Breast Cancer Control Policy – The New Policy
Cancer Alliance Advocacy Toolkit
KNOW YOUR RIGHTS: YOU ARE NOW ENTITLED, IRRESPECTIVE OF WHERE YOU LIVE AND YOUR INCOME LEVEL, TO ACCESS DEDICATED BREAST UNITS. THESE ARE DESIGNED TO ENSURE EARLY DIAGNOSIS OF BREAST CANCER, FOLLOWED BY TIMELY AND EFFECTIVE LIFE-PROLONGING AND LIFE-SAVING TREATMENT.
“We envisage that the policy will … positively contribute to reducing breast cancer incidence and mortality rates, as well as improve the quality of life for women in South Africa.” – Dr Aaron Motsoaledi, Minister of Health1
THE BREAST CANCER CONTROL POLICY 2017
South Africa’s new Breast Cancer Control Policy is a vital document aimed at prioritising breast cancer awareness, prevention, treatment and care in South Africa. Once fully implemented, it will secure access to a network of dedicated regional breast units that will not only improve early detection rates, but also establish guidelines for optimal treatment and palliative care to help drive down death rates from this cancer, which has become a leading cause of death of South African women.
WHY IS SOUTH AFRICA’S NEW BREAST CANCER CONTROL POLICY SO IMPORTANT?
Breast cancer is the most common cancer in South Africa, accounting for about 22% of all new cancers in women2, according to the most recent statistics. It is also the cancer (after cervical cancer) responsible for the second highest number of deaths from the disease in the country. With nearly 20 million South African women older than 15 at risk for contracting the disease – and given significant recent advances in applicable medicine and technology – a revised national programme had become critical. 2
Most importantly, if breast cancer is diagnosed and treated early, it IS a curable disease.
ARE YOU AT RISK FOR BREAST CANCER? 3
You are at higher risk if you fall into one of the following categories:
- Women older than 55
- Have a family or personal history of breast cancer
- Started menstruating before age 12
- Went through menopause after age 55
- Gave birth later in life, or not at all
- Have dense breast tissue
- Had radiation to your chest area before age 30
- Are on hormone replacement therapy (HRT)
WHAT ARE THE SYMPTOMS? 4
If you experience any of the following symptoms, you should consult your healthcare provider immediately:
- A new lump in the breast or armpit
- A painless hard lump with irregular edges (can also be tender, soft or rounded)
- Swelling of all or part of your breast (even if there is no distinct lump)
- Skin irritation or dimpling
- Breast or nipple pain
- A nipple that turns inwards
- Redness, scaliness or thickening of the nipple or breast skin
- Bloody nipple discharge
WHAT DOES THE NEW POLICY MEAN FOR YOU?
It is built on three interdependent strategies that are designed to:
- Increase early diagnosis of breast cancer, by promoting community awareness and educating communities and healthcare workers on breast cancer, and its management.
- Ensure more effective interventions following diagnosis, thanks to dedicated Regional Breast Units (RBUs) planned for provincial hospitals across the country, and improved referral pathways.
- Guarantee timely treatment for invasive cancer at Specialised Breast Units (SBUs), including the administration of Herceptin® for early stage HER2 + breast cancer at designated sites across South Africa. Palliative care for invasive breast cancer must also be provided.
You can read more about your rights to treatment here: http://bit.ly/2PF2P8m
Each of these three components will be addressed in more detail in the next three publications unpacking the new Breast Cancer Policy.
WILL STATE HOSPITAL PATIENTS BENEFIT TOO?
Yes, the policy, the accompanying programme implementation strategy and the clinical guidelines will be applied in the public and private sector, at all levels of the health system. Services to women will be provided in the community, in primary healthcare facilities, at district, regional and tertiary hospitals, as well as in private institutions.
Another crucial element is the framework for the establishment of RBUs across the nine provinces, which will for the first time create parity of care, regardless of where patients live. Until these units are established in every province, patients in provinces where they don’t yet exist will be referred to the closest neighbouring province offering this facility.
Women with private medical aids will also benefit because, according to the rules of Prescribed Minimum Benefits (a feature of the Medical Schemes Act 131 of 1998), members must have comparative access to treatments that are available in the public health sector. This means medical aids will no longer be able to deny women treatment with, for example, trastuzumab on the basis of high cost. Trastuzumab is a targeted therapy for HER2 Positive Breast Cancer. 5
IS THE NEW POLICY ALREADY IN EFFECT?
The revised policy brief was published in June 2017 and officially launched in August 2017. The companion Clinical Guidelines for Breast Cancer Control and Management came into effect in April 2018.
The policy is set to be implemented in phases. In place already are five accredited SBUs at the following five sites:
- Groote Schuur Hospital, Cape Town
- Frere Hospital, East London, Eastern Cape
- Charlotte Maxeke Johannesburg Academic Hospital, Gauteng
- Grey’s Hospital, Pietermaritzburg, KwaZulu-Natal
- Universitas Academic Hospital Annex in Bloemfontein, Free State.
All other planned SBUs and RBUs will be established over the next three to five years. This is a critical step that must be fully implemented before the launch of any extended awareness campaign at primary health-care level, in order to ensure the appropriate pathways are in place to cope with the demand that will follow.
WHERE CAN YOU ACCESS HELP IF YOU OR A FAMILY MEMBER OR FRIEND HAS BREAST CANCER?
- Breast Course 4 Nurses: http://breastcourse4nurses.co.za/
- CanSurvive: http://www.cansurvive.co.za/
- Care for Cancer Foundation: http://www.careforcancer.org.za/
- Helen Harder Foundation: https://helenharderfoundation.com
- Hospice Palliative Care Association of South Africa: https://hpca.co.za/
- Look Good Feel Better: https://www.lgfb.co.za/
- Lymphoedema Association of South Africa: http://www.laosa.co.za/
- People Living With Cancer: http://www.plwc.org.za/
- PinkDrive: https://www.pinkdrive.co.za
- Pink Phoenix Cancer Foundation: http://www.pinkphoenix.co.za/
- Project Flamingo: https://projectflamingo.co.za/
- Reach for Recovery: http://www.reach4recovery.org.za/
- The Breast Health Foundation: https://www.mybreast.org.za/
- The Cancer Association of South Africa (CANSA): https://www.cansa.org.za/
- The Pink Parasol Project: http://pinkparasol.co.za/
- Wings of Hope: https://wingsofhope.org.za/home/
- National Department of Health (2017). Breast Cancer Control Policy 2017. http://bit.ly/BreastPolicy2017
- CANSA. Breast Cancer: Prevention and Control Policies Launched. Retrieved on August 30, 2018, from http://bit.ly/2NLWhD0
- Cancer Alliance (2018). Fact Sheet: Breast Cancer and HER2+ Breast Cancer. Pp 5-7. http://bit.ly/TobekaDaki
- Cancer Alliance (2018). Fact Sheet: Breast Cancer and HER2+ Breast Cancer. Pp 8. http://bit.ly/TobekaDaki
- Council for Medical Schemes (2015). CMScript complete – Prescribed Minimum Benefits. (pdf) Retrieved on September 20, 2018, from http://bit.ly/2yHuqyr
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