It would be naive not to think about how the pandemic has changed the way we view healthcare. However, the pandemic has also provided us with lessons that we can apply to healthcare.
By the end of 2020, 7.8 million women alive had been diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer. That said, there’s a lot that we can learn from the pandemic in regards to breast cancer.
Dr Carol Benn is a specialist surgeon and breast disease specialist. She established the Breast Care Centre of Excellence at Netcare Milpark Hospital.
Read on as Dr. Benn provides insight on how COVID-19 has paved a way to improve breast cancer care.
Breast Cancer Care During A Pandemic
So how has the pandemic affected the way we approach breast cancer care?
“Big issues around breast cancer are always early diagnosis and treatment availability.” explained Dr. Benn,
“The pandemic resulted in fewer women going for their screening mammograms (many women did not screen last year). Whilst I have not been able to crunch the data yet, more women arrived at Helen Joseph Breast Clinic with advanced cancers.”
Innovations in treatments
“In terms of treatment in the private sector, the pandemic has resulted in more patient-centred approaches,” says Dr. Benn, adding that fewer people are rushing into surgery (which is a good thing).
“More women with early-stage hormone-sensitive breast cancer were treated with endocrine therapy as a holding treatment prior to surgery”. According to Dr. Benn, this is a great tactic. How so? Because it ensures women have an opportunity to assess where and what treatments they want.
The growth of telemedicine has also played a role in the treatment and care of breast cancer. Using of telemedicine platform allows healthcare specialists to evaluate, diagnose and treat patients in distant locations.
“Virtual multidisciplinary unit meetings also resulted in more doctors accessing interdisciplinary patient decision making, and there was an international trend of home-based oncology care and safer systems around surgical hospitalisation.” says Dr. Benn,
“ In my unit, due to people not being allowed to visit loved ones, an immediate post-surgery phone call by myself re the surgery was instituted and will become a continued service post-pandemic.”
Dr. Benn adds that they also set up family MS Teams and Zoom chats. This was especially valuable as many families are located across the world.
Breast cancer affects 2.3 million women (and 2650 men) every year. Unfortunately, due to the concern surrounding the COVID-19 pandemic, the risk of breast cancer is sadly not being taken as seriously as it should. While Dr. Benn does note that many people do have anxieties and fears about breast cancer, this is not true for everyone,
“Some people who are anxious have heightened fears around cancer and COVID-19, while others have other concerns ranging from finances to dealing with loss of family members. As a result, cancer risks became less important.”
Fears delay diagnosis
Sadly, the fears surrounding COVID-19 also created a delay when it came to the diagnosis, and later, the care and treatment of cancer.
“On the downside, patients’ fears of hospitals as a result of general fears about SARS-Cov-2, resulted in non-compliance and late access to care.” explains Dr. Benn, “Unfortunately, oncology and radiation services for government patients resulted in delays in receiving radiation and oncology services.”
Lessons to learn
“The pandemic has been a great equaliser in terms of everyone understanding the fragility of life,” says Dr. Benn.
“I have tremendous love, respect and awe for the many ladies who I see with breast cancer and who fight all the odds — chemo is not easy; neither is surgery nor being forced into menopause,” says Dr. Benn. She adds that a diagnosis of breast cancer puts life into perspective and makes us deal with the concept and fear of death, despite many women with breast cancer overcoming the disease and surviving.
“Everyone now has had to embrace these fears. The pandemic has — and should have — us all understanding what the important values of life are. Not money or success but giving forward, bravely tackling every day, appreciating family and friends, and making an effort to connect with people we may not be able to see.” she says.
Breast health awareness
When it comes to breast health and breast cancer, one should never underestimate the importance of awareness and education.
“In terms of breast health, I have thoroughly enjoyed online teaching, working with the breast health foundation to put our information on “knowing your norms” and public education so pools know where they can access healthcare and how to do so safely.” says Dr. Benn, “The importance of vaccinations and public education is an important aspect of health, specifically when it comes to understanding community transmission of diseases, appropriate use of health systems such as when you should see a doctor and which doctor to see, and the value of patient navigators to help negotiate healthcare systems.”
Surviving breast cancer in a pandemic
While we are all each aware of the issues surrounding COVID-19, many people are unaware of the struggles that come with breast cancer,
“These include access to care; financial concerns (in my own experience, I have helped run two units that ensures all women, irrespective of funding, can access care)” says Dr. Benn, “Fear is another, and it has now been heightened by the threat of SARS-Cov-2. There’s also the importance of support, which is where navigation is critical, but also in terms of having family and friends beside you (the power of a good hug is something that is sorely missed); and taking the time to understand all your options and decisions as a patient (i.e. not rushing into “emergency surgery”).”
“The journey with cancer can be likened to a Comrades marathon that must be achieved one small shuffle at a time. And here, I’d like to give a shout out to all the essential workers and all the patients… Together, we can.”
Who is Dr. Carol Benn?
Dr. Carol-Ann Benn is a Fellow of the College of Surgeons of South Africa with a special interest in Breast Disease. Her capacity as Head of the Breast Unit of Helen Joseph Hospital proves her long career and her commitment to clinical excellence in this field of Medical speciality. Prof Benn offers service to society and the greater medical community, both local and international, through her contributions, published and presented, and she is recognised internationally as a leader in Breast Disease. As a lecturer in the Department of Surgery at the University of the Witwatersrand, she contributes towards the education of healthcare professionals.
Through the organisation of foreign and private funding, Prof Benn was able to establish the Breast Health Foundation, various Breast Health Care forums and outreach programmes and in representation on numerous Medical Boards and Health Care Committees, Prof Benn has paved the way for the improvement of women’s health care; has contributed towards the uplifting of women in society and has opened channels for public awareness of breast health.
She established the Netcare Breast Care Centre of Excellence at the Milpark Hospital, Johannesburg. It co-ordinates national efforts for the specialised management of breast conditions to all women. This is the only international accredited unit in South Africa with N.APBC accreditation In addition to her positions of responsibility, Prof Benn manages continuing research and research output. Numerous awards testify to her esteemed position in the Medical field and in South African society.
If your country has gone in full lockdown mode, you’re probably fretting about how you’re going to be able to spend all that time with them without going insane. This is a valid fear considering the fact that since the decree for self-isolation, there has been an “unprecedented” spike in divorces in some districts of Xi’an, capital of Northwest China’s Shaanxi Province. Speaking
Couples & Family Therapist, Author Dr. Kalanit Ben-Ari, a couples’ therapist with over 15 years of experience, revealed that couples living in extremely close quarters may start to feel trapped and plagued by feelings of anxiety. As such, these emotions result in both parties feeling resentful and defensive and, coupled with cabin fever, this is a recipe for relationship disaster.
Love at a time of coronavirus
Additionally, if you aren’t living with your partner, you may be worried that your relationship won’t survive suddenly becoming a long-distance one. Either way, it’s important to know that a pandemic doesn’t mean a reintroduction to single hood. The fact is, you can still help to flatten the curve and maintain the health and happiness of your relationship.
Relationship advice for self-isolation
Couples staying together
A healthy relationship has one component at its core – healthy and open communication.
We’re all battling with the unknown at this time, and this can arouse feelings of fear, anger, sadness, and pain. With that said, it’s important for couples to be able to express their fears.
That said, it’s important that when we find ourselves venting to our partners, we do so in a respectable manner that won’t lead to an intense argument. Feel free to share your feelings with one another, without being judgmental or critical and do your best to stop using words like ‘you’ and avoid statements like “you’re exaggerating,” or “you’re acting crazy.”
“One of the biggest communication mistakes couples make is to talk about their partner in a harsh and direct manner, saying ‘you do/you don’t/you are’, rather than speaking about themselves and what they really want (for example: “I feel anxious about something right now/I need assurance that this will be ok”)” explains Dr. Ben-Ari, “This requires a level of honesty, vulnerability, and tact, but it will help to maintain a healthy and happy relationship.”
2. Carve out some time – for yourself
Just because you’re stuck under the same roof, doesn’t mean that you need to spend every second together. Self-care is just as important and you need to set aside some time so that you can relax and rebalance, letting go of any irritation that may be building up.
Self-care can take the form of a home workout, a long warm bath, sitting quietly in a corner, putting on headphones, mediating or even finishing that Call of Duty game. Do whatever you want but just make sure you’re doing it alone.
3. Keep it light
Just because it’s trending news doesn’t mean that you should be talking about COVID-19 at every turn. Yes, it’s important to keep up to date with the WHO’s guidelines and recommendations but there is a limit.
Instead of getting all worked up over the unknown, why don’t you keep it light by catching up on your favorite Netflix show or by redecorating the house? Can you even have a dance party in the lounge or try to master his mum’s favorite recipe? Additionally, for couples that are both working from home, you can get yourselves an imaginary co-worker to blame things on.
4. Get intimate
New York City’s public health department sent out a notice, specifically outlining how one could practice safe sex while preventing the spread of COVID-19. So if you were worried about being abstinent whilst living with your partner, you’ll be happy to know that you can still enjoy intimacy. In fact, you can even use this time to reconnect physically with your partner.
On the other hand, as stress can affect libido, it’s important not to nag or shame your partner into sex if they’re not feeling up to it as this will only result in feelings of rejection and blame. Just do your best to understand.
5. Acts of kindness
Yes, your partner is driving you insane, but it’s important not to take them for granted. Try random acts of kindness such as making them tea in bed, cooking their favorite meal, or even leaving them messages around the house.
This will help your partner feel appreciated and ease any lingering tension in the house. Remember, it’s the little things.
6. Setting a schedule
A lot of us rely on our schedules to provide a sense of stability. Now, with all of that disrupted, we may find ourselves lost and more irritable. That said, creating a structured plan for the day with your partner can help to restore a sense of normalcy.
Assigning roles and responsibilities for each day can make your time at home pass more quickly and it can also minimize conflicts.
7. Stay in touch with the outside world
Your partner doesn’t have to be your only source of connection. With apps such as HouseParty, FaceTime and Whatsapp, you can still stay in touch with your family members and friends. Regardless of your relationship status, it’s important to still maintain outside relationships.
If you feel unsafe
If unfortunately, you are stuck in the house with an abusive spouse, it’s important to know that no lockdown or quarantine is more important than your health. Police and other emergency response services are operating as normal, and if you are worried about your safety, you should not hesitate to call the authorities immediately.
Couples in a long-distance relationship
1. Watch your digital tone
As mentioned, good communication is at the heart of every healthy relationship. Now with you spending more time away from your partner, it’s important that you maintain a healthy communication balance.
Everyone has their preferences when it comes to chatting online; some people reply late, some overuse memes and gifs. It’s important that you clarify your likes and dislikes and that you do your best not to get into a tiff over a misread text message.
2. (Digital) date nights are still important
There’s no reason as to why you can’t get dressed up, and sit across a screen, sharing a glass of your favorite wine. Keeping up with date nights adds a sense of normalcy that can bring you two closer together. Don’t let absence define your relationship. Rather than moaning about how much you miss each other, why don’t you make a list of the things you’re looking forward to doing post-lockdown, be it travel destinations or restaurant hotspots?
Don’t just stop at date night. You can place your phone in a good spot in the house and cook together, or watch your favorite movie.
Additionally, you can also write them a physical letter or send them an unprompted gift as both will no doubt be well-received.
3. Try cybersex
It’s interesting times and people are finding new and creative ways to cater to their needs, as well as those of their partners.
Before delving into Skype sex, make sure that you’re comfortable and that you discuss boundaries. There are various forms of long-distance intimacy, ranging from texts, to voice notes to a simple phone call. Find out what you’re comfortable with and see what happens.
In regards to texting, especially images, don’t feel pressured to include your face or your entire body. You can wear clothing as well if you prefer, leaving much to your partner’s imagination.
The bottom line
No matter how long you’ve been staying together, or how long you love each other, you and your partner are definitely going to run into conflict. It’s a stressful and uncertain time, so of course, you’re going to be more aggravated than usual. With that said, it’s important to remember that none of this will last forever. You’re both doing your part to protect everyone’s health. So, forget the unnecessary drama and look forward to the good times you’ll get to enjoy in the future.