The Pink October campaign has provided an excellent platform to reach out to all audiences. This designer campaign came together with tremendous effort from professional people that improved upon last year’s campaign.

Companies offering specialised support to NGOs are to be lauded and the government should incentive them through tax credits or other forms of incentives to support their corporate and social responsibility.

In an ever-increasing need to be breast aware and with prompt prevention, national breast screening saw an increase in the number of women accepting an invite for screening. In September and October this year there was an 85 per cent acceptance rate. This is a contributing factor to picking breast cancer at an early stage.

Since the inception of the Breast Screening Unit in 2009, 320 cancers were found at an early stage. With a 62 per cent overall acceptance rate, there is definitely room for improvement and we are concerned about the 38 per cent who refuse the invite.

As similar programmes abroad indicate, calling back the women after two years rather than three is far better.

Referring women for an interim mammogram is not the ideal. Breast cancer screening recommendations for women at average risk made by three major health organisations (American Cancer Society, National Comprehensive Cancer Network and the US Preventative Services Task Force) all advise that screening should be done every two years.

The scientific evidence concluded that mammography every two years gives almost as much benefit as mammography every year while halving the risks. These risks include false positive results, overdiagnosis and overtreatment.

Continuing to call women for mammogram every three years will nullify the effectiveness of the purpose for which it was set up in the first place.

The American Cancer Society (ACS) and most of the breast imaging researchers generally feel that the “responsible use of MRIs for the evaluation of the breast should be focused on patients with a high probability of breast cancer”.

This is felt to include women who have a 20 per cent or higher lifetime risk of breast cancer. Women in this high-risk category include those with a strong family history of breast and/or ovarian cancer or those whoare likely or known carriers of the BRCA1 or BRCA2 mutation (a breast and ovarian cancer gene mutation).

Annual breast screening by means of an MRI is also recommended for women who have undergone radiotherapy to the chest for Hodgkin’s disease.

It is also a matter of great concern that women going through chemotherapy for breast cancer might have the unfortunate instance of brain metastasis. In Malta, it would be between 10 to 12 patients a year that encounter this occurrence and these are patients that failed Herceptin, and to further aggravate the matter the cancer had metastasised to the brain.

Cancer patients should not be faced with situations where they have to beg for funding for specialised treatment, which the State should be providing

In such cases Lapatinib is the ideal drug prescribed although unfortunately it is not available on the government formulary. Our foundation has prompted meetings with Health Secretariat officials to lobby for such drug and other similar drugs for breast cancer patients.

Studies revealed that women taking Lapatinib in combination with capecitabine survived for an average of 75 weeks, while those taking capecitabine alone survived for an average of 64.7 weeks.

In another study, women whose cancer was expressing large quantities of HER2, taking Lapatinib in combination with letrozole survived for an average of 35.4 weeks without their disease getting worse.

This compared with a survival of 13 weeks in those taking placebo in combination with letrozole. In a third study, women taking Lapatinib with trastuzumab lived without their disease getting worse for 12 weeks on average, compared with 8.1 weeks in those taking Lapatinib alone.

Action for Breast Screening Foundation emphasises the need to upgrade the government formulary to reflect today’s needs. The drug mentioned and other similar cancer drugs create a financial burden on the patients themselves. Alternatively, the foundation recommends that such drugs are approved on a named patient basis to be made available as and when required.

These drugs offer the patients better quality of prolonged life which cannot be denied to any citizen, considering that these drugs allow patients to continue to participate in an active life while continuing with their day to day activities.

One cancer patient, Claire Ebejer, said in an interview recently that her supposedly cured breast cancer had, in fact, spread to her brain and cannot be operated upon.

Her only hope to prolong her life was Lapatinib, which cost around €3,000 a month. She also called on the government to reform its medicines formulary list so that it could account for recent medical developments in the treatment of cancer.

In the 2016 Budget, the government announced that it would add diabetes medicine to the list, but nothing was said about adding cancer medications.

We are currently faced with a situation where patients have to procure these drugs themselves and then refer to Malta Community Chest Fund for a possible financial grant. Recent feedback from MCCF reliable sources shows that between January and September this year the MCCF has issued grants totalling €1,097,831 in specialised chemotherapy. The most expensive and specialised form of chemotherapy during this period cost €13,750 a month.

One would ask whether this is the proper way to deal with such trying situations. Should the onus not be on the government to make provisions in the financial estimates of the Health Department for sufficient funds to provide these drugs on our NHS? Here we are talking about an estimated expenditure of €1.5 million per year.

The question is: can the government provide this sum to render our formulary more holistic and patient oriented?

This plea is being made in the interest of cancer patients who should not be faced with situations where they would have to beg for funding for specialised treatment, which the State should be providing.

Our foundation notes with satisfaction that the drug Xeloda, which is used to treat breast cancer patients, is to be included in the Department of Health’s Schedule V. While acknowledging that this is a step in the right direction, the foundation feels that this is just a drop in the ocean and there is still a long way to go.

While conveying our concerns to policy and decision-makers, we also voice our hopes in allies such as Michelle Muscat, chairwoman of the Marigold Foundation and the Parliamentary Secretary for Health, who always support our cause.

This year’s campaign was particularly endorsed by the Ministry for Health, the Ministry for Family and Social Solidarity and the Prime Minister’s wife.

Esther Sant is chairwoman, Action for Breast Cancer Foundation Malta.

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