When 66-year-old Mary Vella received a call for the National Breast Screening, she accepted the appointment and gave it little thought. Having no reason to believe there was anything amiss, she viewed it more as a routine test, optional, almost. She showed up to the appointment fully believing she would be sent on her way with a “see you next year”.

As it turned out, she was wrong. The results revealed a Grade 1 cancer and, before Vella knew what had hit her, she was on her way to surgery.

“I do not have any history of breast cancer in the family and I had not even felt anything wrong. I carried out routine tests and they always came back negative,” Vella says. “I suppose it sounds strange to say this but I consider myself lucky. Had I not received the unsolicited call, who knows what might have happened? Whether I might have caught it too late?  I do count it as a blessing,” she says.

Vella’s story comes with a happy ending as, a course of radiotherapy and one year later, she is fully recovered. But, as Esther Sant, chairperson and co-founder of the Action for Breast Cancer Foundation and three-times cancer survivor says, the same cannot necessarily be said for all the rest who choose not to take up the call for national breast screening that is offered by the health services for free every three years to all women aged between 50 and 60. Some 14,000 women are invited to take part every year.

“A hefty percentage of those who receive the call, about 40 per cent in fact, choose to ignore it. It is a shame because so many cases can be caught before they reach a critical stage. The programme can literally save your life,” she says.

Sant knows what she is talking about.  Diagnosed with breast cancer aged 34 – a young age by usual standards – she had decided to go and get herself checked out after feeling something “not quite right”. However, for her the visit to her family doctor was almost a formality and she was pretty sure she would be told it was nothing. Like Vella, she turned out to be wrong.

“My doctor sent me for tests immediately and, so some three weeks later, I received a surprise visit by my doctor and assorted family members who had already been informed of my results. As you can imagine, the results were not good and the family figured I needed moral support. It was not quite the scenario I would have preferred and, in fact, I pretty much sent everyone away so as to be able to process what was happening to me.”

The results were even more negative than she had initially feared, with the specialist advising a full mastectomy. Within a week, everything was in process and Sant was on her way to surgery.

“It felt like an attack on my femininity.  My husband was of the belief that my health came first and, of course, he was right. As soon as I decided to go ahead, it was like a rollercoaster. After the surgery everyone kept telling me that the worst was over but I knew that this was not true and that there was a gruesome time ahead of me, with therapy, medication and radiotherapy, “ she remembers.

My family doctor insisted there was nothing to worry about; three weeks later my gynae found a lump and I was diagnosed with Grade 3 cancer

And yet, it was not the physical tribulations that troubled her most. Rather, it was the lack of facilities available to women who had been through similar procedures and the lack of community support.

“I took it upon myself to contact Malta Hospice and they were a tremendous help. I remain indebted to them to this day,” she says.

However, the more time passed, the more Sant realised that survivors needed better aftercare and a specialised support system.

“I remember being sent to pick up my first prosthesis from a garage in Mosta, all those years ago. The garage was only open after 5pm and when I turned up, I was informed that if I wanted to have the ‘good one, I would need to fork out 20 Maltese lira’.

Happily, things have progressed considerably since then, mostly thanks to the efforts of the Action for Breast Cancer Foundation, which Sant co-founded with Helen Muscat.

Today, thanks to the efforts of the foundation, breast cancer survivors have access to high-quality prosthesis on the national health service, a free mastectomy bra, detailed and well-organised information about their personal case and, very importantly, free counselling by mental health professionals in order to help them cope with their new reality.

“Breast cancer survivors would often find themselves unsure what exactly would be happening after their surgery, with their treatments and so forth, so we hit upon this initiative to give every patient a personalised information folder that contains only that information relevant to her case. I got the idea from the Royal Marsden, after receiving treatment there and realising just how much more reassuring it is to have all your personal information there, at your fingertips,” Sant says.

Now, she would like to see the free counselling services also enjoying a higher take-up. The foundation offers survivors a course of 15 free sessions by fully-qualified professionals – more, if needed.

“It is so important for women to also take good care of their mental health and their emotions, when they have been put through such an ordeal. The same applies to partners and spouses, or other close family members and we do offer these services to them too,” she says.

One survivor who agrees about the importance of self-care is Lorraine Vella, diagnosed with Grade 3 breast cancer last year, aged 40. Having a history of breast cancer on her mother’s side of the family, she knew better than to take a chance when she felt a pulling sensation that ran from her underarm to her breast.

“I remembered my mother feeling the same thing, so I went to my doctor immediately.”

However, after examining her, the doctor said he had found nothing wrong and that there was no need for her to go to the Breast Clinic. Vella, however, remained unconvinced.

“I was also feeling pain in the area but my family doctor insisted there was nothing to worry about. Three weeks later I had an appointment with my gynae and asked him to examine me. He found a lump and immediately referred me for more tests,” Vella says, highlighting the importance of not ignoring your instincts.

The cancer turned out to be a particularly aggressive one and she was sent for a course of chemotherapy before surgery took place. Radiotherapy followed, as well as medication and, today, she is cancer-free.

All three women stress the importance of a strong support system and are currently working hard in preparation for Action for Breast Cancer Foundation’s next fundraising event, a six-kilometre walk starting at 9am tomorrow from Pjazza Tigné, Sliema, to mark Pink October. A group of breast cancer survivors will also row boats from Vittoriosa Waterfront. Both activities will finish at the Valletta Waterfront Laguna. 

www.actionforbreastcancer.org