Razia (name changed) was only 21 years old when she was diagnosed with breast cancer. Now in her late 20s, she has come a long way from the “extremely challenging situation” in the beginning after she was diagnosed with the disease. It is mostly because of her personal bravery, her parents, her siblings and her caring husband. The latter choose to marry her even after knowing about her medical condition, but provided her full support despite his not so good economic status.
“I particularly want to mention my husband who has been a great emotional support. He makes it easier for me to deal with my health issues,” Razia, who lives in a north Kashmir village, told Kashmir Observer. Her discharge certificate from the hospital mentions that she had “ca in right breast followed by axillary clearance on right side.”
“When I was diagnosed with cancer, I had not even thought of living for a few more years, forget about thinking of getting married. But, by Allah’s grace, I did not only survive, but my husband also proved me wrong when he chose to be my life-partner despite the fact that my breast had been operated upon thrice. Ever since, he has been my strength,” she said.
“I remember those initial days after our wedding when he used to repeat every so often that we have to leave our worries behind us, move ahead with hope and bank on Allah’s blessings to overcome our sufferings,” Razia said while finding it hard to control her emotions. “My husband is a poor man, but his compassion knows no bounds,” she said and added that her relatives have also been very supportive to her.“My parents sold off livestock and other valuable things for my treatment which has taken lakhs of rupees so far,” she said.
Razia is now a cancer survivor and the couple has a few months old daughter as well. But, the health risk for her is far from over as has been the case with cancer survivors. She has to go for regular check-ups and has to be careful that she doesn’t take her medical condition lightly. “The doctors have told me to be very careful. But, thanks to my husband and my relatives, I have never missed any appointment with the doctors so far,” Razia said.
One can’t go through the travails of cancer treatment all alone, she said adding that a cancer patient has to have people around to provide emotional support. “It gave me a lot of encouragement having my loved ones with me all the time,” Razia said.
“She is an amazing fighter. And I found her husband a great support to her,” said Dr. Shiekh Zahoor Ahmad, a Professor and Oncologist at Sher-e-Kashmir Institute of Medical Sciences (SKIMS), one of the senior doctors who has seenRazia during the treatment process. Kashmir Observer spoke with two more breast cancer patients who also highlighted the importance of human element to a cancer patient’s treatment process.
One of the patients from central Kashmir said that she did not only get emotional support from her relatives and friends, but her family was also offered financial support by some of them. Cancer patients and their families bear significant financial burden in different categories which include direct payments for medical care and indirect costs such as lost livelihoods and travelling expenses. These treatment-related costs and other associated costs burden the patients and their families for years after diagnosis. “Thanks to the support from our relatives, we didn’t feel the financial burden to that extent,” the patient’s father told Kashmir Observer.
The government supported health insurance scheme is availed by people ever since the central government announced the scheme a few years back. This reduces their burden to anextent, but some families who have no option than to treat their patients in private hospitals outside the valley are unable to bear the costs unless supported by a relatives and thesociety.
In June this year a cancer patient’s family from south Kashmir’s Pulwama district received 10 million rupees within 24 hours from public following a crowd funding appeal. This was after the family had exhausted all resources at home and made the appeal for donations.The patient however couldn’t survive and lost her battle to cancer early this month. Interestingly, there was a moral outrage from social media users against a tweet suggesting that the sum which was collected for the family should now be made available to some other patient.
Most of the social media users suggested that if someone else is in a similar need, funds could be again collected through crowd funding and that “there is no need to disturb the bereaved family.”
A 2021 study titled “Experiences of social support among Kashmiri women with breast cancer”, which was published in a Taylor & Francis journal and focused on social support, has concluded that breast cancer patients get a lot of social support within the Kashmiri society.
“The study revealed that participants received overwhelming support (emotional, financial, practical, moral, and informational) from significant others (parents, siblings, husbands, children, extended family), important others (relatives, friends, neighbours, colleagues, peers), healthcare providers (doctors, nurses, paramedics, physician’s assistants), and religion and spirituality (religious beliefs and practices, spiritual healers, shrines) throughout their journey with breast cancer and reported varying positive outcomes as a result of the support received,” the study says.
Moreover, the study adds, “social support provided them with strength, and encouragement and instilled a feeling of optimism that helped them to deal with their illness.”
Nazia (name changed), a breast cancer patient, whose medical record says “ca in right breast”, was overwhelmed by the emotional support of the people related to her and associated with her and her family.
“Having the support of your close relatives might not be the cure for cancer, but it helps a great deal to cope with the disease when you chat with other humans. I must have been visited by dozens of families which are related to us and are friends with us. Just imagine the number of stories all these people would have shared with me,” said Nazia who was diagnosed with cancer three years back and has undergone treatment. “And then the relatives and friends often make phone calls asking about how it is going and discuss other things as well. I find it soothing when I am in a mood to talk,” she said.
There has been a sharp increase in breast cancer cases in Kashmir. The number of cancer patients registered at (SKIMS) has witnessed over 100 percent increase in 2022 as compared to 2010, revealed the data accessed by Kashmir Observer at SKIMS.
The SKIMS data further revealed that the total number of breast cancer cases registered at SKIMS in 2010 was 167 which went to 358 in 2022, reflecting a sharp increase in such cases. According to the International Agency for Research on Cancer (IARC), which is part of the World Health Organization’s Global Breast Cancer Initiative, the global breast cancer burden by 2040 will increase to more than 3 million new cases per year (an increase of 40%) and more than 1 million deaths per year (an increase of 50 percent).
IARC further says that breast cancer is the most commonly diagnosed cancer type, accounting for 1 in 8 cancer diagnoses worldwide and that breast cancer incidence rates are highest in countries that have undergone economic transition, but transitioning countries carry a disproportionate share of breast cancer deaths.
Despite Kashmir’s exemplary social structure characterized by compassion, cancer leaves significant impact on patients and families. For example, stigma associated with cancer in Kashmiri culture.
According to a study, Lived experiences of women suffering from breast cancer in Kashmir: a phenomenological study,published by Oxford University Press in June 2021, women suffering from breast cancer do not only have to bear the disease and the direct worries associated with it, but have to also bear other burdens such as financial constraints, negative attitudes and stigma.
One of the themes that emerged during the research study explained the lived experiences of women with breast cancer which included challenges encountered– altered body image, embarrassment, perceived worries, financial constraints, dealing with negative attitudes and stigma. The other important theme according to the study was coping strategies — reliance on religion and spirituality, social support, living as usual, optimistic attitude and will to recover, and venting out.
“The findings revealed that breast cancer diagnosis influences women significantly as they acknowledge that it was the most traumatic experience of their life; however, with time, they started to accept the reality and made use of various methods to cope up with their illness,” the study says.
Post Script: There is not a clear explanation why cancer is rising among young people, but experts say there are several possible reasons behind the trend, including rising obesity rates and lifestyle factors such as sleeping poorly and being sedentary. Environmental factors, including exposure to pollutants and carcinogenic chemicals, also probably play a role. Global cancer cases in people under the age of 50 have risen by 79 per cent between 1990 and 2019, according to new research. Cancer deaths in the same age group also grew by more than 27 per cent, with more than 1 million under-50s a year now dying of cancer. Based on estimates of new cancer cases in 2023, as per the recent study by the US National Cancer Institute, 4.4% of all new cases will occur among ages 15 to 39. 85.8% of Adolescents and Young Adults (AYAs) diagnosed with cancer will survive their cancer for 5 years after diagnosis.
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