Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or "bomoh" at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.
Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34). All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32-2.64). Top 10 items with "moderate to high" level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old), had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups.
Triple negative breast cancer (TNBC) is associated with aggressive tumour phenotype and early tumour relapse following diagnosis. Generally, clinicopathological features such as tumour size, patient's age at diagnosis, tumour histology subtypes, grade and stage, involvement of lymph nodes, and menopausal status are commonly used for predicting disease progression, prospects of recurrence, and treatment response. Prognostic value of clinicopathological features on Malaysian TNBC patients is limited. Thus, this study is aimed at investigating the association of clinicopathological features on disease-free survival (DFS) and overall survival (OS) of Malaysian TNBC patients undergoing TAC chemotherapy. Seventy-six (76) immunohistochemistry-confirmed TNBC patients were recruited. The clinicopathological features of TNBC patients were collected and recorded. Kaplan-Meier and log-rank followed by a Cox proportional hazard regression model were performed to evaluate the TNBC patients' survival. Out of 76 TNBC patients, 25 were chemoresistant and 51 were chemoresponders to the TAC chemotherapy regimen. The overall 5-year cumulative DFS and OS of TNBC patients were 63.5% and 76.3%, respectively. Multivariate Cox analysis demonstrated that medullary and metaplastic histology subtypes and positive axillary lymph node metastasis were significant prognostic factors associated with relapse with adjusted HR: 5.76, 95% CI: 2.35, 14.08 and adjusted HR: 3.55, 95% CI: 1.44, 8.74, respectively. Moreover, TNBC patients with medullary and metaplastic histology subtypes and positive axillary lymph node metastases had a higher risk to death than patients who had infiltrating ductal carcinoma and negative axillary lymph node metastasis (adjusted HR: 8.30, 95% CI: 2.38, 28.96 and adjusted HR: 6.12, 95% CI: 1.32, 28.42, respectively). Our results demonstrate the potential use of medullary and metaplastic histology subtype and positive axillary lymph node metastasis as a potential biomarker in predicting relapse and survival of the TNBC patients. This warrants further studies on intensification of chemotherapy and also identification and development of targeted therapy to reduce relapses and improve survival of TNBC patients.
Introduction: Breast cancer is a global health challenge with significant mortality, affecting millions worldwide. The current study is aimed at evaluating awareness and practices related to breast cancer screening, prevention, and treatment among the general public and physicians in Lahore, Pakistan, which has a significant incidence of breast cancer. Methodology: The current study adopted a cross-sectional study design conducted in Lahore, Pakistan, between March and August 2023, among 404 participants from the general public and 240 physicians. Data collection and evaluation involved the use of validated questionnaires, and both descriptive and inferential statistics were performed using SPSS Version 25. Result: In Lahore, Pakistan, breast cancer awareness among the public was low, with 80.2% unaware of its global prevalence, 65.3% believing not everyone is at risk, and only 42.1% recognizing symptoms. Females showed greater awareness (OR: 1.020, CI: 0.617-1.686, p = 0.002) and positive attitudes (OR: 2.711, CI: 1.478-6.478, p = 0.045), while the 18-29 age group had higher odds of positive practices (OR: 4.317, CI: 2.678-5.956, p = 0.004). Educational attainment significantly influences knowledge and attitudes. Only 13.9% practiced self-examination. Among physicians, 88.8% were confident in screenings, but patient fear (42.9%) and financial barriers (79.2%) hindered action. Physicians with FCPS qualifications had higher odds of awareness (OR: 1.550, CI: 1.130-2.117, p = 0.007), attitudes (OR: 1.500, CI: 1.050-2.150, p = 0.025), and practices (OR: 1.470, CI: 1.070-2.017, p = 0.020). Those with 11-20 years of experience also showed better awareness (OR: 1.400, CI: 1.050-1.868, p = 0.022) and attitudes (OR: 1.450, CI: 1.045-2.018, p = 0.029). Conclusion: In conclusion, breast cancer awareness among the general public is limited, highlighting the need for tailored education programs. Although most physicians show high awareness, challenges in patient communication and barriers, such as fear and financial constraints, must be addressed to improve screening uptake. These findings emphasize the importance of targeted interventions to enhance public awareness, screening practices, and physician-patient communication.