Coming back to life: voices from breast cancer support groups in cuba

In Cuba, breast cancer is the most common cancer in women (excluding skin cancer) and the second cause of cancer death in women. The Ministry of Public Health recognizes breast cancer as a major public health problem, and aims to reduce mortality 15% by 2015-from the 2004 adjusted mortality rate of 14.1 per 100,000 population to 11.9.[1,2] Programs are underway to lower mortality and improve survival through improved screening, research on risk factors and new therapies, and broader public education about the importance of early detection. Women in breast cancer support groups are also beginning to play a key role in raising awareness about the disease and about life-after-mastectomy, as well as providing emotional and practical support for each other and their families. The first, and now largest, breast cancer support group was started in Havana in 2003 by a few surgeons and their patients who had undergone a radical or partial mastectomies. For these women and the majority diagnosed with breast cancer in Cuba, surgery is the most common shared experience with the disease, and they refer to themselves as 'operadas' (operated on) or 'mastectomizadas' (mastectomized), rather than 'survivors'. However, the group's name, Alas por la Vida (Wings for Life), symbolizes the spirit of hope and determination uniting these women. Today, over 300 women, family members and doctors participate in bimonthly meetings at the Manuel Fajardo Clinical-Surgical Teaching Hospital in Havana. Inspired by this group's experience, breast cancer survivors in other communities are forming their own, supported by the Federation of Cuban Women. MEDICC Review talked with members, physicians and families involved with three groups-in urban Havana, the semi-urban Cotorro municipality on the outskirts of the city, and the rural town of Batabanó, two hours south of the capital-about their experiences with cancer and what the group has meant for them.