Celebrating life
Reconstructive breast surgery to restore, uplift and empower cancer survivors
Breast cancer is the most common cancer and the leading cause of cancer-related deaths in women worldwide; it is also the most commonly diagnosed cancer in South African women and accounts for around 20% of all cancer cases. In addition to the physical strain that women undergoing treatment experience and the psychological trauma of a potentially fatal diagnosis, studies have found that around half of breast cancer patients often struggle with self-esteem, body image, sexual expression and mental health.
In South Africa, one in every 26 women is at risk, and 16% of cancer deaths are as a result of breast cancer. However, a lack of screening and poor access to medical care, especially for black women, means the diagnosis usually comes at a late stage. Dr Brian Monaisa is the head of plastic and reconstructive surgery at Chris Hani Baragwanath Hospital in Johannesburg and runs a private practice in Krugersdorp on Gauteng’s West Rand. He says screening and early detection are key to ensure that women are protected and empowered in the fight against breast cancer.
This is particularly important in the case of triple-negative breast cancer, an aggressive type of breast cancer that is increasingly found in young, black women who have historically been considered a lower risk group. And is harder to treat than other types of breast cancer.
“It’s not enough to just deal with the aftermath of cancer,” Monaisa explains. “We’re not raising enough awareness, we’re not screening enough, and by the time we detect the cancer it is often quite advanced. This needs to change.”
Surgery saves lives, but can impact self-esteem
Once a diagnosis is made, a number of treatment options exist, especially if the cancer is caught early on. A lumpectomy is known as a breast-conserving surgery, where the tumour and some of the surrounding tissue is removed in an effort to stop the spread of cancer. A mastectomy is a life-saving surgical intervention that removes all of the breast tissue on one or both sides.
Surgery is often a first line of attack against breast cancer, and although it is an important weapon in the fight for survival and health, it can take a serious toll on a patient, Monaisa explains.
“You fear for your life, for what will happen to your family if they were to lose you, but you also fear the losses that might come while you are still alive — the loss of your breasts and the perceived loss of femininity that accompanies that. Afterall, breasts are seen to represent womanhood, motherhood, sexuality and desirability, and their removal can impact the way a woman views herself.”
One study found that 33% of women who had undergone surgery for breast cancer said that it had negatively affected their relationship with their partner, with 31% reporting that they felt less attractive and 30% saying that they felt their partners found them less attractive. Around 80% of younger women and almost
60% of older women said they cover their body during intimate contact. More than 70% of women across all age groups reported a deterioration in sexual activity and sexual satisfaction.
Reconstruction as an act of self-love
Breast reconstruction can help cancer survivors to feel at home in their bodies again, but it is not for everyone. “Deciding whether to have
surgery is deeply personal, and there are no right or wrong choices. After extensive surgery to remove the cancer, many women decide that they would rather not undergo more operations.”
Other women, however, see reconstruction as a reclamation of self and a celebration of life.
“Many of my patients view the procedure as an act of self-love, and of restoring hope and joy,” he says. “It can be an act of empowerment, and it’s a privilege for me to be trusted to walk that road with someone,” he says.
For those who decide on reconstruction, some women opt to have the surgery at the same time as the cancer-removing surgery, while others wait months or even years to go under the knife again.
This reconstruction, however, does not come cheap — the cost ranges between R70,000 and R250,000 depending on the type of procedure. The surgery, often regarded as cosmetic, is not covered by most medical aids.
“Many women do not have the funds for reconstructive surgery, while others can partially fund their surgery but not cover the full cost,” he explains. “It’s heartbreaking to see women stripped of the opportunity to choose simply because they cannot afford it, especially when they have been through so much already.”
It was his interaction with women who wanted to reclaim their lives through breast reconstruction but could not afford it, that inspired Monaisa to take action.
Smile Artists Africa
The Smile Artists Africa initiative is a fundraising art auction that raises money to reduce the financial burden on breast cancer survivors and empower them to live their fullest lives — on their own terms.
“I’m vocal about the reconstructive work that I do and the impact it can have, and I think this passion is contagious,” Monaisa laughs. “I’m also an art lover and an art collector, and Smile Artists Africa is where these two aspects of my life collide.”
Monaisa rallied established and rising artists to donate work towards the cause — the response was overwhelming. The annual Smile Artists Africa Fusion Art Fashion Auction, which this year will be held at Cradle Boutique Hotel in October, is a star-studded extravaganza and one of South Africa’s most high-profile charity events.
“What we do on the day is champion South African culture and South African expression through the arts,” Monaisa says.
The funds also go towards raising awareness and promoting screening initiatives and early detection, especially in high-risk groups.
“October is Breast Cancer Awareness month, and our artists and celebrities also get involved in the month leading up to the event to promote self-screening, raise awareness and talk about prevention,” he explains.
Last year, a number of fashion designers decided to join the party too, with each dressing a celebrity and an artist as part of the art exhibition.
“The event gives you the chance to talk to creators and artists about the work that they do and what drives them — that’s an opportunity that does not come along every day!”
He says it is an occasion to engage with and celebrate beauty — beautiful people in beautiful clothes at a beautiful location, surrounded by breathtaking art, all for a good cause.
“While it is a glamorous occasion and an exhilarating experience — for example, last year we had luxury cars donated for the day and sculptures coming out of the walls — we never lose sight of the message,” Monaisa explains. “And that message is that ordinary people can join hands to do something amazing and make a positive impact by doing what they do best.”