Medicosnext
The word cancer evokes a rather fearful response in most of us. Breast cancer is a leading cause of death in women worldwide and is the most common form of cancer in women. For a long time, women have had the message drilled into them through various mediums that they must be on the lookout for breast cancer through breast exams and regular mammograms. However, one thing we must keep in mind is that we must not let fear overwhelm us when it comes to breast cancer.
“Cancer is a dangerous word,” says Dr. Prafulla Shakya, Consultant Breast Oncoplastic Surgeon at Nepal Cancer Hospital and Research Center, who has found that the word itself tends to send a lot of patients into a state of panic. “However, what people need to know is that cancer, when treated in time, is curable,” he adds.
This leads to the first and possibly the most important part of cancer prevention, which is screening and early diagnosis. There are three major symptoms of breast cancer that one should be on the look out for. The first symptom is a lump in the breast. Not all breast lumps are cancerous, but a lump is often the first sign of breast cancer. One can easily perform self-exams in the shower to check for any sign of a breast lump. The next symptom of cancer is nipple discharge. Any kind of fluid, whether it is clear or bloody, leaking out of the nipples could be a symptom of breast cancer. And finally, recurring infections in the breast could also be another symptom of cancer. If one or more of these symptoms are seen, it is time to go to the doctor for a breast cancer screening.
Since breast cancer is more common in women of older age, women over 40 must be particularly cognizant of the risk of breast cancer and go for breast cancer screening. “Breast cancer screening is a method of detecting cancer in its very early stages. Any woman over 40 should have a mammogram done at least once and see a specialist breast cancer surgeon to define her risk of breast cancer,” states Dr. Shakya. They’ll ask questions, run a few tests, and analyze the risks of breast cancer for that particular patient. Depending on the risk analysis, the specialist will then let the woman know how often they need to get screened for breast cancer. It’s not necessary that every woman gets breast cancer screening done every year. How often screening should be done depends on the individual risk factors for that particular individual.
Although breast cancer is most common in older women, it can occur in younger women, as well. For women younger than 40 years, Dr. Shakya suggests that they check for breast lumps, and if they find lumps or experience other symptoms like nipple discharge or recurring infection, then they should go to the doctor to check if they have breast cancer.
At the doctor’s, the first step in diagnosing a breast cancer is through a mammogram or a USG. This will show whether there is a lump in the breast or not, and whether the lump has characteristic features of breast cancer. Once a lump is discovered, a biopsy is done to confirm whether the lump is cancerous or not.
There are many risk factors that contribute to the likelihood of getting breast cancer. However, the most important risk factor is genetics. Women with the BRCA1 and BRCA2 genes are highly likely to get breast cancer. This gene is hereditary and can be passed from parents to offspring. So, if women in your family have a history of having breast cancer, it increases your chances of getting breast cancer, as well. Other risk factors include gender, age, hormones, reproductive history, and previous treatment using radiation.
While most risk factors for breast cancer are outside of our control, the one thing you can do is adopt a healthy lifestyle. “We are not meant to be immortal, we all have to die one day, but in the meantime, the question remains, how much can our body bear? Cancer is the breakdown of a body at a cellular level. So, eat healthy food, avoid junk food, exercise, don’t take unnecessary medications, and listen to your doctor. A healthy lifestyle means a healthy body.”
When it comes to screening and treatment of breast cancer, Dr. Shakya, who is also the first breast cancer specialist of Nepal and the only breast cancer specialist with a license from European Surgery Association, suggests always opting for a doctor whose sub-specialty is in breast cancer. There are many doctors who treat breast issues, but your best bet is to consult someone who specializes is breast cancer particularly. “You need to know your doctor. Before you go into a consultation, research the doctor beforehand. Ask at the hospital’s reception or information center about which sub-specialties the doctor you are seeing practices, and find one who specializes specifically on breast cancer.” he says. “For instance, if you’re given a choice between a doctor with 20 years of experience who operates on breast cancer as well as other areas of the body like thyroid or intestines, and a doctor with 7 years of experience who only operates on breast cancer, then the choice is easy to make.”
While breast cancer is an umbrella term, there are many types of breast cancer, and each type of breast cancer presents itself differently. So, it is never advisable to compare your breast cancer with another, as different kinds of breast cancer present differently in different people. And, for each type of breast cancer, there is a different treatment plan that must be followed. “We see the patient, we define the type of breast cancer, we see what kind of treatment works and prepare a specialized treatment plan for each patient,” he says.
There are several treatment methods for treatment of breast cancer, some of which are tried and tested, while some are new and innovative. The first treatment method for breast cancer is surgery, which removes the cancerous mass from your breasts. Other traditional treatments include chemotherapy and radiotherapy. In chemotherapy, powerful drugs are used to kill and eliminate fast-growing cells in the body. Radiotherapy uses high energy beams to kill cancerous cells.
The newer methods of treating breast cancer include hormonal therapy and targeted therapy. Some types of breast cancers are sensitive to hormones, like estrogen and progesterone. The cancer cells attach to receptors in the hormones, and this helps them grow. Hormone therapy works by blocking the hormones from attaching to the receptors.Targeted therapy is the newest therapy introduced in Nepal. It targets receptors in the cancer cells, thereby killing them in the process. Based on the cancer and its characteristics, the type of treatment used is determined by the doctor.
“Unfortunately, in Nepal, patients have a tendency to self-diagnose. They get tests done, see the reports, and go haywire. What we suggest is, as soon as you discover a breast lump, see a doctor, and they’ll tell you if you have cancer or not and recommend the right treatment plan,” says Dr. Shakya. As long as the cancer is discovered in time, he assures that it can and will be cured. “Sadly, many of my patients come in at an advanced stage. If someone comes in with stage 4 cancer, there isn’t much we can do to help them. But, as long as the patient comes in early and the cancer is diagnosed in time, we can cure them. So, if you think something is wrong, please don’t waste time and go see a doctor.”
Since October is Breast Cancer Awareness month, let us take this opportunity to learn about this disease and take necessary steps to protect ourselves and our loved ones from breast cancer.
