Aishah Knight

Understanding Barriers to Malaysian Women with Breast Cancer Seeking Help

Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.

A qualitative exploration of Malaysian cancer patients' perceptions of cancer screening

BackgroundDespite the existence of different screening methods, the response to cancer screening is poor among Malaysians. The current study aims to examine cancer patients’ perceptions of cancer screening and early diagnosis.MethodsA qualitative methodology was used to collect in-depth information from cancer patients. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted. All interviews were audiotaped, transcribed verbatim, and translated into English for thematic content analysis.ResultsThematic content analysis yielded four major themes: awareness of cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening, and cues to action. The majority of respondents had never heard of cancer screening before their diagnosis. Some participants reported hearing about mammogram and Pap smear tests but did not undergo screening due to a lack of belief in personal susceptibility. Those who had negative results from screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constraints were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including the role of mass media in disseminating the message ‘prevention is better than cure’.ConclusionsPatients’ narratives revealed some significant issues that were in line with the Health Belief Model which could explain negative health behaviour. The description of the personal experiences of people with cancer could provide many cues to action for those who have never encountered this potentially deadly disease, if incorporated into health promotion activities.

Complementary alternative medicine use amongst breast cancer patients in the Northern region of peninsular Malaysia.

BACKGROUND Breast cancer is a common cancer affecting women in Malaysia and the use of complementary/ alternative medicine (CAM) has been associated with delays in getting treatment. The aim of the study was to explore the use of CAM and the influencing factors in the Northern region of Peninsular Malaysia. MATERIALS AND METHODS This was a cross-sectional descriptive study on a convenience sample of 100 Malaysian breast cancer survivors. FINDINGS The reported use of CAM among the breast cancer survivors was lower than in other studies but the types of CAM used had a similar pattern with nutrition supplements/vitamins being the most common. The factors that positively influenced the use of complimentary/traditional therapy were income and getting information from television or radio. Survivors with access to internet/blogs appear to have lower odds of using complimentary/traditional therapy compared to the respondents who reported no such access. CONCLUSIONS Information transmitted via television and radio appears to have a positive influence on CAM use by breast cancer patients compared to other information sources and it is important to ensure that such information is accurate and impartial.

Prevalence of Diego blood group antigen and the antibody in three ethnic population groups in Klang valley of Malaysia

Background: Diego blood group antigen, Di(a), is very rare among Caucasians and Blacks, but relatively common among the South American Indians and Asians of Mongolian origin. The antibody to Di(a) is clinically significant to cause hemolytic disease in a new-born or hemolytic transfusion reaction. Objectives: This study was designed to determine the prevalence of Di(a) antigen among the blood donors from the three major ethnic groups in Klang Valley of Malaysia as well as to find an incidence of an antibody of the Diego antigen, anti-Di(a), in a tertiary care hospital to ascertain the need to include Di(a+) red cells for an antibody screen cell panel. Materials and Methods: Serological tests were performed by column agglutination technique using commercial reagents and following instruction as per kit insert. Results: Di(a) antigen was found with a frequency of 2.1% among the Malaysians donors in three ethnic groups viz, Malay, Chinese and Indian. It was present among 1.25% of 401 Malay, 4.01% of Chinese and 0.88% of 114 Indian origin donors. None of the 1442 patients, including 703 antenatal outpatients, had anti-Di(a) in serum. Conclusion: The prevalence of Di(a) antigen was found among the donors of all the three ethnic background with varying frequency. Inclusion of Di(a+) red cells in routine antibody screening program would certainly help in detection of this clinically significant antibody and to provide safe blood transfusion in the Klang Valley, though the incidence of antibody appears to be very low in the region.

Pancreatic Cancer in Universiti Sains Malaysia Hospital: A Retrospective Review of Years 2001-2008

Pancreatic cancer is usually detected late and has a high mortality rate. Since little is known about this cancer in Malaysia, a review of all cases admitted to Universiti Sains Malaysia Hospital was conducted to identify the epidemiological distribution and assess survival. A list of pancreatic cancer patients in 2001-2008 was obtained from the Hospital Record Department. Only cases confirmed by radio-imaging or histo-pathology examination were included. We excluded those with incomplete medical records. Kaplan-Meier and Cox proportional hazard approaches were used for data analysis. Only 56 cases were included with a mean (SD) age of 49.6 (16.0) years, with 60.7% males and 82.1% of Malay ethnicity. Previous history included cholelithiasis in 23.2%, diabetes mellitus in 16.1%, previous laparotomy in 10.7%, chronic pancreatitis in 7.1%, alcohol drinking in 5.4% and positive family history in 3.6%. The common presenting history included 67.9% loss of appetite, 66.1% loss of weight, 58.9% jaundice and 46.4% abdominal pain. Tumour staging was: 21.5% stage l, 17.8% stage ll, 3.6% stage lll and 57.1% stage lV. The median (95% CI) survival time was 3.4 (0.5, 6.3) months and significant prognostic factors were duration of symptoms (HR 0.97; 95% CI: 0.95, 0.99; p value 0.013), ascites (HR 2.64; 95% CI: 1.28, 5.44; p value 0.008) and Whipple surgery (HR 4.20; 95% CI: 2.27, 7.76; p value <0.001). The history of presenting complaints was short and the majority presented at late stages of the disease, thus the median survival time was very poor.

The Use of Energy Medicines (EM), Manipulative Body Based Therapies (MBBT), Therapies from Whole Medical Systems (WMS) and Health Related Quality of Life (HRQoL) of Cancer Patients

Objectives: Although Complementary and Alternative Medicine (CAM) use is common among healthy individuals and patients with chronic diseases, there is paucity in data regarding the use of Energy Medicines (EM), Manipulative Body Based Therapies (MBBT) and therapies from Whole Medical Systems (WMS) among Malaysian oncology patients. The study aimed to examine the use of EM, MBBT therapies from WMS and the Health Related Quality of Life (HRQoL) in a group of Malaysian cancer patients. Methods: This cross-sectional study was conducted among 393 cancer patients at the oncology clinic of Penang General Hospital, Malaysia, using a self- administered questionnaire while the HRQoL of the participants was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQC30). Results: Out of 393 respondents, 46.8% (n=184) had used CAM for their condition. A total of 73 (39.6%) reported to use different types of EM, MBBT and therapies from WMS. The majority of the EM, MBBT, WMS users were female 52 (71.2%), aged between 48 and 67 years 42 (57.5%), and were Buddhist 35 (49.3%, p=0.007) from Chinese ethnicity 37 (52%, p-0.011). Therapies from WMS such as traditional Chinese medicines 39 (53.4%), traditional Malay medicines 16 (21.9%), Homeopathy 7 (9.5%), Ayurveda 6 (8.2%) were most commonly used by the participants. Only 18 (24.6%) reported to spend between 101-500 Ringgit Malaysia (MYR). Friend and family members 58 (76.7%) were the most important source of information. No significant difference was found in Global health status/quality of life scores between EM, MBBT, WMS users and non users (p=0.763). Conclusion: Therapies from WMS is somewhat common among M

Use of Medicinal Flora Enlisted IN Quran And Ahadith by Malaysian Oncology Patients

Faculty of Pharmacy, Universiti Teknologi MARA, Bertam Campus, Kepala Batas, 13200, Penang, Malaysia; Discipline of Social & Administrative Pharmacy, Universiti Sains Malaysia, 11800, Penang, Malaysia; Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, 13200, Penang, Malaysia; Department of Medicine, Allianze University College of Medical Sciences, 13200, Penang, Malaysia; Faculty of Pharmacy,Universiti Teknologi MARA, Puncak Alam Campus, 42300, Bandar Puncak Alam; E-mail: maryam089@ppinang.uitm.edu.my