This article has been written by Claudiaexpat and Silviaexpat that share a similar experience abroad.
Years ago I lost my sister to breast cancer, and as a result I made sure that I had a check up every year. I also believe that medical prevention is so widely available now that not to have an annual health check, is reckless. Living in Peru should’ve been no exception.
On my fourth year in Lima I decided to go to a clinic where a friend worked for my so called “annual check-up”. She was a new acquaintance and worked as a gynecologist at the Instituto de Ginecologia y Reproduccion de Surco. I was extremely worried when the doctor informed me that there was a shadow on the right side of my breast that the scanner was unable to read.
It was recommended that I make an appointment for a magnetic resonance test just to be sure, but even then I was advised that I should wait some months, even if the test proved to be OK. I didn’t know whether to be more worried about the shadow or the test. I had my misgivings and felt that I shouldn’t listen to any more advice, even though the doctor seemed pretty relaxed about the whole thing.
I was confused and in some doubt when I had the resonance test, which, in itself wasn’t anything to worry about too much. With half my body in the machine I felt cold and shivered from the contrast liquid they used for the test.
After a ten day wait for the results, which I was certain would be negative, my husband gave the game away as he turned very pale whilst reading the results; the outcome was an underlying alteration of rhythm which basically meant I had something malignant in my breast. I went out of mind immediately.
We phoned the gynecologist who gave us the contact details for two cancer experts who worked at the same hospital, which was the best in Lima.
The first expert suggested that a needle be inserted into my breast so that a biopsy could be taken, and he also advised I have a further examination at a better-equipped hospital.
I went to the second expert a bundle of nerves, but I thought his prognosis a bit more reasonable. He examined me first, shaking his head, and told me he had already come across a number of patients who had had the routine magnetic resonance test as a check for breast cancer. He admitted that he didn’t quite agree to this method, which was widely used throughout Peru as the preferred method to test for breast cancer.
He advised me to get in touch with the European Institute of Oncology, where he had worked in the past, and show them my case.
Feeling a little more comforted, I immediately got in touch with the European Cancer Institute, who informed me that I did not need to go to Milan immediately. They advised that I should nominate a close friend in Milan who could come to the Institute with my file and a doctor could then look into my case. I was secretly thankful that all I had to pay was the DHL cost. Better that than the cost of a return air ticket.
My close friend Fabrizia took my file and met Dr. Paolo Veronesi who happened to be the son of Dr Umberto Veronesi, the famous professor and surgeon, who specialized in research and oncology.
Dr. Veronesi confirmed the findings of the second expert doctor I had seen in Lima. He too advised that I wait until the summer holidays to have another check-up. He was so kind and sympathetic. He gave me his email address and told me he could always answer any questions I had, online.
As soon as I returned to Milan I underwent further tests with him and vowed that in future all check-ups would be taken at the Cancer Institute. Today though, I feel as fit as a fiddle!
I had my first child in Erevan, Armenia. After happily breast feeding for 10 months and thinking about giving it up, I was surprised one day to find a hard and painful lump in my breast, when showering. I didn’t think anything of it but 6 months later, I felt another lump and decided to make an appointment for a check-up.
I don’t remember how I contacted the best oncologist in the country, and was unaware that I had met him even before I had seen a gynecologist and had a breast x-ray. However, I went to his consulting rooms, which were elegant and adorned with a few diplomas from American universities. I carefully explained my situation to him and asked whether the lumps were from breastfeeding. My husband sat next to me, translating in Russian.
The doctor put on his glasses and examined me. There was ‘something’ there and advised that x-rays were needed. (In 2000, there wasn’t the necessary equipment to have a mammogram in Armenia).
We sought out a private clinic, paid a hefty fee, only to discover that the whole image was blurred and useless. However, we went back to the first doctor who told me that I definitely had breast cancer and that I could die if I didn’t undergo surgery, which he was willing to do for the sum of US$ 3,000.
The return journey home was worrying. We both decided the surgery was necessary, but in Armenia or in Germany? I chose the latter and after one week I was in back in Berlin. My mum was happy to look after the child whilst I went and had a second opinion with a German doctor. She saw nothing abnormal but advised further x-rays just to make sure. The results were negative. Nothing was wrong.
The upshot was, that I had experienced a charlatan doctor in Armenia who just wanted to take advantage of my situation.
A year later, I had a very painful ankle and was advised to undergo very expensive surgery on my foot. I just burst out laughing and decided that from now on, I would have all my check-ups done in Berlin.
Claudiaexpat from Jerusalem
Silviaexpat from Berlin