The journey of a person with breast cancer is long and complex. There are a number of factors that need to be taken into account, and no two people will have exactly the same experiences.
The first step on the journey is the detection. In an ideal world, this will be as early as possible, but the reality is that this does not always happen. Breast health services are not always accessible. The reasons for a later diagnosis are many, including a lack access to information , about breast cancer in all our official languages as well as cancer stigma .
One of the things that ABC is lobbying for is the provision of annual, clinical breast examinations at all primary healthcare facilities which would improve the rate of early detection and save lives. At present, and especially for patients in the public health sector, diagnosis is often only made at secondary level provincial hospitals and treatment is often only available at tertiary level hospitals. This causes delays in treatment. The time lapse is mainly caused by non-existent referral pathways between primary health facilities and other levels of care.
Diagnosis is only the beginning of the journey. The next steps are to provide effective and standardised treatment for all breast cancer patients in South Africa. This is expensive and will only become a reality once we know more about breast cancer in South Africa. Because there is no accurate, up-to-date data of breast cancer incidence, mortality and survival, it is impossible to plan or budget for a treatment protocol.
The diagram shows what an ideal journey for a breast cancer patient would be. The seven steps provide a consistent structure around which treatment can be provided.
Each of the steps on the journey must be underpinned by five key principles. These are:
- Patient-centred care;
- Safe and high quality care;
- Multidisciplinary care;
- Supportive care; and
- Coordination of care.
Over the next 10 days, we will be unpacking and explaining what is meant by each of the five key principles, as well as looking more closely at what we mean by access to care and what a patient centred approach is.