At least 90,000 women suffer from breast cancer in Pakistan every year, said University of Health Sciences controller of examinations Dr Junaid S Khan while delivering a lecture on Cosmetic Options in Breast Disease Management at Sukh Chan Wellness Club on Saturday.

He said that half of 90,000 women affected with breast cancer were in the Punjab alone. He said only 10 percent of women were diagnosed and that out of them about 75 percent women did not treat the problem and die within five years.

He said the women who underwent surgical removal of a breast were an important concern around the world. He said aesthetic problems related to the surgery could be easily redressed, but lack of awareness caused low self-esteem, keeping low stooped posture, lack of confidence, social dissociation and in some cases suicide among the patients. He said the women who had surgical removal in the West suffered far less these problems.

He said there were various techniques were now available for maintaining the volume and appearance of the breast. He said when most part of the breast was removed then the space could be filled with some other body tissue or with prostheses like silicone or saline breast implants.

He said various plastic surgery options were available, but in Pakistan the same old techniques were in practice, which provided little relief to the patients. He said, “The main reason is the shortage of trained doctors to manage breast related problems.”

Khan said that it was unfortunate that in Pakistan it was still considered a taboo for women to take care of their bodies. He said women were afraid to talk about breast cancer.-[via DailyTimes]

Don’t beat your breast over breast cancer, cautions Dr Shaista:

The fear of hospitals and doctors, of losing a breast, of dying and concern for children are major impediments to treatment of breast cancer which is the most common type among women in Pakistan, said Dr Shaista Khan of the department of surgery, Aga Khan University Hospital (AKUH), during a seminar held Saturday to commemorate Breast Cancer Awareness Month.

Dr Khan informed the audience about the treatment for breast cancer. In the West, it is second only to lung cancer in the female population. The removal of a lump after early detection could make treatment easier and having it detected in stage one is necessary.

The number of stage one breast cancer cases, where the tumors are benign, were shown in a presentation using cases from 1986 to 2006, and have been increasing. Dr Khan said that women should come forward and cooperate to make treatment successful. When a lump develops, a woman should not hesitate to go for a check-up.

When breast cancer patients enter the oncologist’s room, they are usually depressed and gripped with various fears, mainly “psycho-social issues.” Who the woman is, what matters to her and what she holds dear, her family concerns and her relationships with broader issues have to be dealt with before a surgery, Dr Khan said.

Post-treatment psycho-social issues that most women fear include weight gain, fatigue, fear of follow-up visits, social isolation and the effect on their relationships with their husbands.

Dr Azmina Vali Mohammad shared her views about the different stages of treatment. Pre-surgery and post-surgery therapy is given to patients, such as neoadjuvant therapy (pre-surgery), adjuvant therapy (post-surgery) and then there is metastic disease therapy, for patients in whom the disease has metastasized.

On post-surgery systemic therapy, Dr Azmina said that it depends on the condition of the tumor and the risk of a relapse, which is monitored via the patient’s pathology report.

On chemotherapy, Dr Azmina informed about the short- and long-term side effects. Short-term side effects include loss of hair, nausea and vomiting, change of taste, diarrhea and fever. Long-term side effects include toxicity and numbness, which are often experienced in some patients.

The difference between hormonal therapy and targeted therapy was also discussed. Targeted therapy helps fight the cancer cells only, and hormonal therapy is for controlling estrogen, progesterone and the tumor(s). Pre-menopausal women are given Tamoxifen, which is an orally active selective estrogen receptor modulator that stimulates (or inhibits) estrogen-like action in various tissues.

The participants expressed various concerns and also suggested some solutions for patients to overcome their pre-treatment fears. Making them aware of the illness and its treatment helps to cope with their illness. Social support, such as talking to someone about it and listening to someone in a similar position, helps them feel accepted. Furthermore, the oncologist (or team of oncologists) designs a different treatment plan for different patients; there is no “one size fits all” treatment.

On radiation, Dr Farrok Karsan, assistant professor and head of the radiation oncology section, said that radiation treatment uses ionizing radiation. In order to protect normal cells, the radiation is limited and the treatment is spread out over five to six weeks.

Tissues and organs that do not require treatment are protected as much as possible, said Dr Karsan. Radiation is one part of the treatment plan for managing breast cancer. It is usually not used as the only treatment, except for those who undergo breast conservation surgery (lumpectomy).

Some patients who have had mastectomy (the entire breast removed), have MRM (where the tumor is larger than five centimeters) or if their disease can spread beyond the breast get the radiation treatment.

On side effects, he said that in some cases there is no hair loss, nausea or vomiting. A serious side effect is when a very small portion of the lung is permanently injured, but, this does not cause any noticeable change in daily life. The breast(s) can also become harder, which can be treated, unless it is the left breast in which case there is a small risk of injury to the heart.

He said that 80 to 85 percent of the women who get radiation treatment to the breasts report that the cosmetic results were good or excellent.

Some patients who had been treated for breast cancer were present during the seminar and some of them also spoke about their experience with the disease.

In the end, a memorandum of understanding was signed between AKUH and WEG (Women Empowerment Group) to spread awareness of breast cancer.-[By Shahzad Shah via DailyTimes]

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