Eminent breast surgeon Dr Iris Brune Erber has relocated to the Kingdom after many years practising in neighbouring Saudi Arabia. She talked to Liz O’Reilly about her medical journey and making the move.
Please tell us about your history, how you got started and what made you decide on this particular field of medicine.
My mother, father and both grandfathers were physicians; so medicine was never really a question. I chose surgery because it is one of the active disciplines where you can intervene and make things happen. However, medical development over recent decades has put surgery, which in the past was the only treatment for breast cancer, somewhat to the background. Today surgery is only one element alongside chemotherapy, radiation, hormonal treatment and other developments. With progress, not only the role of surgery but also its invasiveness has decreased. Today, an increasing number of ladies are candidates for breast preserving surgery, which is a smaller procedure and more respectful of the woman’s body image.
How long have you been in the Middle East and what brought you to this part of the world?
We were actually very happy in Munich where I was a surgeon at a teaching hospital. However, I felt ready for change and wanted to utilise my skills and personal capabilities where they could make a big difference. Since breast cancer is mainly a women’s disease and it is sometimes difficult here for women to approach a male physician, combining my expertise with a purely female environment has made it easier for women to come forward.
Are there any specific problems you see here?
The fear of breast cancer is probably equally scary for women everywhere. The incidence has shown to be around 12 per cent – one in eight women will suffer from breast cancer. However, based on the cultural environment, the perception of this fear may vary. While some countries have an open approach to the disease, others still consider it a punishment the woman should be ashamed of. Social stigma is another hurdle. A more practical implication is the uncertainty as to the husband’s reaction, support and loyalty when faced with the consequences of treatment such as cosmetic changes and hair loss. Economic dependence on the husband may enhance this fear.
How is this dealt with?
The only way to help women overcome their fear is education and information. The only way
to improve treatment success is early detection and treatment. Bahrain has shown really exceptional activities in both areas in recent years, both in quality and quantity.
The information campaigns are very well designed, provide excellent information and are within everybody’s reach. A substantial number of ladies have joined support groups; many of them are speaking up from first-hand experience, having survived the disease and serving as exemplary figures for those trying to overcome the social limitations in doing so. These groups provide the ladies with advice, moral support and also practical help.
Availability of early detection and all treatment modalities has grown at a very fast pace and continues to do so. Today, ladies in Bahrain have access to the most modern breast imaging such as digital mammogram, ultrasound, MRI of the breast or PET CT scan. All treatment modalities such as surgery, chemotherapy or radiation are available and several major projects catering to oncological patients are in the pipeline.
What services will you be offering at Awali?
Awali Hospital has just recently installed a brand-new breast imaging suite to the highest standards. The new digital mammography unit is providing excellent imaging while radiation is significantly reduced as compared to older-generation equipment. We can offer ladies a one-stop-shop breast cancer screening [annual for women with no symptoms, in order to detect a mass while it is still so small it cannot be felt] and diagnostic examination [for women who have symptoms such as pain, a mass, nipple discharge or axillary lymph node enlargement]. We are working on streamlining the processes.
So when the patient comes, we can take the history, examine her, do the required X-rays, inform her of the result and give her the recommendation for further management. The whole range of breast surgery for benign and malignant conditions is also offered.
In addition to breast problems, I have a clinic dedicated to proctology: all anal problems such as haemorrhoids, anal fistula or fissures can be dealt with in a very private setting. Whenever possible, we favour management that is not invasive or destructive.
What are your plans for the future?
Having worked the last 13 years as a surgeon in Al Khobar, Saudi Arabia, I am looking forward to participating in developing breast cancer management activities within the framework of Bahrain. The quality of life here in Bahrain, combined with the drive towards continuous improvement of breast cancer treatment, makes it a wonderful base for my family and me to work, live and enjoy.
Call Iris on 3941-7861 or email email@example.com.