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“Culture is the core, fundamental, dynamic, responsive, adaptive, and relatively coherent organizing system of life designed to ensure the survival and well-being of its members, being always shared to find meaning and purpose throughout life and to communicate caring. This system comprises beliefs, values, and lifestyles to enable successful adaptation within a biotic and abiotic geographic niche by using available technology and economic resources” (Kagawa-Singer, 2001).
Western societies today seem to have freed themselves, at least partially, from that ignorance about oncological pathology that has permeated the attitude of stigma and silence that has been widespread for decades. This entails and has entailed in the past decades, that many patients were inclined to denial, linguistic reticence, and rejection of the disease (Tralongo et al., 2020).
To date, 87% of Italians know what chemotherapy is, there is more information on what cancer is and how this disease is not transmissible. However, 53% of Italians are afraid of chemotherapy because they consider it such an invasive treatment that it does not allow them to lead a “normal” life, while 37% of Italians are convinced that this therapy is an outdated treatment. This is a snapshot of our country provided by the data collected through a survey by the Italian Association of Medical Oncology (AIOM, 2020).
The results of the survey demonstrate how far we still have to go to arrive at a correct level of information when it comes to cancer and oncological treatments even though the level of cultural awareness of this pathology has increased enormously in the last thirty years (Tralongo et al., 2020).
In the current state of medical-scientific knowledge, however, it’s necessary to let citizens know that chemotherapy cannot be done without a complex form of treatment that has changed a lot over time and which will probably continue to change in an ever more profound way. Therefore, perhaps it’s possible to state that in Western societies we have passed from the stigma on the disease to a stigmatization of the cure, even in the face of a slow acquisition and sedimentation of concepts such as quality of life and state of health in the course of the disease.
A different situation, however, is that of third world countries where the stigma towards oncological disease is still strong and deeply rooted today.
The stigma, in fact, is aimed at all forms of physical disability but also towards mental illnesses, all those which are different from the general population.
As far as cancer is concerned, these societies are characterized by poor information campaigns and people often lack the educational tools to understand the causes and course of the disease. For example, in Uganda, Burkitt’s lymphoma is particularly common. It’s an aggressive lymphoma that causes inflammation of internal organs and noticeable swellings on the neck, cheeks, or abdomen, but most parents, especially in rural areas, do not recognize the symptoms (Orem Y et al., 2011).
Against this, 47% of affected children still die, although in developed countries, on average, between 75% and 90% of cases recover. Prejudices, lack of knowledge, and not having enough money to reach hospitals also lead to death (Nakaganda et al., 2021).
Also, in countries like Uganda, there is a strong belief in witchcraft and fear of curses. So, the child suffering from a pathology such as cancer is considered “cursed”, becoming the object of further stigma and isolation, as to this is added the lack of knowledge of the causes and transmissibility of tumors.
Parents, therefore, often refer to sorcerers and traditional healers, rather than doctors, and these, using sharp tools like knives, try to cut into the swelling caused by the tumor, causing these children infections and leaving deep scars (Galabuzi, Angela, Fugo & Kamoga, 2010).
Therefore, we are still far from a complete overcoming of the stigma and a complete acceptance of the oncological disease, it’s causes and treatments in different countries and cultures.
Selene Amonini
Bibliography
Galabuzi C., Angela J., Fugo B & Kamoga R. (2010). Traditional medicine as an alternative form of health care system: A preliminary case study of Nangabo sub-county, central Uganda. African Journal of Traditional, complementari and alternative medicines. Vol (7), n. 1
Kagawa-Singer M. (2001). From genes to social science: impact of the simplistic interpreta- tion of race, ethnicity, and culture on cancer outcome. Cancer. Vol: 91(1 suppl): 226-232.
Nakaganda A. Solt K. Kwagonza L. Driscoll D. Kampi R & Orem J. (2021) Challenges faced by cancer patients in Uganda: Implications for health systems strengthening in resource limited settings. Journal of Cancer Policy. Vol. 27.
Orem Y. Mulumba Y. Algeri S. Bellocco R. Wabwire Mangen F. Katongole Mbidde E. & Weiderpass E. (2011). Clinical characteristics, treatment and outcome of childhood Burkitt’s lymphoma at the Uganda Cancer Institute. Transactions of the Royal Society of Tropical Medicine and Hygiene. Volume 105, Issue 12, pp 717-726
Tralongo A et al,. (2020). Management of chemotherapy-induced neutropenia in patients with cancer: 2019 guidelines of the Italian Medical Oncology Association (AIOM) Sage journal. Vol 106, Issue
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