Dr Houriya Kazim, the UAE’s first female breast surgeon discusses raising the awareness of cancer during the global pandemic, not just in October but all year round
After attending medical school in Ireland, Dr Houriya Kazim returned to the UAE to intern at a government hospital in Dubai. At the time, breast cancer was a subject that women didn’t like to talk about it and the taboo surrounding the disease meant that many women weren’t diagnosed until it was much further developed in their bodies. Kazim saw some of the most advanced breast tumours she had ever seen and this both shocked and worried her for the future. She discovered that superstition, fear, lack of knowledge and mainly modesty, prevented many Emirati and Arab women from seeking treatment from the country’s predominantly male medical establishment and knew that she wanted to pursue a career in this field in order to try and help remove the stigma around the disease. She became the UAE’s first female breast surgeon after pursuing further training in The United Kingdom and The United States before returning to work in the UAE once again.
Motivated by what she’d seen during her internship, Kazim created an ambitious outreach programme to educate women about breast cancer, taught them about breast (and body) awareness, and offered treatment advice and options. In 2006, she opened the country’s first Well Woman Clinic staffed exclusively by women for all women’s healthcare needs. She also established Brest Friends, a charity organization that includes the first breast cancer support group in Dubai. In 2015, Brest Friends partnered with Al Jalila Foundation, a non-governmental organization established by His Highness Sheikh Mohammed Bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai. The joint mission is to promote early detection of breast cancer, expedite support with medical treatment and research into the epidemiology of breast cancer in the UAE and the region.
Much of Kazim’s work has helped to reduce the taboo around breast cancer and subsequently saved the lives of women in The Emirates, but there’s still much to be done. As cancer rates continue to rise globally, further development in medicine and technology is crucial in the fight against this disease. On the occasion of Breast Cancer Awareness month we discover more about what we can all be doing to keep the awareness going not just in October, but all year-round.
This past year, health has been at the forefront of everyone minds – how do you think this has impacted the approach to breast cancer?
The entire world has been collectively anxious for the last year and a half, however, my breast cancer patients were doubly so – having to deal with two potentially lethal illnesses. Unlike other parts of the world, our cancer patients in the UAE had continuity of their care. There were some changes in their management though, such as minimising the extent of surgery to decrease the time staying in hospital. This sometimes meant they needed another operation later to complete their surgical care. We often changed the order of treatment for a patient – giving them chemotherapy as an out-patient first, before surgery, again to limit the time the patient stayed in hospital.
Of course, COVID-19 has become something we are all aware of but why is it important to continue to raise awareness of breast cancer, especially when are in a global pandemic?
People still get cancer, despite the prevailing pandemic. Some patients, even though they are aware that their check-ups are due, are still afraid to visit hospitals due to the perceived risk of getting COVID-19. So, it’s important to keep reminding women to continue with their usual medical screenings. I’ve had many patients, who found a lump during the early part of the pandemic but didn’t visit a Specialist until much later as they were afraid of getting COVID-19 if they left their homes.
What advice would you give to women who have been putting off visiting a doctor to get their breasts checked because of the restrictions around COVID-19?
The COVID-19 situation in the UAE is so much better now, and most people are vaccinated. In addition, all medical centres have stepped up their sterilisation programs to minimise the risk of covid transmission. I would advise women to please continue with their usual breast checks.
Can you tell us about any new developments in technology around breast cancer that could be particularly beneficial to women moving forward?
We now have 3D mammography (called tomosynthesis) which can pick up the early stages of breast cancer much better than the previous 2D mammograms. From a surgical management point of view, we are always trying to minimise how much surgery we do on the breast and the lymph nodes, which can only be good news for the patient. The medical treatment of breast cancer is very dynamic with new drugs being developed that target cancers with a particular biology. We use immunotherapy for some cancers and we even have drugs that treat cancers that have occurred due to an inherited gene mutation. So, it’s not one drug for all breast cancers.
What is something we can all do at home to check for lumps or abnormalities in our breasts?
All women should be body aware – not just breast-aware. They should know what their bodies look and feel like and if they ever notice anything new, they should show it to a specialist. The best way to screen for breast cancer is by having regular mammograms.
How do you think the stigma related to breast cancer has lessened in the Middle East over the past years?
The stigma is still there but much less so over the past two decades. I think the awareness programmes and the internet, have been responsible for this welcomed change.
What can we all be doing to educate our children and the younger generation on breast cancer?
Breast cancer is a disease whose risk increases with age. The median age of breast cancer in Europe and North American is 62 years. In the MENA region, it’s in the mid-40s, so I don’t believe we should be scaring children about breast cancer. And even for adults, it’s also important to remember that 9 out of 10 women will NOT get breast cancer and that more women will die of heart disease than breast cancer. So, education for the younger generation should be about their general health – things like diet and exercise – and not just focussed on the breasts.
What is the biggest challenge you face now in what you do?
Breast cancer treatment is a long journey that can be very expensive. The biggest challenge that I have professionally is not a medical issue but is in trying to help patients have their treatment without the added financial worry.
What is the biggest reward you get from your job?
My biggest reward is my patients. Every day they show me how strong and resilient women really are!
What is something you still want to do that you haven’t done yet?
I would like to research why, in this part of the world, (MENA and Indian Subcontinent), the median age for breast cancer is almost two decades younger than in the West. This has huge implications. A woman getting breast cancer in her 40s or younger, would be in the prime of her life, the peak of her career or bringing up a young family when affected with this disease.
Tell us about some of the recent charity work you have been doing and how is it helping men and women?
In 2002, I set up Brest Friends whose mission is trifold – breast cancer education and awareness, to offer financial help to pay for treatment, and locally-based research into the disease. In 2015, we partnered with the Al Jalila Foundation, whose mission aligned with ours. The Foundation helps raise money for our cause but also for a host of other worthy causes that men, women and children in our community will benefit from.
What is something you will be doing to raise awareness this October?
As breast cancer occurs all year, our awareness programs run all year! We do step things up in October with informative talks to ladies’ groups, schools and colleges, local and international companies. Most importantly, we plan special events for breast cancer survivors such as “look good, feel good” events with our cosmetic partners etc.
What is a message you would like to send to our readers around the topic of breast cancer?
To please keep up with your usual health checks, including mammograms.