Gulnaz Ayaz, a 37-year-old educationist from the Pakistani city of Lahore, got married in January 2011 and gave birth to a baby girl the same year. She did not expect her life to take a tragic turn in 2014.

"I felt a small lump in my left breast," Ayaz told DW. "Initially, I was not alarmed by it. I went to my mother, who said it could have been formed because of breastfeeding."

She then consulted several doctors. "I went to several hospitals. All doctors assured me it [the lump] would go away, but those did not allay my fear."

"So, I decided to get the lump removed and sent the specimen to the Shaukat Khanum Cancer Hospital. After four days, I was asked to collect the report. It turned out that the lump was malignant. It shocked me and plunged me into a state of despair. I was worried about my daughter who was only 2 1/2 years old at the time," she said.

Social discrimination and stigma

"Instead of showing concern about my health, my husband taunted me for losing hair. He never visited me at the hospital during my treatment," Ayaz said, adding that her in-laws also treated her badly and were insensitive.

"Then one day, while I was being treated, my husband decided to divorce me. That was during the first year of my treatment, and he left me to deal with the disease alone."

Ayaz said only her father and siblings supported her during that difficult time.

Civil society experts say breast cancer is a taboo topic in Pakistan, with just the pronunciation of the word "breast" considered immoral in the Muslim-majority country in South Asia. So people generally use the term "cancer for women" to talk about breast cancer.

According to Pink Ribbon Pakistan, a breast cancer awareness group, one in nine women in the country, which has the highest rate of the disease in Asia, is at risk of being diagnosed with breast cancer.

There is no national database for breast cancer statistics in Pakistan, but health experts estimate the disease kills nearly 40,000 women in the country every year.

Creating awareness

One of the problems is that there is very little awareness about the disease in the country. A study of 600 women by the Rawalpindi General Hospital about breast cancer awareness found out that nearly 70% of the participants didn't know anything about the disease, 88% did not know about breast self-exams and 68% did not understand the significance of finding a lump in their breast.

Cancer awareness groups say that even after they discover a lump in the breast, many women are reluctant to share the news with even their close family members.

Ayaz, who fought breast cancer and was declared cancer-free in 2020, said she is determined to raise awareness about the disease in Pakistan.

"People don't even talk about breast cancer in cities, what to say about rural areas. If I am alive today, it is because I talked about it openly and refused to be passive about it," she told DW.

"I have been going to different colleges and schools to tell girls about my ordeal and the importance of early detection."

Ayaz admits breast cancer treatment is expensive, but advised women suffering from it to look for welfare hospitals that treat the patients free of cost.

Ayaz is now a single parent who is looking after her 11-year-old daughter. "My daughter is my source of strength. I intend to do a PhD in education and excel in my profession," she said.

Edited by: Shamil Shams