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Committee Connection

Lebanon Lights Up in Pink its Landmark Raouché Rocks in the Middle of the Mediterranean Sea

21 Nov 2012 5:07 PM

By Katia Khoury, MD, research fellow, Breast Center of Excellence, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon

Hussein A. Assi, MD, research fellow, Breast Center of Excellence, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon

Nagi S. El Saghir, MD, FACP, Professor of Clinical Medicine and Director, Breast Center of Excellence, NK Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon; President, Lebanese Breast Cancer Foundation

Throughout October 2012, the Lebanese Breast Cancer Foundation together with the American University of Beirut (Breast Center of Excellence-NK Basile Cancer Institute and Mamdouha Bobst Breast Unit) and the Municipality of Beirut held an extraordinary event termed “Pink Raouché,” which received significant media attention in Lebanon and the Arab world.

 
 

Raouché Rocks lit in pink during sunset. (Photo taken by Rima Sabbah)

Pink Raouché consisted of lighting up the landmark Beirut twin Raouché Rocks in pink, a symbol of the fight against breast cancer. The Ministry of Public Health along with the Lebanese Society of Medical Oncology and Hoffman-La Roche also lit up in pink the Lebanese Presidential Palace in the presence of the First Lady and Minister of Health, along with billboards and media ads to promote breast cancer awareness. The event had two goals: to promote breast cancer awareness in October and to celebrate breast cancer survivorship.

Awareness and early detection campaigns
Awareness efforts included promoting breast self-exams and clinical breast exams, as well as screening mammography starting at age 40. Lebanon—with a population of four million people, according to the Lebanese Ministry of Public Health—has approximately 8,000 new cancer cases each year, of which 4,000 affect women. Of those 4,000 cases, 1,700 are breast cancer cases and 50% of those occur in women below age 50.

Lebanon has various levels of cancer care resources within its cities and high levels of education among its population. We recommend annual screening starting at age of 40—stressing quality mammography and demanding spot checking on mammography films, readings, and post-mammography follow-ups to make sure that the benefit outweighs risks. The Ministry of Health along with the Lebanese Society of Medical Oncology and Lebanese Society of Radiology runs parallel workshops and training for radiology and mammography technicians to improve their skills.

Early detection means more cures and less interventions
 
 

Dr. El Saghir (center) with a group of survivors and organizers at the Pink Raouché event.

The Pink Raouché event stressed that cancer does not necessarily mean death, especially if it is diagnosed at an early stage and before symptoms occur. When patients are diagnosed early, they can even be cured without a mastectomy. The event also emphasized that women do not need to have all axillary lymph nodes removed, especially if the first sentinel lymph node does not have cancer spread to it. In other words, women who are diagnosed early will have a better chance of having less arm edema and enjoying normal usage of their arm after breast surgery. In addition, patients with early-stage diagnoses may require less chemotherapy and targeted therapy, and would receive only adjuvant hormonal therapy if their tumors have strong staining for estrogen receptors.

Raouché Rocks as symbols of survivorship
In Lebanon and many Arab countries around the world, cancer remains a taboo that is associated with the certainty of death. Many women in Arab countries and developing nations do not seek initial health care and only do so after the disease becomes symptomatic, large, obvious, and causes local and/or systemic symptoms. We addressed women saying that with early detection, more women are cured and survive breast cancer.

We asked women with breast cancer to consider the landmark Raouché Rocks as a symbol of survivorship. The rocks went through great difficulties of weather, including severe storms, strong waves, and natural disasters over thousands of years, and yet remained standing and beautiful.

The 2012 Pink Raouché October campaign was supported by donations from Sanofi, Novartis, Roche, and private donors. In addition to lighting up in pink the Landmark Raouché Rocks by special LED lights, the campaign included a celebration with pink balloons, pink chocolates, live music, a piece by Lebanese tenor Edgar Aoun, and distribution of educational flyers.

Survivors help us tremendously in removing taboos and fatal beliefs. A large numbers of women survivors at the event were not afraid to tell people that they had breast cancer and survived. Breast cancer survivor and Vice President of the Lebanese Breast Cancer Foundation Mirna Hoballah shared, “I had breast cancer. I went through many difficulties during my diagnosis, surgery, chemotherapy, and hormonal therapy—and I made it. To women who get breast cancer: you can make it like I did. And to all women: it is easier when you have breast cancer diagnosed at an early stage. Do not hesitate; get screened.”

Positive impact of awareness campaigns
Thanks to these campaigns, which we have been organizing over the past 15 years, we have recently noted a significant downward change in the stages of breast cancer at our clinics and hospitals; we are currently seeing relatively less advanced cases and more early cases. Locally advanced and metastatic breast cancer remains very common in low- and middle-income and rising countries. Awareness campaigns are highly recommended to downstage breast cancer at presentation in those countries. The sharing of experience helps to encourage and improve international communities.

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