The Opportunity to Choose: Location shouldn’t determine cancer survival

 

On Tuesday, March 24, Angelina Jolie openly shared the details of her preventative fight against cancer in the New York Times. Two years after her double mastectomy, she underwent an oophorectomy to remove her ovaries and fallopian tubes, courageously encouraging women worldwide to know their treatment options and to take charge of their own health—for themselves and for their families.

Jolie’s choice for preventative treatment following her screenings for breast and ovarian cancer highlights the power of making informed decisions about personal health. “It’s not easy to make these decisions,” Jolie wrote, “but it is possible to take control and tackle head-on any health issue. You can seek advice, learn about options and make choices that are right for you.”

For millions of women worldwide, cancer has been cloaked in stigma and treatment has been hindered by infrastructure and cost. This is especially true of Georgia—where breast cancer remains the leading cause of death for women ages 15 – 49. In an era where screenings, surgeries, and treatments can offer hope for life in rich countries despite a breast cancer diagnosis, Georgian women lacked an opportunity to access state-of-the art treatments that could save their lives. Mammography screenings were virtually unavailable and treatment options remained incomplete.

When JSI launched the USAID-funded Healthy Women in Georgia Project in 2003, we concentrated our efforts on advocacy, education, and partnership with the government of Georgia, civil society, and private sector organizations to inspire awareness about the importance of early diagnosis of breast and cervical cancers. We strove to facilitate a culture of routine screenings and encouraged women to openly speak out about reproductive cancers despite stigma and fear.

Ten years later, in conjunction with the launch of Georgia’s universal health care, all women over age 40 now have access to mammograms and Pap tests—completely free of charge and various treatment options.

I’ve spent much of my career as an Ob/Gyn fighting for Georgian women to have the same level of care as women in the West, and I’m encouraged by the progress I’ve seen. Yet in many other low- and middle-income countries (LMICs) in Asia and Africa, huge challenges for women remain. In these countries it’s a common health myth that because there are so many other health problems—infectious disease, malnutrition, etc.—women don’t die from reproductive tract cancers. In reality, the World Health Organization estimates that over 1 million breast cancer cases will occur in LMICs by 2020. This estimate means that in some countries women living with HIV have a better chance of survival due to antiretroviral drugs than those living with potentially treatable breast and cervical cancers.

Together with the government and our partners, JSI is working to ensure that breast cancer is no longer a death sentence for the women of Georgia, but women worldwide face risks that are not enough of a priority within global health. Jolie’s piece ends with a simple phrase— “knowledge is power”—that echos worldwide. Her words speak to the importance of not just awareness, but an increase in international funding for breast and cervical cancer community education, early diagnosis, and treatment options, especially for women living in poor and low income countries.

Where you live shouldn’t determine if you life—each woman’s rights to prevent, fight, and survive breast and cervical cancer are the same worldwide.

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