I had a teacher at school who unlike most others simply detested me. I didn’t like her at all since she used to scold me for no apparent reasons, or maybe that’s what I had conjured up in my mind. Today, when I look back at that I think that it could be that scolding that gave me the impetus to do as good as I did in her subject. I could not thank her though because she left school that year and sometime later we heard the news that she succumbed to the fight against Breast Cancer. I remember that she had a small son and could not but think of him again and again back then. In no way did she look sick or diseased in any means but it all happened so fast leaving all of us shocked.
This is but a single example of a case of Breast Cancer and how it has touched my life. I am pretty sure that it has touched each and everyone’s life either directly or indirectly in some form. Each and every patient has their own story to tell about the fight that they had to put against this disease. Some won the fight while in other cases the disease prevailed.
Breast Cancer is the most common cancer among women in the world and the one that kills the most as well. In 2008, about 1.4 million new cases were detected and 458,000 women died due to breast cancer all around the world (Globocan 2008, IARC). Although previously believed to be a greater burden in the developed world, this has increased as a burden in the developing world as well owing to the urbanization, adoption of Western lifestyle and lack of proper education. More women have been killed in the developing countries than the developed world primarily because of detection in later stages when the prognosis is poor and survival rates are low.
RISK FACTORS – Familial history of breast cancer, mutation of some genes sometimes increases the risk. Increased exposure to the hormone Estrogen in case of late menopause or early menarche, child birth at older age, nulliparity, along with use of external source of these hormones like Oral contraceptives and hormone replacement therapy increases the risk of breast cancer. Lifestyle related factors such as overweight and obesity, physical inactivity, tobacco and alcohol use has also been included as a risk factor for breast cancer (IARC 2008, Lacey et al, 2009).
If detected early or at an early stage, breast cancer, or any other forms of cancer can be treated appropriately and the outcome is better as well as survival is more. The worst case scenario in a country like Nepal is that a woman hides the ulcer, lump or swelling in her breast due to the fear of the society until it is so big that it cannot be hidden. In this case, the cancer would have spread not only to adjacent tissues but also metastasized or spread to far away organs and developed secondary cancers there. The consequence is that the cancer is too advanced and the prognosis or the outcome is very poor. This is the primary reason for the maximum number of deaths in the developing world due to breast cancer.
Another case scenario is of a patient of mine, who went to the doctor at an early stage. She detected a lump in her breast and went for a check-up right away. The diagnosis although taking some time came and she got the cancer surgically removed and went through radiotherapy.
Today, she works, looks after her family, talks about her story time and again and she visits me every 6 months for a regular dental check up with a very wide smile of her. The impact of EARLY DETECTION could be life saving for most in case of breast cancer. So, I urge every one of you to talk about breast cancer with your family, not make it a stigma in today’s society. Breast self examination is an easy method to regularly check oneself and increase one’s awareness of the disease. If any sign such as swelling, ulcer, discharge is seen, then please consult with your doctor or physician to rule out breast cancer.