Breast cancer: Single largest cause of death for women in Pakistan
October 27, 2013
Rawalpindi
Recent trends have shown that breast cancer incidence is registering an alarming increase in young girls in Pakistan and out of control due to increase in urbanisation and adoption of western lifestyles.
Pakistan has the highest rate of breast cancer in Asia. One out of every nine women is at the risk of breast cancer, the prevalence of which is the highest amongst all cancers in Pakistan. Every year breast cancer kills 40,000 women although it can be completely cured through early detection. However, there is no specific data of total cancer patients in Pakistan as there is no centralized cancer registry.
It is not the cancer of breast that is causing problems; it is lack of awareness, ignorance and associated stigma that is causing all the problems. Due to late childbearing, small timing of postpartum breastfeeding and the general lifestyle of women, young women are at risk of developing breast cancer. There have been several reported cases of women as young as 20 years of age who have been diagnosed with the disease.
Head of Community Medicine at CMH Lahore Medical College Dr. Muhammad Ashraf Chaudhry expressed this while talking to ‘The
News’ in connection with
Pink Ribbon Day being observed on October 28.
October is the official month of ‘Pink Ribbon — Breast Cancer Awareness’ worldwide. The Pink Ribbon Campaign is an international symbol of support for breast cancer awareness. This year, Pink Ribbon Day is on Monday, October 28th. Dr. Ashraf said that it is time to tell our young girls every single detail about breast cancer.
Pakistan has to overcome many barriers such as illiteracy, misconception, social stigma and lack of medical facilities on the subject, he said.
He added that most significant risk factors that may increase chances of getting breast cancer are gender (being a woman), age (growing older) and family history of cancer. Family history is the key in breast cancer. Other risk factors are intermarriages, early menses before 12 years of age, late menopause after 55 years, late childbirth after 30 years of age, no children, no breastfeeding, lack of diet and weight control (physical inactivity, high fat diet, low consumption of fruits and vegetables and obesity), previous history of breast cancer, higher socio-economic status, exposure to pesticides, alcohol consumption, smoking, high dose radiation to chest, and genetic abnormalities, he explained.
To a query, he said that early stages breast cancer may be asymptomatic. Most breast cancers present as hard lumps, may be associated with in drawing of nipple and fluid or blood discharge, new lump underarm (armpit). There may be changes in the skin such as redness, scaling, swelling, changes in texture, and puckering. There may be a pain in any area of breast. All these are warning signs of breast cancer and as soon as any of the signs develop, the female should undergo medical examination, said Dr. Ashraf.
He said that screening is a tool by which we diagnose the disease at early stage and can reduce the mortality and morbidity from breast cancer. Various methods of diagnosis are Breast-Self Examination (BSE), clinical examination by a doctor, ultrasound, MRI (magnetic resonance imaging) and biopsy. The recommended early detection strategies for low-and middle-income countries are awareness of early signs and symptoms and screening by clinical breast examination by a doctor or nurse in demonstration areas. “If you are 50 years and above, be sure to have a screening mammogram every two years.” He added that there is a dire need of educating women through mass media about the warning signs of breast cancer and also about breast-self examination. Although some NGOs in urban areas of country are running awareness campaigns, but unfortunately there is no such campaign for rural women where majority of women reside, said Dr. Ashraf.
Women should begin monthly examination of their breasts from the age of 18. It is just two minutes exercise. Menstruating women 5-7 days after the beginning of their period, menopausal women - same date each month, pregnant women same date each month. Examine all breast tissues. There is no reason to conclude that breast cancer will end up killing you. Breast cancer is no longer a death sentence and early detection and appropriate treatment of Breast Cancer has 90 per cent chance of surviving making prevention, rather than cure, an important intervention, said Dr. Ashraf while responding to a query.
He, however, added that poor health facilities for breast cancer patients in the country hinder timely treatment. The number of female oncologists is also very few in Pakistan. There is a need to open more Breast Clinics and launching of mobile screening bus facilities especially for rural women so that free screening services could be provided to women at their doorsteps, he suggested.
He explained that treatment includes the combination of surgery, radiation therapy, chemotherapy, and anti-hormone therapy. The most common treatment of Breast Cancer is surgery, which may be of two types that is mastectomy (complete removal of breast) and lumpectomy (removal of cancer and small amount of tissue around it). However, surgery is not only way out. If the cancer is detected at early stage, then you can go through chemotherapy and there is no need of surgery for removing your breast, said Dr. Ashraf.
He said that at least one-third of cancers are preventable. Women may reduce their risk of breast cancer by maintaining a healthy weight, being physically active and by breastfeeding their children.
Talking of the remedy, he said that cousin marriages should be discouraged. Smoking should be quitted, as it is the root cause of all cancers. A new research has shown that fish oil cuts breast cancer risk of women. Healthy foods should be eaten, which include foods low in saturated fats, high in whole grains, fruits and vegetables, and low fat meats including fish and chicken. Regular exercise at least 30 minutes walking, swimming etc per day should be included in daily routine, said Dr. Ashraf.
In our country recently, trend/fashion of late marriages, late children and not breastfeeding especially among working women is increasing which has also contributed to increase in breast cancer cases. Fashion of late marriage and late children should be discouraged. Women should have children sooner (before 30 years of age) rather than later in life, breastfeed their babies, restrict sources of red meat, eat more fruits and vegetables, and avoid exposure to pesticides and prolonged use of antibiotics. Avoiding tight fitting bras 24 hours a day, and women from age of 20 onwards should carry out self-examination every month, concluded Dr. Ashraf.
Recent trends have shown that breast cancer incidence is registering an alarming increase in young girls in Pakistan and out of control due to increase in urbanisation and adoption of western lifestyles.
Pakistan has the highest rate of breast cancer in Asia. One out of every nine women is at the risk of breast cancer, the prevalence of which is the highest amongst all cancers in Pakistan. Every year breast cancer kills 40,000 women although it can be completely cured through early detection. However, there is no specific data of total cancer patients in Pakistan as there is no centralized cancer registry.
It is not the cancer of breast that is causing problems; it is lack of awareness, ignorance and associated stigma that is causing all the problems. Due to late childbearing, small timing of postpartum breastfeeding and the general lifestyle of women, young women are at risk of developing breast cancer. There have been several reported cases of women as young as 20 years of age who have been diagnosed with the disease.
Head of Community Medicine at CMH Lahore Medical College Dr. Muhammad Ashraf Chaudhry expressed this while talking to ‘The
News’ in connection with
Pink Ribbon Day being observed on October 28.
October is the official month of ‘Pink Ribbon — Breast Cancer Awareness’ worldwide. The Pink Ribbon Campaign is an international symbol of support for breast cancer awareness. This year, Pink Ribbon Day is on Monday, October 28th. Dr. Ashraf said that it is time to tell our young girls every single detail about breast cancer.
Pakistan has to overcome many barriers such as illiteracy, misconception, social stigma and lack of medical facilities on the subject, he said.
He added that most significant risk factors that may increase chances of getting breast cancer are gender (being a woman), age (growing older) and family history of cancer. Family history is the key in breast cancer. Other risk factors are intermarriages, early menses before 12 years of age, late menopause after 55 years, late childbirth after 30 years of age, no children, no breastfeeding, lack of diet and weight control (physical inactivity, high fat diet, low consumption of fruits and vegetables and obesity), previous history of breast cancer, higher socio-economic status, exposure to pesticides, alcohol consumption, smoking, high dose radiation to chest, and genetic abnormalities, he explained.
To a query, he said that early stages breast cancer may be asymptomatic. Most breast cancers present as hard lumps, may be associated with in drawing of nipple and fluid or blood discharge, new lump underarm (armpit). There may be changes in the skin such as redness, scaling, swelling, changes in texture, and puckering. There may be a pain in any area of breast. All these are warning signs of breast cancer and as soon as any of the signs develop, the female should undergo medical examination, said Dr. Ashraf.
He said that screening is a tool by which we diagnose the disease at early stage and can reduce the mortality and morbidity from breast cancer. Various methods of diagnosis are Breast-Self Examination (BSE), clinical examination by a doctor, ultrasound, MRI (magnetic resonance imaging) and biopsy. The recommended early detection strategies for low-and middle-income countries are awareness of early signs and symptoms and screening by clinical breast examination by a doctor or nurse in demonstration areas. “If you are 50 years and above, be sure to have a screening mammogram every two years.” He added that there is a dire need of educating women through mass media about the warning signs of breast cancer and also about breast-self examination. Although some NGOs in urban areas of country are running awareness campaigns, but unfortunately there is no such campaign for rural women where majority of women reside, said Dr. Ashraf.
Women should begin monthly examination of their breasts from the age of 18. It is just two minutes exercise. Menstruating women 5-7 days after the beginning of their period, menopausal women - same date each month, pregnant women same date each month. Examine all breast tissues. There is no reason to conclude that breast cancer will end up killing you. Breast cancer is no longer a death sentence and early detection and appropriate treatment of Breast Cancer has 90 per cent chance of surviving making prevention, rather than cure, an important intervention, said Dr. Ashraf while responding to a query.
He, however, added that poor health facilities for breast cancer patients in the country hinder timely treatment. The number of female oncologists is also very few in Pakistan. There is a need to open more Breast Clinics and launching of mobile screening bus facilities especially for rural women so that free screening services could be provided to women at their doorsteps, he suggested.
He explained that treatment includes the combination of surgery, radiation therapy, chemotherapy, and anti-hormone therapy. The most common treatment of Breast Cancer is surgery, which may be of two types that is mastectomy (complete removal of breast) and lumpectomy (removal of cancer and small amount of tissue around it). However, surgery is not only way out. If the cancer is detected at early stage, then you can go through chemotherapy and there is no need of surgery for removing your breast, said Dr. Ashraf.
He said that at least one-third of cancers are preventable. Women may reduce their risk of breast cancer by maintaining a healthy weight, being physically active and by breastfeeding their children.
Talking of the remedy, he said that cousin marriages should be discouraged. Smoking should be quitted, as it is the root cause of all cancers. A new research has shown that fish oil cuts breast cancer risk of women. Healthy foods should be eaten, which include foods low in saturated fats, high in whole grains, fruits and vegetables, and low fat meats including fish and chicken. Regular exercise at least 30 minutes walking, swimming etc per day should be included in daily routine, said Dr. Ashraf.
In our country recently, trend/fashion of late marriages, late children and not breastfeeding especially among working women is increasing which has also contributed to increase in breast cancer cases. Fashion of late marriage and late children should be discouraged. Women should have children sooner (before 30 years of age) rather than later in life, breastfeed their babies, restrict sources of red meat, eat more fruits and vegetables, and avoid exposure to pesticides and prolonged use of antibiotics. Avoiding tight fitting bras 24 hours a day, and women from age of 20 onwards should carry out self-examination every month, concluded Dr. Ashraf.
