Breast cancer stigma among Indonesian women: a case study of breast cancer patients

Abstract

Background The stigma experienced by cancer patients stems from the association of cancer with death, as cancer is the most feared disease worldwide, especially among cancer patients and their families. The stigma regarding breast cancer screening behaviour has not been critically evaluated and is poorly understood; therefore, we aimed to analyse the stigmatization of breast cancer patients in Indonesia to reduce the morbidity and mortality of breast cancer. Methods A qualitative study using a focus group discussion (FGD) and in-depth interviews with thematic analysis was conducted. Results One informant experienced breast pain and kept the referral letter, in which the medical doctor advised medical treatment, to herself for 3 months due to her embarrassment. A traditional healing practice known as ‘kerokan’, which involves scraping of the skin, and consumption of a traditional drink were used by most informants to decrease their breast pain. Finally, most informants were diagnosed with an advanced stage of cancer when they returned to the health care facility. In addition, financial difficulties were noted as barriers to breast cancer screening in Indonesia. Conclusions Feelings of fear and shame when diagnosed with breast cancer were reported by the informants in this study. Alternative treatment known as ‘kerokan’ was the first treatment sought for breast cancer symptoms due to financial difficulties among breast cancer patients. Informants were diagnosed with an advanced stage of cancer after they returned to the health care facility. A better understanding of early breast cancer symptoms could motivate women to seek out breast cancer treatment.

Determinants of Breast Cancer Screening Practice among Women in Indonesia: A Nationwide Study

“…In Indonesia, a significant number of women are diagnosed for breast cancer in the advanced stage of the disease due to lack of knowledge and awareness, insufficient social support, numerous psychosocial factors, and, often times, the socio-characteristics of breast cancer patients (Setyowibowo et al, 2017;Anwar et al, 2018;Solikhah et al, 2020). A large-scale study in Ghana found that the educational background of a breast cancer patient is significantly associated with breast cancer screening (Agyemang et al, 2020).…”

Factors Affecting Delayed Presentation and Diagnosis of Breast Cancer in Asian Developing Countries Women: A Systematic Review

“…However, further studies have been shown to obtain contradictory results (Rivera-Franco and Leon-Rodriguez, 2018). Meanwhile, higher formal education and socioeconomic status could reduce delayed diagnosis, even though several studies, contrastingly, did not report similar results (Bodapati and Babu, 2013;Lim et al, 2015;Roy et al, 2015;Dyanti and Suariyani, 2016;Solikhah et al, 2020). Residential status and distances to healthcare facilities were also among factors related to delayed diagnosis in breast cancer (Bodapati and Babu, 2013;Thakur et al, 2015).…”

The relationship between NFKB, HER2, ER expression and anthracycline -based neoadjuvan chemotherapy response in local advanced stadium breast cancer: A cohort study in Eastern Indonesia

“…Most breast cancer patients in Indonesia that come for treatment are usually in the advanced stages, and 63% are in stages III and IV at diagnosis [ 24 , 25 ]. This behavior is related to socio-economic problems, breast cancer stigma, and education levels [ [24] , [25] , [26] ].…”

“…From the patient's point of view, Indonesian women do not seek help earlier due to financial problems, rural residence, health expenditure, healthcare access, and lower education level. In addition, other recognized barriers to early detection of breast cancer in Indonesia include belief in traditional medicine and a lack of autonomy in decision making [ [25] , [26] , [27] , [28] ].…”