How I found out my mom has breast cancer: Experiences of Middle Eastern women
By Asal Kashani
“MOM HAS CANCER!”
That’s how I found out. Just like that.
I had been asking my father about the date to host brunch at our house for my friends. I was adamant about choosing the date so I could start organizing everything. My parents kept pushing it off saying, “Just wait.” I didn’t understand. Wait for what?
And then my father just blurted that out. I remember where I was sitting, where my father was standing, how the sun was shining into our house through the skylights. I remember standing up and walking to my bedroom, speechless.
“Don’t tell anyone,” my father said, passing by my bedroom a few minutes later. That was all. “Mom has cancer. Don’t tell anyone.” What the hell was I supposed to do with that?
A study found that Iranian women tend to associate breast cancer with stigma: a sense of shame in having the disease and a tendency to hide it from others.
Throughout my mother’s cancer journey, it stayed like that. “Don’t tell anyone.” It was only my mother’s place to tell anyone. My mother had to approve who was told, when they were told, what they were told. My brothers never knew. My mother’s parents never knew. My father’s side of the family? Never knew.
But I knew. My mother said, “My doctor said I had to tell you because you are now at high risk. She said boys, it’s OK not to tell them, but if I had a daughter, I had to tell her.”
So I was there, knowing when she had doctor appointments and what the doctors said. I received the photos from my father of my mom before and after surgery. I prepared soup for after the procedure. I helped her change her bandages after surgery, bought her new cotton bras that wouldn’t irritate her and told her to rub coconut oil on her skin after radiation. I saw her ring the bell after her last radiation treatment through video as I was in college already by that time. But I saw it all.
When I got to college, it was OK to tell. It was OK because no one knew my mother. It was OK because if Persians knew, then everyone knew, and everyone would talk about her and pity her and bombard her. My mother only told a few of her cousins (because they had breast cancer and knew the best doctors), our Rebbetzen (because my mom had burst into tears at the supermarket when she had been asked how she was) and my mom’s brother and sister-in-law (because if my brother needed to be picked up from school, she needed help). And of course, me.
I was considered lucky — my mother was open about her cancer. It seems like the opposite, but with me, she was open. She told me everything, asked me questions and needed me for support. She didn’t hide anything and relied on me to guide her, as if I had any idea what was happening. But she trusted me, and that meant the world.
But Jennifer, who is also Persian, had a very different experience when dealing with her mother’s cancer journey. She noticed her parents being secretive with one another, and her mother was continuously going to doctor appointments and mentioned surgery as well. Jennifer knew something was going on, but she found out about the diagnosis on her own, saying, “I ended up looking through some of her medical records that the doctor gave her and that is how I unfortunately found out. I would have hoped that my mom would have had the courage and trust to tell me and my siblings.”
In her family, cancer was never spoken about. In our Persian culture, cancer is stigmatized. As Jennifer said, “In Persian culture, it is so important for everyone to keep to themselves and not spread the word, and protect your kids. It was clear she did not want me to worry, so she shut me down.” Growing up, her mother would never even let her say “the C word.” Like my mother, Jennifer’s mother “is very reserved and kept her diagnosis completely private.”
But while the Persian community has their own approach to breast cancer, it’s not that way for every Middle Eastern community. Remi, a young woman in her 20s, shared glimpses of her Israeli mother’s story with us. Her mother was diagnosed in July of 2022, and she found out by receiving a phone call at work. Initially in shock, Remi says, “[It] made me realize that I needed to be more there for her — I took a day off of work to tend to her and stay with her all day [after her procedure] and everyone was supportive and stopped what they were doing to care for her.”
Remi’s mom, unlike mine, was open to discussion about her diagnosis and treatment. While my mother blamed “the town’s water” on her health, Remi’s mother attributed the cause of her breast cancer to stress and other life circumstances.
“The doctors believed her diagnosis was due to stress, trauma and other negative people,” Remi said. “She had just been through a lot with her mother having early stages of dementia, her stepfather passing away and the divorce my father causing her to move out. She is an empath, making these big life changes be felt at an extremely deep level. After the surgery, she refused to conform to societal norms, familial constraints and other aspects she believed triggered her cancer.”
While many of the true causes of breast cancer are unknown, mutations in the BRCA gene is an indication that an individual has a much higher risk of developing breast cancer or ovarian cancer in their lifetime. It’s been well-known that Ashkenazi Jews, or Jews with ancestors from Central and/or Eastern Europe, are more likely to have this gene mutation than the general population. However, research has now found that there are “11 different BRCA mutations — which includes three mutations specific to Sephardi populations,” or populations of Jewish individuals who have ancestors from Spanish regions, North Africa and/or the Middle East.
As a Sephardic Jew myself, I know my risk. And so did Remi, who thankfully indicated that preceding the test, “[doctors] concluded it was in fact not hereditary and a single diagnosis.” Unfortunately, this doesn’t erase our risk.
“Having a first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman's risk.” And double’s a woman’s fear.
Jennifer believes “it’s important for family members with a strong family history of breast cancer to be informed that it is a risk so that they could also be more cautious and get checked and screened earlier. I wish I had the ability to communicate that to [my mom] — that her diagnosis is not only important to her, but it is important to us: her children.”
An issue arises when culture prevents women from protecting themselves or others. A study found that Jordanian and Palestinian immigrant women were presented with the following barriers regarding participation in BCS (breast cancer screening): (1) culture-specific barriers such as embarrassment, family relationships, fatalism and traditional healers consultation; (2) immigration-related barriers (citizenship issues and language); (3) general barriers (including nonparticipation in health screening, stigmatization of cancer, fear and ignorance about BCS); and (4) irrelevant barriers. Because of factors like these, Middle Eastern immigrants might be more likely to be diagnosed with breast cancer at an advanced stage.
With so many cultural considerations that vary from Western views, it can be difficult to draw the line between respecting culture and pushing for change. Unfortunately, the likelihood of breast cancer screening in immigrants from the Middle East is also even low, influenced by factors such as perceived importance of mammography, intent to be screened and religious/cultural restrictions. Middle Eastern women also “tend to get very busy in their houses, prioritize their families, and not go to the clinician until symptoms appear.”
When trying to find the line between culture and health, it’s important to not question the beliefs behind the cause of cancer and the reactions to and manners in which the person deals with their diagnosis. Rather, try to embrace the cultural views while still emphasizing the importance of health for family and for the individual themselves. Simply, focus on educating about the importance of screening and preventative care, providing support and love, and using as much understanding as possible. Remember that everyone’s experience is different and unique, and breast cancer is never a simple illness.
Author: Talia Bina
Header Photo by Klaus Nielsen / Pexels
