Part 2: Conflicting advice from doctors and high cost of drugs
Bertha’s battle with breast cancer is part 2 of three part special report on the plight of a PNG woman having to contend with a dysfunctional health system and high costs of drugs in Papua New Guinea.
Much of what Bertha has learned about cancer has been through her personal experience, and one thing she notes is that the doctors and specialists she has seen, had different views of the type of treatment she could get.
“Everybody’s not all working as one so you know they discuss my case and be all on the same page with the type of information that they give me.”
“It’s just been like I see one doctor and they say okay, now you don’t have to do the mastectomy…and see another one…[and they say] yeah, you have to do the mastectomy”.
This made it difficult for her to make informed decisions, and to understand exactly what she needed to get done.
When she went back to Bialla after receiving her diagnosis in 2021, her company doctor sent her to Kimbe to the cancer clinic.
Conflicting advice
The initial advice she got was that invasive ductal carcinoma was highly treatable, and to avoid the risk of recurrence (which would be more aggressive), she had to do the whole triage which involved surgery, chemotherapy, and radiation therapy.
Upon this advice, Bertha made up her mind to do all 3 however, when she went to the cancer facility at the Port Moresby General hospital, she was told she didn’t need to do radiation therapy.
“He made it sound like it was an optional thing for me to do and something that I didn’t really need to do but if I wanted to I could… so I was unable to make any good choices then.”
“We did initially start fundraising last year but then when I got the information that I didn’t need to have radiation, I just kind of like okay…that’s fine.”
When Bertha returned to Kimbe, her doctor was shocked at the advice Bertha had been given in Port Moresby. She went over the biopsy results again with Bertha and explained why she needed the treatment.
In April 2022, she went back to Port Moresby to pick up her passport and apply for the international vaccine card, because she had decided to do a PET (positron emission tomography) scan to see if there was any spread of cancer, in order to take the next step.
During that time, Bertha had also been feeling as though there was something in her neck, which she felt every time she wanted to swallow food.
She went to Port Moresby International Hospital where a visiting cancer surgeon from Australia (a Papua New Guinean) was working during that month.
Radiation therapy
The doctor went over Bertha’s biopsy results again with her, and his advice corresponded with what her doctor in Kimbe had told her – that she needed to do radiation therapy.
“With that information, it gave me confidence to make up my mind that okay, you know, some doctors are saying this, some doctors are saying that… with this here, I’m confident that I can make a better decision now.”
The doctor also explained that she needed to do radiation therapy 6 months after the mastectomy, which by now had lapsed. This was information that wasn’t made known to her by the doctors she had seen earlier.
Having had the mastectomy done in May 2022, she would have had to start radiation therapy in November the same year, but was now getting this advice 5 months later, in April 2023. The doctor also checked her neck and found that she also had issues with her thyroid.
Cost of cancer treatment
“I have so many different drugs, so many different issues…I’m just on drugs, I’m just a drug body now”, Bertha exclaimed rather wittily when asked about the type of drugs she was now taking.
She takes tamoxifen for the cancer, and has various other medications for her appetite, nausea, blood clots, and pain.
She recalled taking a handful of drugs per day at one point, which has now gone down.
Along with the drugs, surgeries, and the treatment comes the monetary cost of cancer that many Papua New Guinean families are struggling with.
Since Bertha’s battle with cancer began, more than K60,000 has already been spent, and the cost continues to climb.
“I had my surgeries done at PIH…each one K15,000 plus.”
Much of these costs were covered through her health insurance, assistance from her employer, and also from her pocket.
“I’ve been fortunate enough that my employer has been able to foot the bill for me in most cases.”.
While her employer has helped for the most part, and will aid in certain areas, covering the cost of radiation therapy is something that Bertha will now have to take on herself.
Because radiation therapy still isn’t done in the country, Bertha will have to go overseas for the treatment.
According to the cost received from the referral hospital, it would cost about K30,000. 00 for radiation therapy alone, which covers 25 days of treatment. This is excluding other costs that would be involved as well.
Bertha is now raising funds towards covering the cost of radiation therapy, and because she also has issues with her thyroid, gallstones and fatty liver disease – she is aiming to raise funds to have those conditions treated as well.
“We’ve put our target at K75,000 only because of the other health issues that I’m facing. We don’t want to go there and then find out something and then not have enough to pay for something like that. It’s better to be prepared to have more than to go there and not have enough.”
