How patriarchy and conservatism fuel deadly hesitancy among women with breast cancer

Khoula Mahroof, 43, was barely five months into her marriage when she identified a lump in her right breast. A fortnight later, a biopsy report confirmed that she had third stage breast cancer. Her family members were in shock.

“It was the hardest thing to convince family and relatives that I had been diagnosed with breast cancer and that I needed medical treatment to get cured. They were in denial,” says Mahroof, who lives in Islamabad, Pakistan. They recommended that she drink holy water, go for spiritual spells (dam-darood), and recite the Quran for healing. They did not approve of the recommended standard medical treatment.

“I had eight chemotherapy sessions and seven injections for targeted therapy without being accompanied by anyone,” she told The BMJ. “But I also performed the recommended religious practices so that my relatives didn’t get upset.”

One in nine1 Pakistani women are diagnosed with breast cancer in their lifetime, with mortality reported at 26.76%. Around 89%2 of breast cancer patients are diagnosed at a late stage and 59% at an advanced stage. Part of the problem is the dominance of the patriarch and old religious beliefs3 that lead to misinformation regarding the disease. For example, the word breast might be associated with sexuality instead of health, while guidelines regarding modesty and fatalism4 prevent …