Breaking the silence on breast cancer

National 5 minutes, 48 seconds


Pg Hariani Pg Hj Metussin was diagnosed with breast cancer five years ago, saying that it happened so ‘fast’ and took a toll on her emotionally.

“When the doctor broke the news to me, all I could think about was my children. I was thinking, ‘who will take care of them?’ I still have so much to teach my children. I don’t want to die yet,” said the mother of five and breast cancer survivor.

She is an exception among many women with breast cancer symptoms in Brunei who still adopt the ‘wait and see’ approach, cited as the most common reason for not seeking immediate treatment.

Dk Sukriani Pg Ismail, a breast care nurse from Jerudong Park Medical Centre, said most Bruneian women who seek breast cancer treatment initially assumed their lump was just a harmless cyst or growth, dismissing it as ‘nothing serious’ instead of seeking prompt medical attention.

More women in Brunei are developing breast cancer, and it has been the number one killer of women here for the past few years. But awareness and prevention are challenged, as many Bruneian women still see it as a ‘taboo’, said Dk Sukriani.

According to The Brunei Cancer Centre, a total of 725 breast cancer patients were recorded from 2005 to 2014.

The nurse, who is also a ‘breast scanner‘ with eight years of experience, told The Brunei Times that the ‘wait and see’ attitude has always been the issue and is a barrier for women in getting the help they need.

“Almost all the women that seek breast cancer treatment admit to being scared, embarrassed or are in denial,” said Dk Sukriani, adding that those who are diagnosed often don’t tell their spouses or families.

She said most cases of breast cancer in Brunei are discovered later, when the rate of survival is drastically lower.

“Often Bruneians will seek treatment from a traditional or spiritual healer first, and by the time they see an oncologist, the tumour is more likely to have already spread and is more difficult to treat.”

Dk Sukriani said there are a number of reasons why women delay seeking treatment.

“From my observation, I can see that some are embarrassed because they consider it still as a taboo or something that nobody talks openly about,” she said, adding that some patients said they were too scared to seek medical help out of fear that it might be breast cancer.

She said some diagnosed patients initially believed their symptoms weren’t a serious issue and only sought treatment when their lesions became unbearable.

Dk Sukriani said there were many instances where women with breast cancer only sought medical help after the lumps in their breast ruptured.

“It really is sad when women are so scared that they conceal and keep these things to themselves when they really shouldn’t be going through this alone,” she said.

Cancer was no stranger to Pg Hariani, as her late mother was diagnosed with ovarian cancer.

“One thing I learned from my late mother is to never give up,” she said.

Recounting her battle against breast cancer, Pg Hariani said she discovered a lump the size of a 20-cent coin under her armpit as she was getting ready for work.

“It was hard and craggy but painless. It kind of felt like having a green pea under your skin,” she said.

Upon getting herself checked at Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital the first time, Pg Hariani was told that ‘nothing was there’.

But just a week later, she discovered an even bigger lump.

“I insisted on getting a second review. I wasn’t going to go home, because I just didn’t feel right. I knew something was wrong,” she said, adding that the results came back positive a week after undergoing a breast biopsy with the cancer still in the primary stage.

To prevent the cancer from spreading, Pg Hariani underwent a double mastectomy, or the removal of both breasts.

Napisah Hj Amit, a clerk at the Education Ministry, wasn’t as fortunate as Pg Hariani. She was diagnosed with stage two breast cancer, when the cancer is growing but is still contained in the breast or growth has only extended to the nearby lymph nodes.

Napisah had delayed seeking immediate help even after suspecting the lump was cancerous.

“I first noticed a pebble-like lump on my nipple, but I brushed it off. But when I started having pains, I decided to tell my husband and went for an analysis,” she said.

“I didn’t know how to react when doctors first told me the news. All I could think about was death and that it’s too late to do anything about it.”

Napisah said family and friends tried to ease her pain by saying ‘There’s a cure! You’ll be fine. My sister/cousin/hairdresser had it, and they survived!’

“When I was told I had cancer, I was afraid because I had no knowledge about the disease. I hear about cancer all the time, but never did I imagine it would happen to me,” she said.

As part of Napisah’s treatment to fight off breast cancer, she had to undergo eight phases of chemotherapy.

Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. It also affects both cancer cells and non cancerous cells.

“The first phase was bearable, and my children and husband were there to give me support. But towards the second time round, the chemo weakened my body and my hair started falling out,” said Napisah.

“Weeks into my treatment, I woke up with clumps of hair on my pillow. My eyebrows started to shed and my lashes too,” she said.

Dk Norhayanti Pg Hj Jaya, another survivor who was diagnosed with stage two breast cancer, said she too was scared to seek immediate help after finding a hard lump in her armpit.

She said doctors only found the cancer after her second check-up.

“The first time I went for the check-up, the doctors couldn’t find anything. They just thought it was a lymph node and performed minor surgery to remove it.

“(But) after the surgery, I started to bleed in the area where the surgery was performed. So I went back for a second check, and that’s when doctors found that it was more than just a lymph node and the cancer was aggressive,” she said.

She said that after several mammograms and ultrasound scans, she was finally diagnosed with stage two breast cancer and was advised to undergo a double mastectomy.

Dk Norhayanti urged Bruneian women of all ages to learn their body and to perform breast self examination religiously.

“Trust your instincts. Learn your body. Feel your breasts regularly for abnormal changes. If you find anything unusual, go seek an expert’s help immediately,” she said, noting that a second review can save your life.

The Brunei Times