MICHIGAN — Breast cancer is preventable with early detection and more treatable, the sooner a diagnoses receives medical attention. However, for too long cultural inhibitions have stood in the way of Arab American women opening up candidly about the disease, or getting the medical care they need to fight it fast enough.  

For a lot of women in the community, breast cancer is a taboo subject that is difficult to talk about, even with their immediate family.  Many Arab women find it shameful and embarrassing to discuss breast cancer, according to Hiam Hamade, supervisor for the Arab American Community Center for Economic and Social Services (ACCESS) Chronic Disease Prevention Programs and head of the organization’s Breast and Cervical Cancer Control Program (BCCCP).   

“This is our culture, and it is very, very common for women to refuse to talk about it. They don’t want to talk about it, and they keep it to themselves,” Hamade said. “It is a taboo issue.”

 She says the majority of Arab American women, who have sought help from the BCCCP, feel uncomfortable opening up about the disease, but not everybody. 

“It is most of them, not all of them,” she said. Cancer, in general, is a silent issue in the community, even among men, because of the stigma that is associated with it. 

Dr. Nayana S. Dekhne, chairwoman of Beaumont Hospital’s Breast Care Program, says it’s crucial that those diagnosed with breast cancer immediately inform family members, because the disease is hereditary and that makes the chances of their relatives getting it higher. 

“You are now at higher risk, when one of your close family members has it, and you should get checked out,” Dr. Dekhne said. “You want to let your sisters know, so they can be tested. You could hurt your family by keeping it a secret.” 

Dr. Dekhne has seen a lot of patients come in to get screenings, because one of their family members was diagnosed, and they know that early detection can help prevent breast cancer.  

The attitude about breast cancer, however, is changing among Arab American women. 

Hamade (L) educates community members about breast cancer.

Hamade says the older generation is different from the new generation, which is more open to discussing breast cancer and raising awareness about it. 

Coming forward about breast cancer can be uncomfortable, because there is a perception that when somebody has cancer, there is no hope for them and it is fatal. Another reason is that drawing attention to your breasts is something a lot of women feel embarrassed about. There are other factors that contribute to cancer being a silent issue in the Arab community. 

Hamade is a breast cancer survivor. She was first diagnosed in 2004 and often discusses her own experiences with cancer to other women, so as to show them that they can live happy, healthy and normal lives after they’ve been diagnosed. 

Both Dr. Dekhne and Hamade say the best way to prevent cancer is through early detection. Dr. Dekhne advises women to conduct a breast self exam once a month to get familiarized with your breasts, so if changes are noticed, you seek care from a specialist right away. She also advises women to get a mammogram once a year. 

“A mammogram is the best way to prevent breast cancer,” Dr. Dekhne says. She adds that when breast cancer reaches a certain stage, it is no longer treatable. 

A lot of women have died of breast cancer, because of the lack of early detection and no access to mammograms. One out of four female cancer survivors have had no access to cancer treatment and many have become victims of cardiovascular disease, diabetes, stroke and other medical complications, because they can’t get affordable screenings and medical lab work done.  

Hamade says that those who can’t afford healthcare should never be swayed away from getting treatment for breast cancer. The BCCCP offers mammograms and clinical breast exams to low income women over 40 years old who have limited access to medical care. It also provides cervical cancer screenings at no cost. 

Once a woman is diagnosed with breast cancer, she automatically qualifies for Medicaid, according to Dr. Dekhne. 

Hamade says that many women don’t seek help from the program, until they experience pain in their breasts, or develop an infection. 

The seminars that ACCESS holds to educate the community on breast cancer teach women about the importance of early detection and encourage them to practice it.  The seminars are bi-lingual and address risk factors, warning signs, and the importance of regularly scheduled screenings. The BCCCP also disseminates Arabic language versions of the Komen for the Cure educational materials. 

“When I come home, I feel happy that I did help and relieved that I gave the message to the women. We serve the community from our heart, when we do the education and awareness,” Hamade said. 

The BCCCP offers support groups that women can find comfort in.  Hamade says that a lot of women also don’t feel comfortable turning to support groups.  

Many women don’t know about the importance of early detection, don’t have enough education on breast cancer, which is why Hamade encourages them to attend the seminars. 

“I encourage women to go get a mammogram and get detected early,” Hamade said. 

The program treats about 2,000 patients a year throughout Wayne, Macomb and Oakland counties. The Breast Care Program at Beaumont Hospital services 1,200 patients annually from across the State. 

In Michigan, nearly 7,000 women are diagnosed with breast cancer each year. Of those, 1,500 are under the age of 50. About 1 in 8 women in the U.S. will develop invasive breast cancer during their lifetime. 

Dr. Dekhne says many women immigrants may think that they’re not as vulnerable to breast cancer, because in the countries they come from the disease is not as prevalent. She says if you have been in the country for five to 10 years, you are just as likely as any other American woman to get it, because causes of the disease can often be linked to environmental factors. 

For more information, or to reach Hiam Hamade at the ACCESS Community Health and Research Center, located at 6450 Maple St, Dearborn, MI 48126, call 313.216.2206.