosed with breast cancer and since then she has been fighting to win the battle against the disease.
She confesses that at first she locked herself up to accept this situation, because in her opinion it is not a disease, but a situation that anyone can suffer, and manifest itself in any part of the body.
One of the factors of this disease is how expensive it can be and that terrifies her: not being able to move on, not getting the medicines that the Ivss supplies to advance in the treatment. She regrets that the medicines delivered by this State institution have already expired, but even so they must use them in her treatment, since necessity forces them to do so.
“There are many of us who go to the Oncology Unit of the Central Hospital of Maturín because we do not have enough money to pay for the care that is required to receive such delicate treatment in a clinic. We bite the bullet (…) only God knows human need. In God we can have faith, but it is man who must act. For this reason, with my discomforts, I have had to get ahead organizing raffles, events to collect money, and so on,” Taly narrates.
Her psychologist recommends that she distract herself “because I can’t get depressed, I can’t go backwards (…), depression is a time bomb.” Despite having turned to institutions such as the mayor’s office and the governor’s office, she is still waiting for help.
She regrets that this is the sad reality, since she considers that “in many eyes, everything is fine”, but she considers that it is with actions that she manages to captivate the people, although she is aware of the many needs: “Health is health, the rest is gain”.
“I already received the chemotherapies and I am waiting for surgery, but they still haven’t called me for surgery and what they tell me is that the waiting list is long. The wait anguishes me, since time passes and it is a physical situation that does not stop. We are in God’s hands,” she points out.
Public Healthcare Requires Modern Equipment
The mastologist Irene Alves regrets that after the pandemic, they are receiving patients with very advanced lesions
One of the flaws in the public healthcare system is the lack of high-tech equipment that allows a more effective diagnosis, which is why many lower-class women cannot even afford a mammogram. Only the Municipal Institute for Women and the Family has a mammography machine, but it is analog-digital, and high resolution is required.
The mastology surgeon with 22 years in this specialty, Yrene Alves, says that the “José María Vargas Ambulatory” cares for more than 20 patients daily. In general terms, 30% to 40% of breast pathology consultations result in a diagnosis of breast cancer. However, it can vary because a patient can go to the consultation several times, before reaching the operating room.
“We try to do a multidisciplinary management where the imaging part is involved, in which the patients go to the private sector, because in the public sector we do not have high resolution equipment. It is important that these are good quality equipment run by doctors trained in breast pathology. We also have the psychology part, we send patients to the psychiatrist who is in the Vargas Ambulatory and in the Women’s House before going into surgery. It is a way of adequately preparing the patient according to a breast cancer protocol,” Alves details.
The mastology professional specifies that after the pandemic, they are receiving patients with well-advanced lesions that are detrimental to the evolution of the person’s health. When this happens, the patient has to undergo systemic treatment, so surgery would not be the first option, but chemotherapy to try to reduce the size of the tumor. Many times they arrive in inoperable states. When advanced lesions arrive, the malignant cells may already be dispersed to other organs such as the lung, liver, bone, hips, among others.
Ms. Alves recalled that in the last consultation, of 22 patients seen, 10 (almost 46%) had a malignant pathology and of those 10 people, 30% were under 40 years of age. That is why she calls on women over the age of 35 to get a medical exam, so they should not underestimate any injury, because they can present breast cancer.
The surgeon suggests that there should be a working Radiotherapy Unit (in the public hospital), since treatments are very expensive in the private sector. At the public level there is no Radiotherapy Unit, so women who need it must travel to other states to stand in long queues to receive radiotherapy. The cost of such a treatment ranges from $12,000 to $14,000 at a clinic, according to testimonials from Dr. Alves’ patients.
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Read More: La Patilla – The drama of being a breast cancer patient in Venezuela: “I had to sell almost everything to pay for my treatment”
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