When elementary public school teacher Camille Analupa was diagnosed that she has stage IIIA breast cancer on October 16, 2022, after the celebration of Teachers’ Day and she just had her straight, long hair rebonded, she immediately told her four-year-old son that she would not be able to breast-feed him anymore. Her husband, a Grab car driver, cried.
The first to mobilize support for Analupa was her fellow teachers in the Quezon City school and plain housewife Margie Bustamante, the mother of her two pupils.
“Si Margie ang unang nagsali sa akin sa mga support groups at sinabi niya sa akin kung ano ang mga dapat gawin. Napabilis ang pag-adapt ko sa sitwasyon ko,” she said.
Bustamante was diagnosed with stage IIB cancer on February 24, 2017. Her husband, a maintenance mechanic in a shop that sells heavy construction equipment, first noticed a lump on her right breast on her birthday a month earlier. She immediately sought help from her two sisters-in-law, from her mother who was in Cebu, and from a friend of hers in Australia.
Unlike Analupa, public university teacher Cynthia Equiza did not tell her students when her oncologist in a private hospital confirmed, after laboratory tests and biopsy, that she had stage IIIC cancer on May 15, 2021. It was the height of the Covid 19 pandemic. She did inform her mother who was in Bicol, her younger sisters, her only son who was studying engineering, and a few of her co-teachers and superiors.
Equiza joined several support groups including the Pink Warriors PH, a spiritual group for breast cancer warriors that holds online fellowships every Wednesday and other activities, and Strong Babes Warrior, founded by businesswomen Wenylane Constancio and Jaylene Licayan, respectively.
Constancio was diagnosed with stage IIIB cancer in June 2012. She was 39. Her parents died in 2003—her mother, of cervical cancer, and her father, of bone cancer. Her grandmother also died of ovarian cancer that year. “That was the lowest point in my life,” Constancio said.
On Facebook, Constancio’s name is Abu Lane. Abu is a term of endearment they use at home. It was how her only son pronounced “I Love You” when he learned to talk. Her group’s banner call is: “Cancer Can’t Cripple Love”.
On August 12, 2020, at the height of the COVID-19 pandemic, Licayan was informed by her oncologist that she had invasive carcinoma stage IIA as seen from a biopsy report of a lump the size of santol (cotton fruit) removed from her left breast.
“Noong tinanong ko ang doctor kung ano yun, sabi niya cancer yan. Hindi ako umiyak agad. Pero pagdating ko sa sasakyan namin, doon ako humagulgol,” she said.
Strong Babes Warrior conducts fundraising activities and outreach programs not only for breast cancer patients but also for patients with other types of cancers. Even before Licayan herself was diagnosed with cancer, she was already conducting charity events for kids with cancer and autism.
One of the beneficiaries of the support groups is Teresita Dingding, a migrant from Davao in search of work in Manila. Until her diagnosis of stage IIB breast cancer in June 2017, she did laundry for several families. Separated with her husband, she lives with her only son who is still single at 33 and works in an electronics repair shop.
“Sobra ang sobra ang sakripisyo ng anak ko sa pagsuporta sa akin. Hindi ko ipinapakita sa kanya na ako ay umiiyak dahil sa aking kalagayan,” she said.
The Department of Health (DOH) data shows that three out of every 100 Filipino women will be diagnosed with breast cancer in their lifetime. In 2020, there were 27,163 cases recorded in the country.
Three out of 100 Filipino women are estimated to develop breast cancer before the age of 75. The Philippines had the highest prevalence of breast cancer among 197 countries in 2017.
Breast cancer is the most common type of cancer in women in the Philippines, with the highest incidence rate of 17.6%, accounting for 15% of all new cancer cases and 8% of all cancer deaths in the country, according to experts.
More than half (53%) of breast cancers in the country are diagnosed in Stages III and IV, while only 2%–3% of cases are diagnosed in Stage I.
Cost of treatment, effects, and family support
After diagnosis and mastectomy, patients undergo challenging medical procedures such as chemotherapy and targeted radiation therapy. They are also prescribed medicines to take regularly. And this is when the patients need constant support—physically, emotionally, and financially.
Analupa narrated: “Noong na-diagnose ako at magpapagamot na, sinabi ko din agad sa school head namin. They suggested na mag-leave ako pero no-work, no-pay kaya tuloy lang ang pagturo ko. Pinaalam ko sa mga magulang ng mga estudyante ko at sa mga estudyante ko at naintindihan din naman nila. At luckily, sinuportahan nila ako at pinagdasal nila ako.”
“Mahirap ang chemo— nangitim ang mga kuko ko sa kamay at paa, nalagas ang buhok, nakaranas ng pagsusuka, pagkahilo, nagka-LBM, nagka-constipation, masakit ang katawan, nahihirapan huminga laluna mula 5th to 8th session,” she said.
Her husband accompanied him on all chemotherapy sessions in the government-run Philippine General Hospital (PGH). He did almost all household chores and took care of our children. He sacrificed his earnings as a Grab driver. But luckily, they already finished paying the amortization of their van.
She said she experienced an average of four hours of waiting for her chemotherapy treatments at the PGH.
For her peace of mind, Equiza had a double mastectomy even if her oncologist in a private hospital recommended only the removal of one.
“Mama, mamamatay ka na ba, tanong ng anak ko. Naiyak ang mga kapatid ko at ang alam nila susunod na ang kamatayan pero pinaintindi ko sa kanila na alaban si Ate, maganda na ang technology, makaka-survive ako. Hindi ako umiyak sa harap nila, ipinakita ko sa kanila na kaya kong harapin at mapagtagumpayan,” she narrated.
Her only son was already a working engineering student before she was diagnosed. But he stopped schooling and went full-time to work to help her with the expenses. Now that she is done with major medical treatments, he, now 25, went back to engineering school.
During her chemotherapy sessions, she was able to get support from the Philippine Charity Sweepstakes Office once and twice from the Philippine Cancer Society. Now, every three months, she gets aid from the social welfare department.
For her chemotherapy sessions, Equiza had a “date every 21 days with my husband. We are separated but we are friends. He accompanied me to all the eight sessions.”
Equiza said she continued teaching during her treatment because it was pandemic time and classes were held online. She rented a place near the hospital for a month during her radiation therapy sessions.
“My laptop was with me always and my co-faculty helped me financially because they were aware of the cost of treatment,” she said.
Bustamante did not have chemotherapy sessions after her right breast was removed. She was prescribed a brand of medicine—P30 per tablet– that she took daily. And up to now.
Licayan underwent eight cycles of chemotherapy, and 18 cycles of targeted radiation therapy and was prescribed an oral medicine to be taken in seven years.
“Kung saan-saan ako ipinapasyal ng mga kapatid ko, sa mall, naliligo kami sa dagat para maging kampante ako at tanggapin ko ang kalagayan ko,” she said.
“I was able to gather the strength to accept my condition from the children with cancer that we used to help,” she said.
And for her continuing chemotherapy sessions, because she had thin veins, a portacath was embedded in her right breast to make the procedure of intravenous therapy simpler and more comfortable.
“Noong nag-chemo ako, nawala ang pansala ko, para akong na-Covid. Ganun ang epekto. Pero kailangan mong labanan. Ang chemo parang papatayin ka, lahat ng hirap mararanasan mo, pero bubuhayin ka,” she said.
Dingding had a right breast mastectomy three months after the diagnosis in 2017. She already completed eight cycles of chemotherapy and a full cycle of targeted radiation therapy in 2018 all by herself.
“I was alone. I commuted from our place in the mountain to the hospital as early as two in the morning,” she said.
She is now under “maintenance and monitoring procedures to check on her other organs. And since she can no longer do laundry as per doctor’s orders, she relies on the continued support of her son and her aunt who lent her money every now and then ever since she started having treatment. Her aunt is the only other one who knows about her condition in their village.
“Kahit hiwalay kami ng asawa ko, alam ko nagbibigay siya ng suporta kasi lagi silang magkausap ng anak ko,” she whispered.
Constancio had her left breast removed in a private hospital in July 2012. That early, she was already supported by immediate members of her family, her eight siblings, close friends, and the Godparents of her son and daughter. “They are the angels of the Lord, they provided much moral support,” she said.
“To chemo or not to chemo, that was my first challenge,” Constancio said. She had her first chemotherapy session at the time when her only daughter was turning 14. She remembered her mom who only had one [chemotherapy session].
Her hair started to fall. On her third chemotherapy session, she felt ill due to wound infection on her left breast. “Bumagsak ang katawan ko. I could have died due to infection and not of breast cancer. Sabi ko kay Lord, ‘kung kukunin mo na ako, kunin mo na ako; kung i-extend mo ang buhay ko, i-extend mo’,” she said.
Constancio had a lumpectomy, mastectomy, double mastectomy, and three sets of chemotherapy until 2015. “I had the willpower to live,” she said. “And in my social media accounts and many gatherings, I declared that I survived cancer and that I am cancer-free even if I was still undergoing treatment,” she continued.
To be able to give back, Constancio asked: “Lord, how will you use me? I want to use my life for others.
She joined various civic organizations like the Rotary Club and set up a group called RCC Pink Warriors and they conducted charity and socio-civic campaigns. And she started a program called “Cancer Can’t Cripple Love: Breast Cancer Awareness Campaign”.
An introvert, she mastered the art of public speaking, giving inspirational messages to many groups, and starting to generate support for cancer patients. She joined the CCF’s Life To The Max Program which propelled her to organize the Pink Warriors PH.
Constancio’s initiatives are supplemented by projects of Strong Babes Warrior, the group set up by Jaylene Licayan.
Licayan said: “Alam ko kung ano ang pangangailangan ng patients. Nag-umpisa din kami sa wala at alam ko kung paano maging mahirap.” When they were just starting a family, she sold food in the streets, did laundry, and worked as a saleslady.
When Bustamante was told by her oncologists that she needed to raise P100,000 for her therapy, she was shocked, speechless. “Saan natin kukunin? Ang sahod mo ay eksakto para sa atin, para sa ating dalawang anak,” she remembered asking her husband.
They got help from her mother who was in Cebu. Her two sisters-in-law also looked for money for her.
“Umutang ako sa isang kaibigan ko na OFW sa Australia pero lingid sa aking kaalaman ay nag-fund-raising pala siya dahil alam niya ang aking kalagayan dahil may kaibigan din siya sa Australia na may cancer din. Pinautang naman ang mister ko ng kanyang kompanya. At tumulong ang iba pang kaibigan. Noong nagpapagaling na ako, pumunta ang nanay ko sa amin at siya ang nagpapaligo sa akin, nagluluto ng pagkain para sa pamilya,” she said.
“Wala akong nakuha sa Philhealth kasi hindi naman ako na-ospital. Pero dahil nagkaroon ako ng Persons With Disability (PWD) ID, pumipila ako kahitmahaba ang pila sa Philippine Charity Sweepstakes Office (PCSO) para sa mga kailangan ko na gamot at para sa bone scan na nagkakahalaga ng P12,000 bawat scan,” Bustamante added.
To augment the income of her husband, Bustamante went into online selling, and she is supported by members of online groups she joined including the Philippine Cancer Warriors.
Analupa said she’s lucky the government insurance system Philhealth covered all the cost of her chemotherapy sessions at PGH. Her co-teachers raised funds for her operation and her high school classmates contributed, too.
“Concert for a cause naman ang ginawa ng mga kasama ko sa simbahan at may isa akong co-teacher na nag-concert sa Tiktok live para mag-fund raising para sa akin,” she said.
She said they were lucky because the vehicle her husband used to earn a living was already paid for before she was diagnosed with cancer. And she continues to receive her salary as a grade school teacher.
Equiza said her mom came over from Bicol took care of her, and cooked food for her and her grandson. Her younger sisters visited often and brought vegetables and fruits.
In the hospital, she gained new friends who are also cancer patients. “We had a group, online and in person. We were like classmates. We shared photos and stories online every day,” she said.
“Just like my new-found friends in Pink Warriors PH, we are true friends because we feel the same.”
As a patient in a government hospital, Dingding thankfully got support from Kasuso Foundation, a breast care center located inside the East Avenue Medical Center. She was also able to get aid from the office of the mayor and the congressman of Antipolo, from the office of then Vice President Leni Robredo, and, like Equiza, from the social welfare department.
“Para sa aking treatment, madaling araw ako umaalis sa amin sa Antipolo. Sasakay ng single na motor, maglalakad, sasakay ng tricycle at jeep para makarating at pumila sa hospital. Natatapos na po ang procedure ng mga bandang hapon na at madilim na kung nakakauwi ako sa amin,” she said.
Anxiety, insecurities, and coping mechanisms
Bustamante’s son suffered anxiety when she was diagnosed. He could not sleep for two weeks. Her husband, too, was crying during the wee hours in the morning for two weeks. “Sabi ng doctor ko, sila ang nag-absorb ng stress and anxiety,” she said.
To offset anxiety, Licayan posts almost all her healing activities on her Facebook and TikTok accounts. “If I am happy, I post. If I am sad, I post. Kailangan kong ilabas kung ano ang nararamdaman ko,” she said. Her Facebook account is now monetized, and she gives back to charity whatever she earns.
Constancio’s insecurity and anxiety stem from seeing herself bald in the bathroom mirror every time she takes a bath. She is visually reminded that she has cancer.
“But the bigger problem that causes anxiety to most cancer patients is where to get money and support for treatment,” said Constancio.
And even if they get support, they ask themselves ‘Gagaling pa ba ako? Ano kaya ang epekto ng gamot sa katawan ko?’.
Keeping their faith
Many patients cling to their faith during their healing journey. There are groups like the Pink Warriors PH established in 2021 by Wenylane Constancio that conduct spiritual healing sessions apart from supporting other survivors on where to get medicines and secure laboratory facility services.
Constancio said: “We have an online group and within that group, we have prayer warriors who respond to prayer requests from patients and survivors. The members are mostly those supported by the Kasuso Foundation.”
Since 2021, Pink Warriors PH conducted regular monthly, sometimes bi-monthly, spiritual sharing, with guest speakers who provided inspirational messages. They were able to conduct a retreat for 30 warriors in May this year and they have plans to conduct a bigger retreat in 2024.
Bustamante said: “For me, the Pink Warriors PH is my spiritual healing group. Sumama ko kasi sabi ko kay Lord, kung bibigyan niya ako ng pagsubok, sana yung kakayanin ko.”
“Sa mga kababaihan, “Laban lang, lakasan ang loob, humugot ng lakas mula sa pamilya, manalig sa Diyos,” she said.
Equiza goes to an ecumenical chapel located inside her university at least once a week. She said she became closer to God and her faith intensified. “Mas nakaka-survive ako ngayon because of my faith,” she said.
Analupa is a member of a choir in her church. “Sa mga prayer meetings namin inilalabas ang mga petitions. Parang binigyan ako ni God ng mission. Sabi ko baka binigyan ako ng Lord ng sakit para may ma-inspire ako na iba pa. Alam ko na gina-guide niya ako mula umpisa kaya hindi ako pinanghihinaan ng loob,” she said.
Licayan said: “September 13 noong tinanggal na ang left breast ko pero malakas ang pananalig ko, lagi kong katabi si Lord. Sabi ko sa sarili ko tanggap ko, pero noong paglabas ko ng operating room, umiiyak akong sumisigaw ng ‘wala na akong dede, wala na akong dede’ pero pinakalma ako ng anak ko at ang pamilya ko na nagdatingan na. Ipinagdasal nila ako.”
Licayan narrated that as part of her healing journey, she, together with her family visited the Antipolo Shrine, the Padre Pio Shrine in Santo Tomas Batangas and a church in Tagaytay City. “Madasalin ako, kahit sa loob lang ng bahay, pero mas nakilala ko ang panginoon noong nagkasakit ako.”
“Para sa akin, bigay ito ni Lord na pagsubok. May plano siya. Hindi niya ibibigay ito kung hindi ko kaya. Pero ang isang ibinigay ni Lord na matagal ko nang hiling, nagkasundo na ang bunso kong kapatid at ang asawa ko na matagal nang hindi nag-uusap dahil sa hindi pagkakaunawaan. Kung hindi pa ako nagkasakit, hindi sila magkakasundo.”
When Constancio started her chemotherapy sessions she prayed a lot. “I asked the Lord that my life be extended, for my kids, who were teenagers at that time. Kahit hanggang maka-graduate lang sila,” she said.
Born and raised a Catholic, Dingding prays that God will give her more years to live. “So that I can guide my son in his life plans,” she said.
Awareness, early detection
The healthcare framework in the Philippines, according to experts, is now shifting to prioritize early detection and comprehensive patient care. And since survival rates for women living with advanced breast cancer are lower than those for women with earlier-stage disease, awareness and early detection are important.
Analupa has this to say: “Mas maganda ang early detection at prevention. Kung sakali na may ma-detect, dadaan naman talaga sa denial stage pero pagkatapos nun kailangan humugot ng lakas kay Lord at sa mga taong nakapalibot sa kanila para mapagtagumpayan nila ang journey nila. Positive lang ang attitude na gagaling ka.”
“Sa mga kapwa ko kababaihan, kung may naramdaman kayo, maging aware sa katawan. Pagkatapos ng menstruation, kapa-kapa lang. Para maagapan kung anuman ang meron kayo. Wala dapat ikatakot,” added Bustamante.
Equiza agreed with Bustamante. And she adds: “Life is beautiful. Don’t waste your life. If you feel lumps in your breasts, go and have a check-up. It is also important to learn more about (our) cancer. Do not be afraid as technology is already advanced.”
“Support groups are helpful. There are groups that can help us. Like the Breast Cancer Warriors, Pink Warriors PH, The Beautiful One Day and ICanServe Foundation,” she says. “May pag-asa po tayo. Kung kailangan natin pumila for government support, pumila po tayo. Kaysa totally tanggapin natin na dahil wala tayong pera ay wala na ring gamutan.”
Call for more support from the government
“Cancer, whatever stage, is really hard. Patients need not only moral but financial support,” Constancio said.
“We are thankful to private organizations like Kasuso Foundation, Philippine Cancer Society, and others because they are helping. But what about the government?” she asked.
Through the Philippine Health Insurance Corporation (PhilHealth), the government provides aid for those diagnosed with early-stage breast cancer, amounting to P100,000 in medical assistance, covering surgery and chemotherapy. This is for those who have PhilHealth cards. Aid is also available for cancer patients at the Philippine Charity Sweepstakes Office (PCSO).
Constancio hopes that the government will improve the services provided to patients. “May sakit na sila, pipila pa nang pagkahabahaba para maka-avail ng kung anong services,” Constancio laments.
“How about a special lane or special hotline number for all cancer patients? Dumadami na po talaga. Improve services to lessen the death rate because of cancer,” Constancio said.
Equiza rallies all Filipino women that “it is time for us to have a voice and seek the help of the government to support breast cancer patients and all other cancer patients.”
“Sa ating gubyerno, tuloy tuloy po sana ang suporta natin sa mga cancer patient, sana mas malaki ang budget (portions) na ibigay ninyo. Kasi sa experience ko laluna sa mga public hospital, napakadami po ang pumipila araw-araw para lamang po magamot sila at para makakuha ng gamut sa mga laboratory.”
“I hope that our people in the government are listening so that we can triumphantly solve breast cancer in our country,” she pleaded.
The story is published with the support of the Philippine Press Institute, Philippine Cancer Society, ICanServe Foundation, and Novartis in collaboration with the Swiss Chamber of Commerce of the Philippines and the Pharmaceutical & Healthcare Association of the Philippines.