From zero awareness to a full package of world-class care and patient support, breast cancer treatment has come a long way in the UAE.
It is 20 years since the founding of Brest Friends, a patient support group which has helped thousands of women deal with the uncertainty and fear surrounding the life threatening condition.
Although survival rates are on the increase, so are cancer rates in general – with the founders of Brest Friends warning complacency is the biggest barrier in the way of further progress.
The latest National Cancer Registry showed breast cancer remained the most common form of the disease, but just 25 per cent of at-risk women were being screened.
One of the UAE’s first female consultant breast surgeons, Dr Houriya Kazim, is medical director of the Well Woman Clinic and founding president of Brest Friends.
While great strides have been made in attitudes towards breast cancer, she said there is still work to do.
“In 1998 when I first arrived here, there was absolutely no awareness of breast cancer, I mean zero,” she told The National. “I was seeing advanced breast cancer cases, and it was very difficult to develop advice and awareness within the cultural boundaries of the time.”
“I put together videos in five different regional languages, basically showing women how to examine their breast without actually showing a breast. Then some women started asking for a support group, as they liked to talk.
“I had people actually call patients up, ask them what they thought and the majority wanted something like that, so it began from there.”
Soaring cancer cases
Cancer is the fifth leading cause of death in the UAE, and responsible for about eight per cent of all deaths.
Since 2019, there has been a 60 per cent increase in cancer cases, largely due to better diagnostic screening and a growing population, but also more lifestyle related risk factors such as obesity and smoking.
Since the launch of Brest Friends in 2005, scores of women and their families have benefited from support and guidance from health professionals, and others who have experienced cancer.
The group meets monthly in hotels in Dubai, bringing the cancer community together to discuss a shared view and pass on advice. A WhatsApp group also exists to offer quick tips and answer questions.
Dr Kazam now believes more is needed to be done for other forms of cancer.
“Our therapy has always been talking to friends and other women, that's just been our way of dealing with life in general,” she said. “We have several patients with other types of cancer because there aren't any support groups for them. Cancer affects everyone, it doesn't know who's rich, or who's poor.”
While arduous radiation treatments and chemotherapies can be physically demanding, the psychological toll on patients is an often underreported aspect of recovery.
Since 2015, the Al Jalila Foundation has been working with Brest Friends to operate a drop-in centre to support women trying to navigate the path to recovery.
Charity partnership
The Majlis Al Amal cancer drop-in centre in Dubai Healthcare City offers a safe space for patients and their families to relax and receive both support and expert advice. All services are offered free of charge, with volunteers often having experienced cancer themselves.
British primary schoolteacher Charlotte Rule was diagnosed with breast cancer in July 2022 when she was seven months pregnant with twin boys. Doctors decided to deliver the babies early through emergency Caesarean section due to an unrelated medical condition, pre-eclampsia.
Three years on and the boys Reuben and Ezra are healthy, while Ms Rule has almost fully recovered.
“The hardest bit was the fact that I actually found a lump in February and it took until July to get diagnosed,” she said. “Originally my condition was misdiagnosed as fibroids, and I was told not to worry about it.
“As it was getting bigger, I moved hospitals to see a breast specialist, but had to wait for my insurance to come through before I was able to get an appointment, which delayed my treatment."
In response to the most recent national cancer figures that showed more than half of cancer (56 per cent) is found in women, doctors said there was an urgent need for a national insurance code for cancer management to improve access to care.
Because of the variation in policies and approvals, early detection can be delayed due to administrative delays, doctors said.
The Al Jalila Foundation said it had seen a huge increase in applications for financial support from cancer patients, largely as a result of increasing cases, insufficient insurance coverage and high treatment costs.
Psychological impact in recovery
Dealing with the long term psychological impact of breast cancer can also be a challenge, and is where support groups come into their own.
Dr Melanie Schlatter, a health psychologist at American Hospital Dubai, said Brest Friends offers support that otherwise may be out of reach.
“Post-diagnosis, women often face emotional distress, such as anxiety and depression, body image struggles and social isolation,” she said. “Longer term, there is psychological impact, trauma, lingering anxiety and identity challenges that can persist for years, even after remission.”
Through Brest Friends, women can access peer connections, survivorship activities and general psychological safety through shared experiences and community building.
Dr Schlatter, from New Zealand, said the model could be replicated to offer similar support for other cancers.
“Financially, it's typically high treatment costs and lack of insurance coverage for mental health care which create barriers to accessing psychological support,” she said. “The success of Brest Friends really shows the value of culturally sensitive, long-term community spaces that normalise emotional struggles and basically foster belonging.
“The model could be adapted or other cancers. There are women who joined many years ago who are still participating now and helping new women. Longer term survivors have a lot to teach the newly diagnosed, it's a really lovely model.”
