A breast cancer survivor of fourteen years and the chairperson of the Action for Breast Cancer Foundation (ABCF), ESTHER SANT is an inspiring leader in the community. She takes a few moments to share her story with SACHA STAPLES. Photography by Jonathan Borg.

Finding a woman in Malta who was willing to share her experiences of overcoming breast cancer was not an easy task. Breast cancer is the number one form of cancer in women and one in eight women will suffer from breast cancer in the course of their lifetime and none of the women I approached were able to publicly share their story. What this revealed to me was the sheer magnitude of the multi-layered experience that is breast cancer and just how traumatising it can be to survive. Then I was introduced to Esther Sant and she was immediately enthusiastic about collaborating on this article. As chairperson and co-founder of the Action for Breast Cancer Foundation (ABCF), Esther understands the importance of raising awareness.Esther was diagnosed with breast cancer in March 2000.

She consulted their family doctor and was immediately referred to Saint Luke's hospital for a wire guided biopsy. After some weeks, pathological results confirmed what so many other women have feared before her: cancer. "I passed through a rough time of anger, denial and stress. What the doctor's advised was quite drastic," says Esther. To have the best chance of survival, at 36-years-old, she had to have a mastectomy. 

Following her surgery, Esther underwent five cycles of chemotherapy and twenty sessions of radiation therapy. As a side effect of the treatment, Esther lost her hair, but wore a wig, "which I hated, but it suited me and no one could tell". She recalls being incredibly sick after each chemo session. A mother to three boys (then aged thirteen, nine and one), Esther is thankful for her husband and sons, each of whom provided support in his own way. "What was very special to me was watching my eldest son taking great care of his little brother and until today they remain very close," notes Esther. 

Although being diagnosed with breast cancer, having surgery and undergoing treatment was a challenge, Esther highlights the fear that persists even after one is given a clean bill of health. It is typical for cancer survivors to worry that the cancer will return - the disease looming at the margins of one's daily life, waiting to strike. Esther was unlucky - her cancer did return, after four years and then again after six years.

In both instances, she had twenty sessions of radiotherapy as treatment. Esther describes these reoccurrences as "huge setbacks" where she felt that she had to "start all over again".Looking back at her experiences, Esther notes that she has seen an improvement in the quality of cancer care and the way patients are treated by the doctors and nurses. Esther believes that today, patients are becoming more vocal, committed to making themselves heard, especially in the media and through social networks, in an attempt to facilitate improvements in whatever necessary piece may be missing from the proverbial puzzle of the healthcare system.In the midst of her breast cancer battle, Esther made a choice: either she was going to wallow in self-pity or she was going to walk the breast cancer journey with all the help she could find. She chose the latter. She got in contact with hospice, she spoke to the psychologist at Boffa (a hospital that specialises in oncology and palliative care), she sought second opinions, she met up with other survivors, attended support groups and then she met Helen Muscat, an extraordinary woman who began her career as a nurse and then lived the latter part of her life campaigning for improvements in cancer treatment and patient care. She left behind quite a legacy when she lost her battle with cancer at this time last year. "Helen taught me a great deal," recalls Esther, "near the end of life she told me, 'We have to learn how to smile while walking the extra mile'.Fourteen years after her initial diagnosis, Esther is still undergoing treated and despite this fact, she remains grateful.

From her perspective, she has been granted not only a second, but also a third chance at life. "I learned to take each day as a gift, to enhance my spiritual communication and not to fret over silly things. Useless worry is waste of valuable time; worry will not change anything. I do my checkups, I take my medication and the rest is out of my control. Only God decides who stays on earth, no matter who you are," says Esther frankly.Esther says that her rational character has allowed her to deal with her cancer in a practical way; she feels that there are many patients for whom the psychological aspects are suffocating. "I think this is an aspect that needs to be addressed and given more importance in a professional way as when you are in a vulnerable situation, such as being diagnosed, your frame of mind can be distorted and a professional outsider, such as a psychologist, can make a great deal of difference," Esther suggests.Has cancer changed Esther? Of course it has. Again, she gives thanks to Helen for teaching her to take everything in stride. For Esther and Helen, their cancer also had the power to lead them down a positive path - together they founded ABCF, which lobbies for better service and treatment on behalf of breast cancer patients in Malta. The Foundation has been a catalyst in significant developments, including the supply of an EU-standard breast prosthesis (given free of charge to all women who undergo mastectomy from the Mater Dei Hospital Breast Clinic).

Esther is proud to be officially opening the doors of the Foundation's first premises in Mosta later this month, on the anniversary of Helen's passing. At the moment, ABCF is lobbying to implement an EU-accredited breast unit in Malta. The EU has passed a resolution that recommends each member state to have a unit in operation by 2016. The ABCF hopes that the Maltese government will not wait until the last minute, but will instead emerge as a leader amongst other EU states by implementing the planning and building of a unit immediately. The existing Breast Clinic at MDH, although valuable, has the potential for significant improvement. A new unit would allow breast cancer patients to be treated holistically, which in turn provides a better chance of survival and a better quality of life. The response from officials thus far has been less than satisfactory, argues Esther, and she counters that all Maltese citizens deserve the same standard of treatment available in other EU states. 

I humbly offer Esther the last word, as our conversation draws to a close: "It is important to raise awareness in the community as early detection can save lives," she says, "and media stories, such as this one, are important to provide a space for the patient's voice, offering an authentic representation of the disease. Sadly, we all know someone who is suffering from cancer or who has not managed to survive and together we can make improvements and provoke change." Esther Sant would like to take the opportunity to thank her family for their continuous support, Helen, "for all that she taught me," and God, for helping her accept and discover an opportunity out of a crisis. For more information about breast cancer or for support, please contact the ABCF or email [email protected]