Breast cancer care: year-round, not just in October!

In Pakistan we see healthcare being sought too late, far too often


Dr Sarah Nadeem October 27, 2019
PHOTO: FILE

It’s that time of the year — the pink ribbons are out along with soft-voiced adverts on the radio. Most just change the station or flip the printed advertisement page talking about breast cancer. It doesn’t concern us. It feels awkward. This isn’t “our problem”. I’m fine. Healthy. But are we really? Pakistan reportedly has the highest rate of breast cancer in Asia (excluding Jews in Israel). We all need to tune in.

In Pakistan we see healthcare being sought too late far too often, women who present with festering open wounds had felt a lump but let it grow for fear of embarrassment, willing it to go away. Not wanting to mention it and having it examined. We need to change this. Efforts in the last decade to start talking about breast cancer and normalise conversation is a positive first step in removing the stigma to just another health issue — a deadly one though.

Breast cancer screening can pick up early cancer. Many women dismiss the concept of screening though. “I don’t want to know if anything is there”, “what’s the point? If it has to happen it will.” Well, screening may be the difference between survival and widespread disease. For sure, screening by itself is not a cure of the disease but gives a fighting chance if the cancer is discovered earlier. Ask any person undergoing breast cancer treatment. What wouldn’t they give to have caught their cancer a day, month or year earlier, even? Cancer is a dreaded word. Hospitals are scary places. Our fears and vulnerability are at their highest within the sterile walls and cold rooms of mammogram testing. Why would one want to intentionally experience it? Because it may make the difference between staying alive or not.

Not all organisations agree on breast cancer screening guidelines, but most emphasise meeting your doctor to review the risks, limitations and benefits of mammograms to determine what’s right for your situation. For dense breasts, an ultrasound may be advised.

Unfortunately, there is no guaranteed prevention method. The American Cancer Society (ACS) states, “Many risk factors are beyond your control, such as being born female and getting older”. But some things may lower your risk.

Maintaining a healthy weight is important. Increased body weight and gain as an adult are linked with a higher risk of breast cancer after menopause. Moreover, multiple studies link vigorous physical activity with a lower risk of breast cancer. ACS recommends at least 150 minutes of moderate-intensity or 75 minutes of vigorous activity spread out through the week, for adults.

Some, studies suggest that a diet rich in vegetables, fruit, poultry, fish, and low-fat dairy products and limiting alcohol might help lower the risk of breast cancer. However, there are no specific supplements that reduce the risk, so don’t waste your time and money on these.

It is important to know your family history of breast cancer. Genetic testing for mutations is available in Pakistan now to identify if you have a higher than average risk of breast (and some other) cancers.

Furthermore, if you have a history of diagnosis and treatment for breast cancer, even if it was years ago, regular follow-ups to evaluate for recurrence are important. Cancer treatment may affect your bones and increase the risk of osteoporosis, years after treatment is completed, so make sure to have a bone density test to screen for this periodically, based on results. Previous history may affect your endocrine (hormonal) and emotional health, and heart and lungs. Regular follow-ups with your physician can help you keep an eye on these and start treatment if needed.

The American Society of Clinical Oncology (ASCO) offers a form called a Survivorship Care Plan. It contains helpful information about the need for future check-ups and tests, the potential long-term late effects of the treatment you received, and ideas for improving your health. (https://www.cancer.net/sites/cancer.net/files/cancer_survivorship.pdf).

Lastly, know your breasts! Here is a useful link about self-examination, to note any abnormality at the earliest: https://www.breastcancer.org/symptoms/testing/types/self_exam

Published in The Express Tribune, October 27th, 2019.

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