Breast Cancer Meanings Symposium (Mar 16, 2018)

"How can we improve lives of women if we do not understand the women?" - Jingmei

Jointly organised by the Saw Swee Hock School of Public Health and the Department of Surgery, Yong Loo Lin School of Medicine in National University of Singapore, the Breast Cancer Meanings Symposium (BCMS) 2018 was held to mark the completion of the first out of three phases of anthropology for research and intervention program on Asian Breast Cancers. The anthropologists and academicians involved in the sharing of their findings for this phase were Dr Celene Ng, Dr Miriam Zeitzen, Dr Martin Platt, Professor Cynthia Chou, Dr Benedikte Kristensen, Ms Misha Zand and Dr Daniella Kuzmanovic.

Unlike the usual symposiums that we have previously attended, among ourselves that attended BCMS 2018 agreed that it provided a refreshing take on breast cancer, in the sense that it wasn’t a heavily scientific figures-and-numbers presentations of results. It addresses the voices, and backgrounds of the Asian breast cancer women affected, which govern their behaviours towards getting checked up, having follow ups and the western treatment.

The symposium started with an introduction of the project and the countries involved, i.e. Singapore, Malaysia, Thailand and Burma, China, Mongolia, Tehran and Turkey. Following that, the anthropologists/academicians that were involved in each of the countries were invited on stage to share what they have found, with regards to the cultures and barriers that are affecting the behaviours of the women. As shared by them, among the factors affecting the behaviours are religious beliefs (relating to treatment itself as well as post-treatment aesthetics), preference for traditional medicines or shamans over western medicine, and the idea that if there is no pain felt, there is no disease.

Subsequently, the recurring observation that Malay women have the lowest survival rates as compared to other major ethnicities in Singapore, i.e. Chinese and Indian, was discussed by A/Prof Wong Mee Lian. This then led to a dialogue session about how the situations we have at hand can be combat by medical practitioners alike.

From the symposium, some thought-provoking concepts were raised, and from Dr Li Jingmei herself, they include: 1) Are women with a higher pain threshold at a higher risk of more advanced disease? 2) If a woman is over-informed about the disease, will she be vulnerable to phantom symptoms that do not exist? Also, as brought up by Brandon, since there was a lack of male interviewees for the project, perhaps an involvement of them might contribute a different perspective on breast cancer as an illness. From here, we believe that the need to understand the breast cancer patients themselves is an essential approach towards increasing their survival rates and better improve their lives.

- Hanis

Reflections taken away from the event:

Chek Mei: This symposium is very different from the scientific symposiums that I have attended before. Usually patients are being reported as just a number or a figure in the results, whereas in this symposium/studies, we got to know the patients' feelings and thoughts, their voices are being heard. What makes it even more special is that it involved Asian women with different culture and religion. We got to know that regardless of the differences, women often put their family before their own health.

Brandon: The Breast Cancer Meanings Symposium provided a different perspective on the fight against cancer. Anecdotal evidence collected by anthropologists and academicians from different parts of the world reinforced the notion that culture and religion may be important factors influencing the behavior of women and preventing them from seeking early treatment. Personally, I found the theme of the symposium to be a refreshing and engaging change from other cancer symposiums. While the effectiveness of a coordinated intervention with other religious and social organizations is not yet clear (and for that we need to wait for the results of the Phase Three study), I feel that this is an important area that addresses the human experience of cancer as an illness and not just a disease. What I thought was perhaps a little lacking was the absence of male interviewees; it might have been interesting to see whether they had any influence on the behavior of their partners. Furthermore, many of the factors discussed such as fear of pain and denial of the problem are not unique to breast cancer. Nevertheless, on the whole, I believe that this is a much needed addition to addressing the multidimensional problem of breast cancer.

Hanis: Having only been exposed to biological aspects of breast cancer in school, attending the symposium allowed me to widen my perspectives about what could be studied from diseases and how its effect on not only the patients, but the people surrounding the patients, is also an essential approach towards increasing its survival rates. Breast cancer patients’ behavious towards getting checked up, towards having follow ups and towards western treatment are among the topics discussed. The differences in those behaviours across Asia are influenced by culture and religion. With this understanding, we can work with the respective cultural and religious figures to help make the lives of breast cancer patients better.