Education conducted by civil society can play an important role in filling breast cancer policy gaps and advancing cancer control, including advanced breast cancer, researchers report at the ESMO Asia 2017 Congress, being held in Singapore, held November 17 ? 19, 2017. 
This sub-analysis of a 16-country study investigated whether National Cancer Control Plans (NCCPs), policies and programmes address each step across the breast cancer patient journey? including early breast cancer and advanced disease ? and looked at what activities could be implemented that would advance breast cancer control. The patient journey steps were: recognition and awareness, diagnosis, coordinated care, treatment, and ongoing management.
… Fatalism, inability to act without her husband?s permission, fear of casting stigma on her daughters, fear of being ostracised, and fear of being contagious are some examples of barriers contributing to delays in seeking medical care…
Lack of awareness
Lack of awareness about breast cancer in Asian women as well as in healthcare providers, particularly primary care providers and nurses, can delay the breast cancer diagnosis because women present late for evaluation; a delayed breast cancer diagnosis can also occur because healthcare providers fail to recognise the signs and symptoms of breast cancer or breast cancer recurrence.
The research presented at the ESMO Asia 2017 Congress highlights potential solutions through advocacy initiatives to address the limited awareness of breast cancer symptoms among women and healthcare providers in China. The authors detail a collaborative initiative, implemented with a two-fold objective: to educate the Chinese public and to train frontline healthcare workers on the importance of early detection and signs of breast cancer.
?Studies by other researchers show that social and cultural perceptions of breast cancer are some of the reasons why Asian women do not visit a doctor until the cancer is in its advanced stage,? noted lead author Katherine Hunt, programme manager, Global Programmes, Susan G. Komen, Dallas, US. 
Fatalism & Fear
?Fatalism, inability to act without her husband?s permission, fear of casting stigma on her daughters, fear of being ostracised, and fear of being contagious are some examples of barriers contributing to delays in seeking medical care. These barriers can be addressed with education programmes tailored to local culture, religion, and social norms,? Hunt observed.
?The study shows that in addition to working with women, it is also effective to work with primary healthcare providers. The timely referral of patients can play a significant role in obtaining diagnosis and referral to the appropriate treatment,? she added.
?Educating people in communities and healthcare providers is key to dispelling myths and misconceptions about breast cancer. By increasing people?s knowledge about breast health, they are empowered to make informed decisions. For this, it is crucial that education is tailored to local culture and beliefs, and that accurate information is provided,? Hunt concluded.
A complete journey
?Since early detection of the disease paves the way for precision medicine and multidisciplinary treatment that can result in improving survivaln outcomes for breast cancer patients, the healthcare providers and the community need to promote the full range of the patient journey steps, i.e. recognition and awareness of the disease, diagnosis, coordinated care and treatment,? said Masakazu Toi, MD, Professor of Breast Surgery, Kyoto University, Kyoto, Japan, commenting on the study.
?For multiple reasons as indicated, the promotion activity might be less in these countries as compared with other countries. Therefore, the information should be shared in our communities and we need to develop a sophisticated system to decrease breast cancer related mortality. In addition, the advanced diagnosis planning may be helpful for the early detection,? Toi observed.
Last Editorial Review: November 19, 2017
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