By Henrylito D. Tacio
It’s “Pink October” once more. It means, the country is again observing Breast Cancer Awareness Month.
The number of women – and some men, too – having the dreaded disease is staggering: more than two million cases are diagnosed each year. The situation in the Philippines is even worse.
Dr. Clarito Cairo, program manager of the Department of Health’s Philippine Cancer Prevention and Control, disclosed that about 27,163 new cases are reported every year, thus making breast cancer the most common type of cancer among Filipinos.
Each day, about 27 Filipinos die of breast cancer. The figure balloons to 9,926 deaths each year.
“Breast cancer is the number one cancer in the Philippines, yet we don’t have a national breast cancer screening program, nor access to free mammograms and breast ultrasounds for the poor,” deplored Kara Magsanoc-Alikpala, founding president of ICANSERVE Foundation, Inc. and breast cancer survivor.
It’s not surprising that to be diagnosed with breast cancer is like a death sentence. Let’s hear the story of Rhodora, who first noticed the lump in her breast a week before Christmas in 2006:
“Initially, I felt a pain in my left armpit,” she recalled. She reckoned the pain must be due to the stressful driving she did from Digos City to Davao City, and then back to Panabo again. But after reading some magazine articles, she surmised that the lump must be something else.
Three weeks after she felt the lump, Rhodora went to see a physician. She was praying that what she was thinking about was just that – a thought. But everything crumbled when the doctor diagnosed her to have breast cancer.
Rhodora was totally terrified upon hearing the diagnosis, but later she realized that everyone has to die anyway. “I accepted it fully as His will,” she said. Considering that she was already 62 years old at that time, “I am ready to return to Him as our life in this world is just borrowed,” she added.
Rhodora died three years after she was diagnosed. She is not alone, though. Almost 500,000 women around the world die from breast cancer every year, according to the International Agency for Research on Cancer.
One death every two hours
Statistics showed one Filipina dies of breast cancer every two hours. Unlike in the Western world, where most breast cancer victims are old, those from the Philippines are getting younger.
The Geneva-based World Health Organization (WHO) reports that 8 to 9 percent of women will develop breast cancer during their lifetime. One person out of four who are diagnosed to have breast cancer dies within the first five years. What is even alarming is that all women are at risk, with approximately 70% of breast cancers occurring in women without the known risk factors.
Current estimates show that 1 in 13 Filipinas will develop breast cancer in her lifetime. But not too many women are aware of this fact. In fact, studies done by the Philippine General Hospital and the Cancer Institute of the Philippines showed “there is low cancer prevention consciousness (in the Philippines).”
Men not spared
It has to be emphasized that men are not spared from breast cancer. Rod Roddy, American male radio and television announcer, died at age 66 from breast and colon cancer. American actor Richard Rountree was diagnosed with breast cancer in 1993, and underwent a double mastectomy and chemotherapy for treatment of the disease.
Studies have shown that men are diagnosed to have breast cancer at less than one percent the rate of women, but when they are, the disease is often more advanced on average, and they are more likely to die from it, according to an international study.
“Men who develop a breast lump delay seeing their doctor longer than a comparable woman with similar symptoms,” said Mikael Hartman, who headed the study. “Male breast cancer is rare, but men can develop the disease and should be aware that they should seek care if a breast lump develops.”
How breast cancer develops
Breast cancer usually begins with the formation of a small, localized tumor. “Some tumors are benign that they do not invade other tissue; others are malignant or cancerous,” states The Medical Advisor: The Complete Guide to Alternative and Conventional Treatments. “The potential for a malignant tumor to spread is common to all cancers. Once such a tumor grows to a certain size, it is more likely to see cells that spread to other parts of the body through the bloodstream and lymphatic system.”
In the early stages, breast cancer usually has no symptoms. As a tumor progresses, a woman may experience pain or tenderness in her breast. She may also observe swelling in the armpit. But the most apparent symptom is a lump in the breast. More than 80% of breast cancer cases are discovered as a lump by the woman herself.
Generally, a lump in the breast can be found through breast self-examination (BSE). One local study reveals that only 54% had done a BSE, of whom only 27% are still practicing it at an average of 9.2 times a year. Some of the reasons given for not doing the BSE: “no symptoms,” “busy,” “don’t know how,” “don’t like,” “don’t think important,” “always forget,” “afraid,” and “not aware.”
Aside from a lump, other indicators include a noticeable or indentation on the breast; a change in the contour, texture, or temperature of the breast; a change in the nipple, such as an indrawn or dimpled look, itching or burning sensation; and unusual discharge from the nipple that may be clear, bloody, or another color.
Risk factors
Although the precise causes of breast cancer are unclear, there are some known risk factors. The risk factors that most fact sheets and bulletins on breast cancer identify include family history, genetics, menstrual period that began before age 12 and ended after age 55, early and repeated exposure to relatively high doses of radiation, and long-term post-menopausal estrogen replacement.
Women should watch what they eat. Recent studies have shown that cooking methods like boiling food in coconut milk have been associated with a significantly increased risk of breast cancer in the country. Another study suggests that high intake of deep-fried, well-done red meat may be associated with an increased risk of breast cancer.
The earlier a cancerous lump is detected and removed, the bigger the chances of treating it, says Dr. Antonio Villalon, the chief of Medical Oncology at the Manila Doctors Hospital and an associate professor at the University of the Philippines College of Medicine and the Philippine General Hospital.
He advised that between 20 and 39 years old, every woman should have a clinical breast exam every three years; and after age 40 every woman should have a clinical breast exam done each year.
Possible treatments
However, women should not panic once they feel a lump on their breast. After all, most breast lumps are harmless, with up to three of four lumps that are suspected of being cancerous turning out to be benign cysts, fibromas or lipomas. To have peace of mind, a woman should have the lump screened by a doctor.
Mammograms — a type of X-ray — are the chief way now to check for breast cancer. However, a radioactive tracer that “lights up” cancer hiding inside dense breasts showed promise in its first big test against mammograms, revealing more tumors and giving fewer false alarms. The experimental method — molecular breast imaging, or MBI — would not replace mammograms for women at average risk of the disease.
But it might become an additional tool for higher risk women with a lot of dense tissue that makes tumors hard to spot on mammograms, and it could be done at less cost than magnetic resonance imaging, according to the Mayo Clinic in Rochester, Minnesota.
If a patient is diagnosed to have breast cancer, Dr. Villalon said that this patient can be given the following treatment options: surgery, hormonal treatment, chemotherapy, and radiotherapy. In the United States, some researchers are exploring treatment with various forms of immunotherapy; by manipulating the body’s immune system, they hope to improve the natural resistance to cancer.
Having breast cancer is not the end of life itself. As Oscar-winning Swedish actress Ingrid Bergman puts it: “Cancer victims who don’t accept their fate, who don’t learn to live with it, will only destroy what little time they have left.” – ###
