One Saudi woman ignored the cancer growing in her breast for fear of seeing a male doctor. Another was summarily divorced on the mere suspicion she had the disease, while a third was dragged away from a mammogram machine — the technicians were men.


Breast cancer is considered a taboo in the religiously conservative Arab countries of the Persian Gulf even as the disease claims more and more victims. But some women are pushing for greater openness about the illness.

Their efforts received a boost last week: a visit from first lady Laura Bush to raise awareness about breast cancer.

On Wednesday, her second day in Saudi Arabia, Bush met with breast cancer survivors in the western seaport of Jiddah. As a token of appreciation, they presented her with a long black scarf — the kind Saudi women use to cover their hair in public — with pink ribbons symbolizing the disease attached to both ends.

They then helped her wrap it around her head, even though visiting female dignitaries are exempt from Saudi Arabia’s strict Islamic dress codes for women.

Reporting lags

"No campaigns, ads or programs would have had the kind of impact that Laura Bush’s trip has given to breast cancer awareness in the kingdom," said Samia al-Amoudi, a gynecologist who was diagnosed with the disease in 2006.

"Her trip will make people ask: ‘Why is she here? For breast cancer? Is it that serious in this country?’" she added.

In Saudi Arabia, about 70 percent of breast cancer cases are not reported until they are at a very late stage, al-Amoudi said. In the U.S., most breast cancers are diagnosed much sooner, when they are more easily cured.

Al-Amoudi also said 30 percent of Saudi patients are under age 40, compared to 5 percent in the U.S.

Breast cancer is the No. 1 killer of women in the United Arab Emirates, according to official statistics, with many dying because the stigma surrounding the disease prevents early detection and treatment.

Breast cancer awareness campaigns are becoming more prevalent in the Arab world. In Lebanon, for instance, a public service TV announcement shows two round, lit candles. One of them is extinguished as an announcer reads statistics about the disease and reminds women to have mammograms.

But in the more conservative Persian Gulf region, such campaigns are less aggressive, not as organized and unlikely to use such bold imagery.

In Saudi Arabia, a campaign that began this month offers price discounts on mammograms and, in billboards, urges women: "Do the test now, for peace of mind."

‘That disease’

The problem is not a matter of resources. The kingdom has some of the world’s best medical equipment and doctors, and even the poor have access to free medical care.

But many Saudis, like other Arabs, won’t even refer to cancer by name, calling it just "that disease" because of the fear surrounding the illness. Some families are afraid no one will marry their daughters if a mother’s cancer becomes known.

For others, however, the greatest obstacle is the idea of women being examined by male doctors.

Al-Amoudi, who chronicled her struggle with cancer in a newspaper, recounted the story of a woman whose husband always pulls her away from the mammogram room because the technicians are male.

"The first thing women ask me when I tell them to get a mammogram is: ‘Will the radiologist be male or female?’" she said.

Asma’a al-Dabag, a radiologist for 27 years, said the woman who was divorced turned out to be cancer-free, while the woman who had cancer kept her disease a secret even from her two brothers — both of them doctors.

"Some people feel that this is something private and if they talk about it, they become exposed," she said.

Al-Dabag said even many gynecologists rarely talk to patients about breast self-examinations or routine mammograms.

She also has yet to hear from the government about a proposal made months ago calling for research on why there are so many breast cancer patients in the kingdom and recommending that a center be established to help patients cope with all aspects of the illness.

Al-Amoudi has urged clergymen to "enlighten the people and take up the issue of women’s health in their sermons."

Somaia al-Thagafi, 32, who discovered a lump in her breast while in London a couple of months ago, was happy with the support she received from her husband and immediate family. But other reactions were depressing.

A widow’s fear

"Some treated me as if I was on my death bed," she said. "Others told me stories about women who died during reconstructive surgery. Some even told me to drop my treatment and take herbal medicines instead."

Fawzia al-Zewid, a 45-year-old mother of six, said her husband’s support was overwhelming after she was diagnosed with the disease two years ago. When she began losing her hair from chemotherapy, he shaved her hair before shaving his. Her two young sons also shaved their heads.

"They didn’t want me to have the only bald head in the house. What more support could you ask for?" said al-Zewid.

Her husband died of a heart attack last year.

"When he was alive, I wasn’t afraid of breast cancer," she said. "Today, without his support, I am."

Via: Houston Chronicle