Breast cancer: undetected problem

If early detection is the key to the battle against breast cancer, the high cost of screening and lack of insurance cover in the UAE are certainly not helping the cause. The number of breast cancer cases in the UAE is said to have doubled over the past decade, making up for 18.4 per cent of all cancer cases. Yet, only 30 per cent of them are diagnosed in the early stages. Doctors, who recommend that a mammogram should be an annual ritual for women post-40, concede the test is still beyond the reach of many. Insurance imperative "If we're asking all women to be screened every year after 40 and it is not covered by insurance, we are doing them a disservice," said Dr Naglaa Rizk, Specialist Obstetrician & Gynaecologist at Welcare Hospital. "When cancer is detected early, it is easier to treat — even cure — the patient and it is cheaper for the health-care system. But when women have to pay out of their pocket to get themselves screened, they tend to avoid it and we end up detecting cancer when it is too late," she said. "Insurance companies should cover screenings for women aged 40 and above," said Dr Zaid Abdul Aziz Almazam, Consultant Breast Surgeon at Dubai Hospital. "If these women come back as patients later, the cost to insurance companies is high." He said women with a family history should begin their screenings from the age of 25. Although a mammogram is the first test for detection, a sonogram and an MRI are added if a suspicious mass is found. The cost of a routine mammogram can range between Dh500 and Dh800. With an ultrasound scan and MRI, the cost can go beyond Dh3,000. "I cannot spare this kind of money every year for a mammogram in addition to what I would have to spend for a pap smear and other tests," said Paula Davis, a 43-year-old housewife who is yet to get her first screening. "I don't understand why insurance companies cover you when you develop breast cancer and not earlier," said Judith Hobby, 47. A resident of Arabian Ranches, she said she gets herself screened annually because breast cancer runs in the family. But hospitals and insurance companies have their own compulsions. Hospitals claim high prices of the tests are justified to cover costs while insurance seldom deals with prevention. As Sanjay Tolani, Director of Goodwill Insurance, explained, "Insurance works on covering cures. Breast cancer check-ups are more of a precaution. Even the few companies which cover annual check-ups do not include breast cancer screening unless medically required by a doctor." "I believe this should change as precaution is always better than cure. If people are covered while they check for major ailments, insurance companies will also be aware of the claims they would have to pay in future," he said. Treatment costs According to him, the average cost of treatment of a typical case of breast cancer can vary between $50,000 (Dh183,650) and $100,000 (Dh367,300), a sum that insurance companies cough up fully if the patient is covered. The need for early screening and timely detection cannot be undermined. Dr Jalaa Taher, Section Head Cancer Control & Prevention at the Health Authority of Abu Dhabi (HAAD), said an increase in the number of public awareness campaigns had brought down the number of cases presenting with late stage breast cancer from 64 per cent in 2007 to 36 per cent in 2010 in the capital. Pink pug Friday On October 21, the Dubai Pug Club, which has around 100 canine members, will be turning its play day into a Pink Pug Friday to create awareness about breast cancer and pitch in for cancer research. The snub-nosed pugs and their owners, all dressed in pink, hope to make a difference by educating the public on the importance of early detection to curing breast cancer. "What better way than this to draw attention?" said Teo Impey, 9, as he played with his pug at a run-up to the event. "It's just a small gesture on our part to create awareness and do what should," said Laura Marr, Founder of the Dubai Pug Club. Free/Discounted Screenings City Hospital: 20 per cent off on mammograms till month-end EHL Dubai Mall Medical Centre: 50 per cent off on mammograms between October 22 and 27 Lifeline Hospital & Abu Dhabi Tourism Authority: Free mammograms at Marina Mall on October 20 & 21