‘Hope and help’: How the Philippines fights to lower breast cancer deaths - Rappler

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MANILA, Philippines – There’s a bold ambition in global cancer research to eliminate breast cancer as a cause of death. 

And it’s this goal that has transformed cancer treatment over the years, even making Stage 4 or metastatic breast cancer — when the cancer has spread to distant organs like the bones, lungs, liver, or brain — more manageable. 

“It’s important for people to know that metastatic breast cancer is not a death sentence,” said Dr. Marvin Mendoza, head of medical oncology and ambulatory infusion therapy unit of the National Kidney and Transplant Institute.

“It’s really very different from before, like the ’90s. We now have a lot of options.”

“The medical advancement in cancer is really fast. There’s a lot of investment in innovative medicine,” added Dr. Kriska Lim, medical affairs head of oncology for AstraZeneca Philippines.

“Most people think when it’s metastatic breast cancer, they won’t get treatment anymore. But even people with this cancer can live meaningful lives if they get the right treatment and the right support.”

But there are still a lot of hurdles doctors and breast cancer advocates face when dealing with Filipino patients.

For instance, some patients diagnosed at advanced stages abandon standard treatment and turn to alternative remedies, believing these will cure them. Others refuse biopsy on a suspected tumor, fearing the procedure will cause it to spread.

Kara Magsanoc-Alikpala, co-founder of the ICanServe Foundation — which helps breast cancer patients by connecting them to medical specialists, educational resources, and support groups — said there are many misconceptions in local communities.

“Common ‘yung nakakahawa ang breast cancer (The belief that breast cancer is contagious is common). A lot of husbands distance themselves, it’s so common in communities,” she shared.

“There’s also the use of underwire bra and deodorants, we still get that. And the biopsy, ’pag ginalaw, kakalat (if moved, it might spread), it’s so common.”

The lack of breast cancer awareness and education remains one of the reasons the Philippines ranks poorly in global breast cancer statistics. 

In the US, around 66% of breast cancer patients from 2019 to 2023 were “diagnosed at a localized stage, meaning the cancer had not spread outside the breast.” This early detection results in a higher survival rate, according to the United States Cancer Statistics. 

Unfortunately, that isn’t the case in the Philippines.

“We’re so far from that. We’re the total opposite,” said Magsanoc-Alikpala. “Around 65% of breast cancer here is diagnosed at an advanced stage, Stage 3 or 4.”

Breast cancer remains the most common occurring cancer among Filipinos, according to the 2024 statistics of the International Agency for Research on Cancer of the World Health Organization (WHO).

It’s the second highest cause of death among Filipino cancer patients in both sexes at 12.9%, just behind lung cancer (13.6%).  

In Asia, the Philippines also ranks in the top six for both breast cancer incidence and mortality in 2024, according to WHO.

“We really want breast cancer, and all cancers in general, to have enough attention. In AstraZeneca, our bold ambition is to eliminate breast cancer as a cause of death,” said Lim.

“Recently, breast cancer is no longer the top cause of death. For it to happen, there’s a lot of things we have to look into. We recognize that it’s not enough that we bring the medicines in, it’s not enough that we invest. We’re supposed to work with like-minded organizations and really help the country move forward.” 

“We do have advanced lines of treatment for metastatic breast cancer. It’s not just chemotherapy. There are a lot of targeted therapies now made available,” added Mendoza. 

“Of course, made available is different from made affordable and accessible. But it’s one thing that they’re already here. We have to do the work to make it affordable for more patients, because treatment can take years or even a lifetime.“

Medical professionals and advocates admit there are still many gaps even as the government expanded the PhilHealth Z Benefit, the health package that covers catastrophic and high-cost medical conditions.

“The biggest program is the PhilHealth Z Benefit package, but the sites and hospitals that offer it are still limited. That’s why the lines are so long,” said Magsanoc-Alikpala. 

Other government programs to help alleviate medical costs include the YAKAP program, which covers cancer screening tests, and the Cancer Assistance Fund under the National Integrated Cancer Control Act, which covers specialized treatments and palliative care.

“There are many initiatives from the government, medical society, and private institutions, but it has to reach the communities. That’s the main barrier,” said Mendoza.

“If people don’t know about the program and initiatives, how to access them, it doesn’t complete the loop. There are still many people who haven’t been reached.”

While a lack of awareness about government programs often leads to late diagnosis and poorer outcomes, navigating the required paperwork once assistance is found presents an entirely different challenge.

“Kailangan pa rin ng kumpas ng gobyerno para mas ma-improve pa (The government needs to provide direction to improve it),” said Mendoza.

For now, some private institutions try to fill in the gaps, with the ICanServe Foundation, for instance, running its Ating Dibdibin (Take Your Breast Care to Heart) flagship program. 

“We partner with local government, usually a city, then we institutionalize the program. It’s a community-based breast cancer control program with the aim of saving lives,” said Magsanoc-Alikpala.

“We bring services to the barangays instead of expecting them to go to the hospital. It’s proactive, going house to house, checking on women, because sometimes they don’t know where to go. We make sure there’s a clear pathway, there are patient navigators to hand-hold the patients.”

Lowering breast cancer deaths in the Philippines through early detection remains the key message among advocates, who hope that conversations would go beyond the Breast Cancer Awareness Month every October.  

“The government should really have a national campaign. It’s the same message every year — early detection,” said Magsanoc-Alikpala.

“We really need to be intentional in the way we promote our message, not only early detection, but there’s hope even if your cancer is diagnosed at a later stage.”

“I want everyone to know there’s hope and help,” she added. 

“There’s the medical world, their supportive care. The government has some help — it’s not enough, but it’s a big help as well. There are foundations willing to help patients. But take charge of your health. Get screened. When you’re young, that’s the best time to find out.” – Rappler.com