(Photos provided by Nuzhat Tarannum Tishna)
Note: Portions of the included interview have been edited for brevity and clarity.
October is Breast Cancer Awareness Month, also called Pink October, in honour of the pink ribbons that we associate with this disease. According to the World Health Organization, this was the most common cancer in women in 157 countries, with an estimated 2.3 million women diagnosed in 2022. In Bangladesh, the mortality rate is especially high, as nearly half of the women diagnosed with it die every year.
Spheres of Influence had the pleasure of interviewing two Bangladeshi changemakers to recognize this month-long health campaign of Pink October. Nuzhat Tarannum Tishna is a breast cancer survivor and founder of TishCAN, a network of patients, survivors, healthcare professionals and advocates that offers mutual support and shares resources. Dr. Lubna Mariam (MBBS, FCPS, M.Phil) is an Oncologist and Associate Professor at the Department of Radiation Oncology, National Cancer Research Institute and Hospital, as well as Consultant at Ahsania Mission Cancer & General Hospital in Bangladesh.
A Survivor and Relentless Advocate
(Nuzhat Tarannum Tishna, founder of TishCAN)
SOI: Can you share a bit about your personal experience with cancer, from diagnosis to treatment, and how it shaped your perspective on women’s health in Bangladesh?
Tishna: It was extremely overwhelming to navigate the uncertainty and financial planning that comes with cancer. It’s more than a disease; it also requires logistical planning. For me, the emotional turmoil actually took a backseat. My family and I were trying to find the best treatment possible with the finances we had.
I was also scrambling to get the right resources and doctors, and I wished that I had been more informed at the beginning of my journey.
SOI: How do you think patriarchy, social judgment, or cultural silence impacts this journey?
Tishna: In Bengali culture, women are not usually motivated to speak out about anything. We are told to silently tolerate anything that comes our way. Self-care is thought to be selfish, and the ideal woman sacrifices her needs for her family. That is why when women have cancer and need care, they are neglected. I’ve read research that says divorce rates are higher for women diagnosed with breast cancer.
Through my journey, I’ve met a lot of women who have been facing social judgment. I found a survivors group to ensure that we have support as we navigate cancer. One of the women in my group introduced me to a 24-year-old who had just gotten diagnosed with breast cancer. She lived in a rural area where neighbours shut her out because they thought cancer was contagious. They would steer clear of her whenever she got out of the house. She also had to pull her son out of school to get cancer treatment, so we raised funds through TishCAN to support her.
SOI: What inspired you to create TishCAN?
Tishna: In 2022, when I started my journal, I only believed in one thing: Tish CAN get well… Tish CAN survive. I had no idea then what Tish CAN could truly become. That resilience gave way to motivation to help others like myself.
I made some mistakes in my treatment journey because I wasn’t informed. Early detection makes things less complicated. Time is really of the essence here. We need to combat our fear of going to the doctor and raise awareness about it.
SOI: Could you walk us through some of the initiatives TishCAN organizes, like charity fairs, doctor information sessions, and wellness workshops? What impact have these had so far?
Tishna: In terms of charity, I organize regular fairs where people donate their pre-loved clothes or household items. The funds raised from this go to an individual who is facing financial barriers while undergoing breast cancer treatment. As for my survivor group, I organize yoga, art therapy, Reiki, group counselling, zumba, and strength training. It is really important to keep your mental and physical health in check even after you’ve defeated cancer.
(Fundraising fair with pre-loved items)
SOI: Bangladesh doesn’t really have thrift stores or a culture of buying second-hand, but you have organized successful charity fairs, helping with both fast fashion and fundraising at once. How did you come up with the idea, and what was that journey like?
Tishna: Cancer really affects your sense of morality. I thought about how a lot of us are hoarding clothes that we might never even get to wear. So I started Pre-love Fairs, initially with just family and friends, and asked them to bring donations so I can fundraise for TishCAN. Initially, I thought I’d sell these items at a low price to those who cannot afford expensive clothes and jewelry. But I was surprised by the response from people of all income levels! I had recently heard about a celebrity who did a similar fair, and I’m glad the idea is gaining traction.
SOI: What’s your dream for TishCAN in the next 5–10 years?
Tishna: Right now, I’m the only one managing the network and events.
I would really like to establish it as a formal entity, with sponsors and official registration. Then, I would focus on information accessibility, especially for those outside the capital city of Dhaka.
An Oncologist’s Perspective
(Dr. Lubna speaking at a TishCAN event)
SOI: In your opinion, how do social norms, such as stigma, shame, or fear, affect women’s cancer journey?
Dr. Lubna: Since Bangladesh is a Muslim-majority and conservative country, people are shy to talk about organs like breasts. Also, a lot of people have never heard of cancer. And if they have, they tend to assume that cancer always leads to death.
I’ve seen and handled many cases like this. I know a young woman who was disowned by her husband and in-laws when she was diagnosed. In another instance, the family of an elderly patient told me to hide her cancer diagnosis from her, as they thought she wouldn’t be able to take that mental burden or opt out of treatment. This is very difficult to navigate as a doctor. I am also frequently asked if breast cancer is contagious and whether family members can safely share a house with patients. I don’t blame them for their lack of information, but these dangerous myths tend to isolate the patient at a time when they most need support.
We urgently need more family counselling to equip patients and caregivers with the knowledge and tools they need to fight this disease.
On our side, oncologists and medical staff also need more training for relationship building. When I was doing my MBBS degree, I noticed a gap in communication skills courses. Whereas when I did further studies abroad and was trained by foreign faculty in Bangladesh, I was taught important skills, such as how to answer questions like ‘How do I break bad news to a patient?’ Do I look into their eyes? Where should we sit? We need steps and structure for these sensitive conversations.
I have not seen such training here in Bangladesh, yet. The hospitals and clinics don’t provide it either.
Do you think mass media campaigns during Breast Cancer Awareness Month are reaching the women most at risk? If not, what could be done better?
Dr. Lubna: Current campaigns are very focused on the capital city, Dhaka. We need more targeted effort in rural areas, where much of the population lives. I also think it would be great if we could do some work in media reframing. Nowadays, I find that the media’s coverage of awareness events can be individualistic e.g. focus on the speakers’ names and background. It would be more helpful to capture the gist of their talks, like highlighting symptoms.
SOI: What role does the government play in bridging these gaps in the healthcare system?
Dr. Lubna: We need to have a better formal structure of the healthcare system. Right now, the General Practitioner (GP) and referral system in Bangladesh is very scattered. This gives way to late detection of diseases. A proper referral system would also mean that I can give more time to each patient. Currently, I see about 50 patients every day. If a better system were in place, I would be able to focus on patients who are in advanced stages.
The Health Sector Reform Commission put forward a proposal to the interim government to improve healthcare infrastructure, which includes a plan to implement a referral system.
SOI: What role can NGOs play in bridging these gaps in the healthcare system?
Dr. Lubna: They can definitely work in the areas where the government seems to have limited effectiveness. They don’t all have to be big events; grassroots organizations like TishCAN make a huge difference as well. However, the sad reality is that some NGOs are not a stranger to corruption and fund embezzlement. They can definitely utilize their funds better for social impact work.
The Way Forward
I had come to know about Dr. Lubna’s work and TishCAN more closely as my own mother was diagnosed with breast cancer in late 2022. We rarely think something like this can happen to us or a loved one, but you never know what life can throw at you! Awareness is integral, but as I have learned from my own experience as a daughter of a survivor and from these interviews, challenging stigma, reimagining care, and making support accessible can revolutionize treatment. Pink October isn’t the only month we should be caring about breast cancer, it affects people every single month and it requires more work from governments, hospitals, non-profits, and caregivers alike.
Edited by Light Naing
