Activist Kreen Dhiman talks to Stylist about breast health in the South Asian community, representation and how we can change the barriers women of colour face when it comes to breast cancer.
In 2017, a BBC investigation found that a number of UK women from South Asian backgrounds who have cancer hide it because of a perceived stigma about the disease.
Pravina Patel, who appeared on BBC’s Victoria Derbyshire programme, spoke of her own experience with breast cancer, where she told the broadcaster that she thought if people “hear the fact that I’ve got cancer, they’re going to think it’s a death sentence”, adding that she remembered worrying that people would say she had lived a “bad life” and God was punishing her for it.
Five years on from this, the stigma and limitations faced by South Asian women remain when it comes to representation and care of those dealing with breast cancer.
“We don’t really have those vulnerable conversations around cancer,” said Kreena Dhiman, an activist, campaigner and breast cancer survivor. “When we’re from the South Asian community, we feel like we have to be strong and tough, not show any weakness and I think now I realised that there was no weakness in any of that time.”
Dhiman was diagnosed with breast cancer nine years ago at the age of 33 – a diagnosis that came as a surprise due to the concerning nature of how breast cancer is often advertised as an “old woman’s disease”.
“It came out of the blue and I had no idea of what breast cancer looked like in younger women,” she admits. “I always thought it was the disease of the older woman and think it’s hazardous to pitch an illness as an older person’s illness because you just don’t resonate with the disease or give it a second thought that it could land at your doorstep.”
Dhiman was initially told by her GP not to worry despite having an inverted nipple and had to “insist” on a referral before being diagnosed.
“My GP said to me that it wasn’t cancer and that I didn’t need to worry about it. But I insisted on a referral to a specialist unit where they found two very clear lumps behind that nipple. I always think had I not pushed that GP I could not be here right now. I think there needs to be a degree of caution and education in what they say when a younger woman lands a potential sign of breast cancer. It’s not good enough just to say you’re too young for a mammogram.”
Being diagnosed with breast cancer presented many challenges for the activist, including difficulties speaking about it among her family.
“When my grandmother had breast cancer, it was very much swept under the carpet, which is really normal in the South Asian community,” she says. “We didn’t talk about it. We didn’t manage it.”
This expectancy to sweep things under the rug meant the diagnosis took an additional toll on Dhiman’s mental health as she felt unable to be vulnerable throughout her journey – particularly around her mother.
“I felt like I couldn’t allow myself to be vulnerable in front of her because I was that pillar of strength and I think that happens to a lot of us South Asians that have seen our parents emigrate to a new country, start from nothing, raise a generation and put everything into educating us at the cost of their own health and happiness,” she says.
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Following her breast cancer diagnosis, Dhiman went on to suffer acute heart failure, a side effect of chemotherapy, three years after treatment. She later became infertile as a result of both cancer and heart failure.
“I felt very alone through my illnesses, the emotional and physical effects of cancer took their toll,” she says.
“I began writing about my experiences initially for my own therapy, however over time I realised that sharing my words could help others in the same position as me.”
This desire to share the story of South Asian women dealing with breast cancer became the focal point of a recent focus group from The Estée Lauder Companies (ELC) UK & Ireland’s 2022 Breast Cancer Campaign.
The campaign aims to give a permanent voice to the underrepresented communities in the breast cancer discourse and help empower them to regularly self-check and was built on research the brand commissioned last year that identified the top three groups that are less engaged in breast health, which include South Asian women.
During the focus group, which took place last month and was led by Dhiman, key findings revealed that South Asian women were not aware of what they should be looking for when it comes to self-checking and that breast cancer was not talked about in their families and information wasn’t as accessible to them.
“Within the South Asian community, women are quite often bottom of the pecking order,” she shares.”The female of the house is the last and lowest on the ladder and probably won’t prioritise her health and so she won’t go to the doctor as frequently.”
“Also, all of the languages from the South Asian geography don’t have a word for ’boob’ or ‘breasts’ or ‘nipple’ – it’s all just called chest. If we don’t have the vocabulary to explain the different parts of our body, that presents another issue.”
During the focus group, the women discussed ways to change the barriers South Asian women face when it comes to breast cancer, with the language being a key factor.
“We need to have readily available information in different languages for these people who don’t speak English so they can understand what ‘dimpling’ or ‘puckering’ is,” says Dhiman.
“It’s about getting the literature out in the right language, getting it out physically in the right places where we congregate, and then getting the breast cancer campaigns to be fully inclusive so we are all seen and represented.”
Images: Kreena Dhiman
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