Syeda Shamin Mortada
Breast cancer is a relatively new issue in our country, one which both patients and doctors are haltingly learning how to deal with. Women generally do not want to talk about their breasts and tend to ignore any pain usually waiting until it is too late. Moreover, one has to deal not only with the disease itself but secrecy, misery and misfortune as well. Dr. Syeda Hasina Azam, Consultant Surgeon, Specialist in Breast Diseases says “Breast Cancer is like a taboo, a stigma in our society.” Once the treatment starts, the woman has to go through the nightmare, the dread of disfigurement, an uncertain future and sometimes death! Humayun Kabir Chowdhury, Professor and Head of the Dept of Surgery, Ibrahim Medical College and BIRDEM says “A large part of the population is ignorant; they are not aware or educated when it comes to Breast Cancer. It is a common affair among the uneducated and conservative people. Many go for other sort of treatments like Homeopathy or other traditional methods based on myths and superstition. The middle class and the educated also feel shy to talk about such issues. Over all the health issue of the women is always delayed in our society.”
This disease is on the rise. More people are being diagnosed with breast cancer every day, not only in our country but also around the world. And for this reason it is imperative that awareness of Bangladeshi women towards Breast Cancer rises as well. According to Dr. Syeda Hasina Azam, “Women are terrified when it comes to breast cancer. Something happens and they think it is cancer, but again they feel shy to talk about it because of our social system. They go to gynecologists or other female doctors for help. The thing is that breast cancer is a surgical problem and they need to consult a breast specialist. ”
Studies show that Asian women tend to have denser breast tissues which are up to five times higher to develop malignancies. Such tissues are said to conceal the disease since both tumours and healthy tissues may appear white on a mammogram. Dr. Hasina says “The good news is that women below the age of 25 usually do not develop breast cancer.”
Recent studies suggest that the more we are taking up a western lifestyle of living the more breast cancer is on the rise; it also says that the first and most important factor in this case is diet. Researchers for a long time have believed that high fat diets contribute to mammary tumours in laboratory animals. The cancer also relies on estrogen to grow and researchers say that there is a connection between the role of fat in developing cancer and estrogen. Biologists believe that estrogen is produced not only in ovaries but also in the fat cells. Obese women have higher level of estrogen than slim ones and are at a higher risk to develop breast cancer after menopause. As estrogen plays a role in developing cancer and as fatty foods directly affect estrogen level, it is biologically rational to say that 'fat affects cancer'. Therefore it can be said that there is a strong connection between breast cancer and intake of fatty foods; which again implies that we need to take more of fibre and less of a high fat diet. Dr. Hasina adds “A balanced diet with proteins, fruits and vegetables should be consumed. Fatty foods and high cholesterol should be avoided.”
The trend of having fewer children in the west especially seems to be another factor. As more women are joining the workforce they are limiting the number of children they are having. Research shows that women who have less than two kids are more susceptible to develop breast cancer than the ones with larger families. This is because pregnancy and lactation provides the body with an estrogen holiday for nine months and more often much longer; they also change the breast tissue by building antibodies which in turn prevent cells from turning cancerous. This means, the fewer the pregnancies the lesser the chances of modification and the higher the risk of developing cancer. Late menopause, after 50; delayed child bearing, after 30; and early menstruation, before 12 are also acknowledged risk factors for breast cancer. Another important factor is the lack of exercise. With the shift towards the globalised world, we are moving from fields towards the offices and doing more of sedentary work, decreasing our overall movement. According to a research released in February 2007, by the University of Southern California, women who were engaged in strenuous activity five hours a week have a 20% lower risk of developing invasive breast cancer. The leaner body mass of an active women added with a healthy diet is sure to help her be in good health! Family ties play a role too. Having more than one, first-degree relatives with breast cancer act as a genetic contributor to the disease. Age is also a factor; the older a woman gets the greater are her exposure to potential cancer promoting estrogen and carcinogens. But some people are just genetically predisposed to develop the cancer.
Doctors unanimously suggest that all women practice self-breast examination regularly. Professor Humayun says “If you find anything suspicious go to a doctor, a proper doctor. This is a serious thing, a life and death issue. Therefore consultation is necessary.” According to Dr. Hasina “All women should have a monthly self examination after menstruation and for older women at one specific time every month. Feel around the breast and under the axilla as well. If you happen to find a lump, go see a doctor. Remember, early detection can save lives and helps one to lead a smooth and safe life.” Clinical breast examination should also be undertaken with the help of a health care provider. Regular mammograms after the age of 40 is absolutely necessary. Screening mammograms find cancer when it is very small and much before it can be felt. And when cancer is found early the treatment is more successful and survival rate is higher. Early detection through mammography often saves the breast as well. A small, early tumour can often be removed with a lumpectomy procedure rather than a mastectomy.
The first step to beat the disease is to understand how it works. Dr. Hasina says “Breast Cancer is curable and treatable, provided women take proper treatment and heed to proper advice.” Mass awareness is necessary in this case; men and women need to be informed and educated about the disease, the risk factors, symptoms, early detection, screening methods and such. Dr. Humayun adds “People need to be told time and again about the risk factors. Media has a very important role to play here. TV and radio should broadcast more programmes on this issue.” Dr. Hasina says “Publicity is a very important factor when it comes to breast cancer and media can play a significant role here.”
Cost is a factor, which discourages many women to take the test. Free annual mammograms with travel costs covered can help to reduce the disease. Husbands need to play their part as well. Women need to cultivate certain habits to ensure breast health. To prevent a disease, one needs to mitigate the risk factors that may lead to breast disease and breast cancer.
(R) thedailystar.net 2008