Cancer Stigma Among British Asians Affects Mental Health, Survival Rates

by Nadeem Badshah

BRITISH ASIAN cancer patients who are suffering in silence need more support to encourage them to speak to their families about their illness, experts have urged.

They have called for the government and mainstream health groups to reach out more to ethnic minorities diagnosed with the disease.

Some are not telling anyone about their diagnosis, which community leaders warn could affect their mental health and affect their survival chances.

A report by The Health Foundation report said efforts to save lives by detecting cancer earlier have stalled because British patients are fearful of wasting GPs’ time.

Balraj Purewal, director of the Asian Health Agency, believes mainstream health groups are failing to tackle issues like the stigma around cancer in the Asian community.

He told Eastern Eye: “There is a lack of community organisations pushing on health issues.

“Mainstream organisation are not penetrating. They are providing information on health issues but are not dealing with cultural issues.

“Clearly, there is an issue of not openly talking about cancer in families. There’s a sense of responsibility and they [patients] don’t want to burden them.

“They are suffering in silence and dealing with it in isolation. Self-help support groups is what is required.

“Dealing with the actual disease, then the total isolation, distress, anxiety… fear of death is a huge mental health issue.”

Purewal, whose organisation is based in west London, added: “For men, culturally, there is shame in talking about testicular cancer. The psychological state of mind can affect treatment, when you are constantly worrying about your condition and family responsibilities.”

Research by CLAHRC North-West Coast, a research arm of the NHS, found that some Asian women with cancer “snubbed” treatment because they did not want people to see them losing their hair.

Other reasons for hiding their condition included fears that they would ruin their children’s chances of marriage.

A study in 2014 by Bridgewater NHS found that South Asian women between the ages of 15 and 64 had significantly reduced survival rate for breast cancer, of three years.

Sophia Lowes, from charity Cancer Research UK, told Eastern Eye: “Talking about cancer can be hard, and in some communities and cultures, it may be even more difficult. It’s important  to break  these barriers down because of the knock-on effects on people’s health.

“For example, evidence suggests south Asian women show lower uptake of screening programmes compared to other women.

“It could also mean that individuals are less likely to go to their GP with any symptoms. Talking to a doctor if you think something is wrong can seem a bit overwhelming, but your doctor is there to help and will want to see you.

“In most cases it won’t be cancer, but it’s better to get it checked out.”

Dr Mahendra Patel, a senior member of the South Asian Health Foundation, said there is sometimes a sense of “guilt or shame” among people diagnosed with illnesses related to smoking or chewing paan (tobacco).

He said: “If the message doesn’t go out early about not telling people or seeing doctors, it could lead to the illness progressing and becoming more difficult to manage and treat.

“Regarding what society thinks, we need to educate so it’s not a taboo. Families need help and support too, if they are grieving or bottling it up.

“The patient may want to deal with it themselves and rest. But the wider aspect is they shouldn’t be hiding it because of what society thinks and shouldn’t close off any form of support, online resources and professional help.

“People have their own personal personal preferences but it could impact on their treatment and mental health.

“It’s important they do not deal with it themselves and reach out to professional organisations and support centres.”

Andrew Kaye, from Macmillan Cancer Support, said: “Who you are or where you come from should never impact on the care you receive.

“However, we know that the stigma around cancer in some communities can mean people don’t go to the doctor when they need to, or feel able to have vital conversations about their health with family or friends.

“The best way to tackle this is for the government to ensure all healthcare professionals are trained in communicating with people confidently and inclusively, and can support their patients to seek the help they deserve, so that they not only live longer but also live well.

“It is also important that people are actively supported in the community to talk openly about cancer outside of health-care settings.”

NHS England said two million urgent GP referrals were now seen each year – 500,000 more than in 2015 and record numbers of people were receiving treatment. A spokesman said, “Cancer survival rates are at their highest ever and work to ensure faster and earlier diagnosis and treatment is already under way.”

Pravina Patel was diagnosed with breast cancer at the age of 36, but kept it secret from her family. She said she felt “extremely lonely” during treatment.

Patel added, “I thought if people hear I’ve got cancer, they are going to think it’s a death sentence. I was going through chemo sessions on my own. I had some very dark days.”

She completed her chemotherapy and is now in remission.