By Umer Nangiana




More and more relatively younger women are being diagnosed with breast cancer here. Apart from genetic problems, the chief cause of this high instance of cancer is unhealthy lifestyle. Almost two-third of cancer deaths are preventable by adopting healthy lifestyle.
This was said by Dr Kulsoom Junejo, Consultant Oncoplastic Surgeon at Hamad Medical Corporation (HMC), at a Shaukat Khanum Memorial Trust (SKMT) Suhoor-dinner hosted by the Pakistan Professionals Forum-Qatar (PPFQ) on cancer awareness here recently.
In Pakistan, the lack of awareness on cancer and lack of health infrastructure is hampering the fight against the deadly disease. Shaukat Khanum Memorial cancer hospital, founded by Imran Khan in 1994, is however going to announce its third and biggest branch in Karachi after inaugurating the second in Peshawar recently.  
In Qatar, the facilities have improved immensely over time. There is a separate cancer hospital and HMC now has super specialisation — every specialisation is separate with its own expertise.
“You can compare these facilities with anywhere else in the developed world. We do get lots of patients from outside,” Dr Junejo tells Community.
In her sub-speciality that is breast cancer, the ladies who had been diagnosed before were in quite late stage. But now, it is improving, she says.
“We are diagnosing more cancers early, although here in this region and especially in the Gulf countries we are diagnosing breast cancer in age group that is 10 years younger than in the Western population. Their peak is 55, ours is 45 (years). So you can imagine we are having so many young women affected by it,” says the expert.
In addition to breast cancer being genetic, another major cause for it is unhealthy lifestyle. Expats in Qatar from Pakistan, India, Philippines and other countries that get diagnosed with breast cancer generally do not have a family history of cancer.
“Two-third of cancer deaths can be prevented. It is just that we have to do some lifestyle modifications. We have to live and eat healthy, do some physical activities and quit smoking,” suggests Dr Junejo.
In Qatar, she says, the government is promoting research because they know research is the only way forward to treat this disease. Weill Cornel Medical College and HMC are both conducting research on cancer separately.
In Pakistan, SKMT is looking to expand its operations and research. However, the major challenges still are lack of awareness and infrastructure.
“We have 150,000 cases being diagnosed in Pakistan annually. And these are just the cases that we know from when somebody goes to the doctor. [Admissions to the] Shaukat Khanum Hospital were at its highest last year when it accepted 11,000 patients,” Nadeem K Qureshi, Assistant Regional Manager, SKMT Middle East region, says.  
“We are only just scratching the surface. When we look at statistics, we have to decline about 80-85 percent of the cases that come to us because we do not have the capacity,” he adds.
Now that Shaukat Khanum Peshawar is coming up, they are optimistic. It will be bigger than the hospital in Lahore and will be at its full capacity by the end of next year. The first phase started in December last year and the project will be in its third phase by the end of this year. 
An announcement for the third branch of the cancer hospital is also expected by the end of this year. They already have the land for it and the hospital there is going to be bigger than both Lahore and Peshawar.
At present, Shaukat Khanum is a state-of-the-art facility. But there are more than 100 kinds of cancers, and they are right now focusing on what they can tackle and treat.
“So we have to make a very tough call when we get stage IV cancer patients, we have to decline them irrespective of what cancer it is, unless there is a very strong case to give it a shot,” says Qureshi.
“And this is because the time and effort that we put into that patient, there is an opportunity cost. By the time we are done with that patient and we would be able to do very little for them, another patient would have progress from maybe stage I to stage III,” he explains.
The biggest challenge is lack of infrastructure in Pakistan. For a diagnosis to happen, the patient has to go to the hospital. And people do not go to hospital, until it becomes painful and pain is not a very good indicator, says Qureshi.
“At Shaukat Khanum, we create awareness with whatever we can but at the end of the day the solution lies with the entire structure built up where patients can have regular medical check-ups and have healthcare available to them,” he adds.
Also, at Shaukat Khanum, 70% of the patients that they get receive financial assistance to free treatment. There is a committee that sits on each and every case before they accept a case.
“We get our funds from [the people]. People’s contribution is just amazing. It is the most uplifting thing that we have,” reveals Qureshi.
Although the hospital itself has revenue generation streams in the form of 160 laboratories, the income that comes from diagnostics and research centres and symposiums constitutes just 40% of the hospital’s revenues. 
The other 60% comes from donations that people make. Some make them in lump sum, some in sponsoring of patients and some come in the form of sponsoring parts of the hospital. It is an ongoing process.
“I meet these people on daily basis and I can tell you it is the most humbling experience in the world. You get people [with very meagre means] coming and contributing whatever they can and then people who write whopping amounts of donations to the hospital. And they do not want their names to be mentioned,” says the SKMT representative.
For Shaukat Khanum, next up is Quetta after Karachi. The ultimate goal, he says, is for SKMT to reach out to every single cancer patient in Pakistan and provide them treatment, and if possible provide it to all of them free-of-cost. For that they will have to set up 15 hospitals, given the number of cases diagnosed. 
PPFQ continues to play a vital role in helping the expat Pakistani community stay connected with social initiatives in Pakistan. “We held yet another successful event and received an over-whelming response from the community. We are very grateful for their support and interest in SKMT Suhoor-dinner and plan to undertake similar initiatives in the future,” says Uzma Shehryar, President PPFQ.
“We believe that all people should be treated with consideration and dignity. Shaukat Khanum Memorial Trust Hospital’s encouraging and supportive environment allows volunteers and staff to thrive, and contributes to the ability to advance this cause,” General Secretary of PPFQ Sana Salman adds. PPFQ Chairman Mohsin Mujtaba also spoke at the occasion. The dinner was attended by a large number of Pakistanis.