The battle against
breast cancer continues
By RONALD DELOS REYES, Ramon Aboitiz Foundation Inc.
October 3, 2013
By simply being a woman
makes all women at risk of contracting breast cancer.
However, those who have had
early menstruation (before age 12), those who went through late
menopausal (after age 55), and women who did not have children or who
had their first child after the age of 30 have a higher risk of
developing breast cancer.
This is attributed to longer
lifetime exposure to the female hormones estrogen and progesterone.
Just what is breast cancer?
It is a type of cancer that
originates from a breast tissue. Lack of childbearing, sex, high fat
diet, tobacco use, alcohol intake, obesity, and heredity are the other
risk factors of the disease.
Breast cancer is the most
researched type of all cancers. Published in various research papers,
methods of early detection, prevention, and treatments have already
been laid down by medical professionals. However, the incidence rate
of the life threatening disease is still increasing over the years.
Globally, for every eight
women, one develops breast cancer before the age of 75. In Third World
countries such as the Philippines, in every three women diagnosed with
breast cancer, one dies within the same period. In fact, breast cancer
is number one in incidence and mortality rate in developing countries.
In Cebu, breast cancer is
the leading cancer-related deaths among Cebuano women. Based on the
population-based Cancer Registry of the Ramon Aboitiz Foundation Inc.
(RAFI) Eduardo J. Aboitiz Cancer Center (EJACC), women ages 50 to 54
are the ones most likely to be diagnosed with breast cancer.
In 2003-2007, there were 657
recorded deaths out of 1,349 breast cancer cases. Of the
newly-diagnosed cases in Metro Cebu, 70 percent were found in the
later stages of the disease.
While women cannot do
anything on their lifetime exposure to estrogen and progesterone, they
can help reduce the risk through breastfeeding.
When mothers breastfeed
their newborn, there is a suspension of the production of the
hormones. A year of breastfeeding is best recommended, not just for
the welfare of the newborn but also for the mother.
Cancer is always associated
with despair and death. For women afflicted with cancer of the breast,
death is just around the corner. The fear is the reason why it takes a
lot of time for them to see a doctor and undergo treatments.
Financial constraints also
prevent women from responding to symptoms as soon as possible. Another
reason is lack of information. The more information about cancer she
knows, the higher is the likelihood for a woman to act swiftly.
Less than 30 percent of all
types of cancers, including breast cancer, have ďcommonĒ early
detection. It is important to note what stage a personís cancer
already is primarily determines the patientís survival, if not cure.
Breast cancer screening
means is important because it detects cancer even before there are
signs or symptoms of the disease. When abnormal tissue or cancer cells
are found at an early stage, it is easier to treat the disease.
The three periodic
screenings to employ are monthly breast self-examination (BSE), annual
clinical breast examination (CBE), and annual mammography.
Beginning in their 20s,
women must check their breast through BSE. This examination enables
women to check their breasts and armpit area for possible lumps and
changes or abnormalities in shape or size.
BSE should be performed five
to 10 days after the monthly menstruation period. For women who no
longer have monthly periods, they can do the examination any time of
If during BSE you notice
swelling of the breast, nipple discharge (not breast milk), nipple
pulling inward, and unusual pain in the breasts area, see a doctor
immediately. These might be early symptoms of breast cancer.
When women reach 40, they
should start an annual CBE done by a trained and healthcare
professional. The advantage of talking to your doctor is he can advise
possible tests or interventions if malignancies are detected.
Another way to screen for
breast cancer is to have an annual mammography for women ages 40 years
old and above, especially those with large breasts. A mammogram is a
low dose X-ray of the breast used to detect abnormalities, even when
they may be too small yet for you or your doctor to feel or see.
If after three consecutive
years of mammography the doctor detects no cancer development, it is
advisable not to undergo mammography the following year.
These examinations should be
done periodically even if a woman is not suspected with breast cancer.
More lives will be saved if women will take advantage of the
Through the years,
researchers and medical practitioners have developed life saving
treatment advances for breast cancer. Treatment is the other
determinant of survival in every type of cancer.
Aside from hormonal therapy,
there are three conventional ways to treat cancer. These are surgery,
chemotherapy, and radiation therapy. These treatments are
evidence-based and scientifically proven medicine.
Once a cancer diagnosis is
confirmed, it is time to determine how to treat it. The three
conventional ways to treat cancer are surgery, chemotherapy and
Surgery is the mainstay of
therapy for breast cancer. The choice of which type of surgery is
based on a number of factors, including the size and location of the
tumor, the type of tumor, and the person's overall health.
Depending on the staging and
type of the tumor, a lumpectomy (removal of the lump only) may be all
that is necessary or removal of larger amounts of breast tissue may be
Lumpectomy is utilized by
many patients for breast-conservation cancer surgery. Another surgery
is mastectomy where the entire breast with cancer, including the skin,
areola, and nipple are removed.
Mastectomy usually takes two
to three hours of operation.
Mastectomy doesnít eliminate
the risk of breast cancer. It just reduces the risk of not contracting
the disease by 90 percent.
If a patient wants to have a
breast reconstruction (surgery to rebuild a breastís shape after a
mastectomy) it may be made with the patientís own (non-breast) tissue.
On the other hand,
chemotherapy is a cancer treatment that uses drugs to stop the growth
of cancer cells, either by killing the cells, or by stopping them from
dividing. Chemotherapy can be taken orally or, more commonly, by means
of intravenous injection.
The treatment gets rid any
cancer cells that may be left after the surgery. Chemotherapy has an
average of six cycles in a span of six months. The way the
chemotherapy is given depends on the type and stage of the cancer
Chemotherapy can be a
frightening prospect for anyone. It has many side effects because it
targets multiple areas of the body simultaneously. Unpleasant effects
include vomiting, nausea, hair loss, fatigue, and mouth sores, among
Lastly, the third common
conventional treatment for cancer is radiation therapy. It uses
high-energy x-rays, or other types of radiation, to kill cancer cells,
to keep them from growing.
Radiation therapy damages
the cancer cells, but this method can also damage or kill the healthy
cells inside the body. The death of healthy cells can lead to side
effects such as hair loss and thinning of skin tissue.
Conventional treatments are
made available for patients to increase their survival rate and/or
their quality of life. If patients do not undergo any treatment,
cancer would cause complications inside the body.
Based on available records,
most patients do not die of breast cancer; they die due to
complications, such as cardiac arrest. Breast cancer can affect other
areas of the body; this is called ďmetastaticĒ breast cancer. If there
is metastasis, other parts of the body have already developed breast
A woman should not rely on
the fact that the family does not have a history of the disease. Even
at an early stage, she should observe her breast for early
malignancies. One never knows when these damaging cells would develop.
In a study entitled,
Mortality among offspring of women diagnosed with cancer: A
population-based cohort study, a group of researchers composed of
Helena M. Verkooijen, Joella X. Ang, Jenny Liu, Kamila Czene, Agus
Salim, and Mikael Hartman evaluated the mortality risks in offspring
of mothers with history of cancer in relation to timing of birth and
From the Swedish
Multi-Generation Register and the Cancer Register, the researchers
identified 174,893 children whose mothers had been diagnosed with
cancer between 1958 and 2001.
The study revealed that
offspring of mothers diagnosed with cancer had no increased mortality
risk. Increased mortality risks were found in offspring of mothers
with tobacco-related cancers (head and neck, thoracic and cervical),
in children born around the time of their motherís diagnosis, and in
children born after their motherís hematopoietic cancer diagnosis.
However, exposure to (the
effects of) diagnostic investigations, radiation therapy, and systemic
treatment before and around the time of birth may have adverse effects
on the child.
It is also important to note
that before undergoing the mentioned treatments, patients must first
discuss their treatment options with their doctors, especially if they
In its 10th year now, the
Moonwalk, an advocacy campaign of RAFI-EJACC held every October, will
again gather thousands of people for an awareness campaign on breast
cancer. It is a time to call all women to act now.
EJACC also advocates
exercise, a well-balanced diet, and healthy lifestyle to be the
secondary prevention methods one should do.
Since its inception 25 years
ago, EJACC has already served more than 50,000 people in Cebu
province. Its services include cancer education, cancer screenings,
diagnostics, and primary treatment, psycho-social support, linkaging
and network, and the Cebu population-based cancer registry.
Though breast cancer can
bring a womanís life to a standstill, there is ray of hope for them to
fight it. While there is no primary prevention available for breast
cancer, the best way to do is early screening and detection with
corresponding treatment at an early age.