By – Dr. Bhawna Sirohi, Lead Consultant Medical Oncologist, Apollo Proton Cancer Centre, Chennai, India
October is celebrated as breast cancer awareness month but awareness about all cancers is important as 1 in 5 of us is likely to develop cancer within our lifetime. More than half of the cancers are preventable based on the information that we have today from key research that has been conducted. It is important to remember that men can also develop breast cancer so the following applies to them also.
The ABC’s makes it easier to remember :
- A : Avoid Tobacco, Alcohol, Processed foods, Sugars, nutritional supplements (unless there is a vitamin deficiency), Oral contraceptive pills (OCP) & Hormone replacement therapy (HRT). Less than 4 years of postmenopausal oestrogen-progestin combination therapy does not appear to increase breast cancer risk. There is approximately a 10% increase in the risk for breast cancer for every alcoholic drink per day. Some vitamins may increase the risk of cancer.
A : Aim for a healthy waist measurement (< 31 ½ inches / 80cm for women;< 37 inches / 94cm for men), Aim for a healthy weight for one’s height (BMI of 20-25kg/m2).
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- B : Be Breast aware / Breast Feed. For early detection of breast, knowledge and awareness about ones breast is important. Breast self examination is the most cost- effective methods to do an initial screen for any abnormality in ones breast. Feeling embarrassed and being scared has been the most common barrier to see a doctor which needs to be addressed with public awareness and education. Breast feeding can lower the risk of developing breast cancer if done for one year, though risk reduction is apparent post 6 months also.
- C : Calm /Compliance Though there have been conflicting reports whether stress is linked to breast cancer, almost 50% of women who are diagnosed have cited stress as a contributory factor, hence it is important we mitigate this by various strategies like yoga, meditation or psychological support. Compliance to recommended treatment for breast cancer will prevent recurrences or new cancers.
- D : Diet. Eating a balanced rainbow diet which includes fruits, vegetables, wholegrains is protective though diets high in saturated fat (meat, butter, cheese, pastries, cakes) and high fat dairy foods may be associated with increased risk (low fat dairy foods are good to include. Sugary drinks and sugars contribute to weight gain, hence are not recommended.
- E : Exercise. Studies have shown that there can be as high as 25-40% decreased risk of developing breast cancer if one exercises. Even 1-3 hours of brisk walking/week matters and the benefit is greatest in thinner women. WHO recommends at least 30 mins exercise daily that increases heart rate.
6. F : Family history /Follow-up. About 5-10% of breast cancers are associated with a positive family history. One must know the family history of cancer, so that timely advise and genetic counselling and testing can be undertaken if required. Follow-up with the physician post any test or follow-up screening appointment in diary is important as healthcare for oneself is lifelong.
7. S : Sleep / Screening. A population based study done in Spain showed that having supper early before 9pm and a long interval between supper and sleep reduces risk of developing breast cancer by 20%. Screening for breast cancer involves a simple mammogram. This should be done annually starting from the age of 45 years. Younger women between 40 and 45yrs can consider a digital mammogram with breast tomosynthesis. Every woman needs to be aware of and engaged in a screening program.
Early detection and stage migration to diagnosing cancer in early stages will improve our cure rates and outcomes in India. All of these are strategies that one can make part of lifestyles not only prevent breast cancer but other forms of cancer as well. We can overcome “the fear of cancer” if we are disciplined and proactive about our health.
