New Delhi, October 30-The Breast Cancer Awareness Month is observed in the month of October every year across the world. It helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of this disease.
According to a study by IARC Globocan database, Breast Cancer claims 458 000 people every year with 1.38 million new cases. Breast cancer is by far the most common cancer in women worldwide, both in the developed and developing countries. In low- and middle-income countries the incidence has been rising up steadily in the last years due to increase in life expectancy, increase urbanization and adoption of western lifestyles.
According to World Health Organization (WHO), Breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. While breast cancer rates are higher among women in more developed regions, rates are increasing in nearly every region globally.
HealthWire (HW) speaks to Dr. Sidharth Sahni (SS), Senior Consultant Surgical Oncology, Indraprastha Apollo Hospitals on the nature, symptoms and prevention of Breast Cancer.
HW. What is the growth rate of Breast Cancer in our country? What are the its symptoms?
SS. Breast Cancer is unfortunately growing at a very rapid rate in our country. I is estimated that 1 in 8 women living in metro cities of India is likely to get breast cancer.
The signs and symptoms actually appear quite late. It is a disease which needs to be picked up before any signs or symptoms. The commonest signs and symptoms are a lump which is usually painless, a nipple discharge which is spontaneous, particularly from one side, irrespective of the colour of the discharge; any dimpling of the skin of the breast, any retraction of the nipple which occurs, they are all big warning signs of a potential presence of breast cancer and it is a cancer which conversely can be cured 100% if picked up early. So the entire ball game is early detection of cancer and to do a few a things that might make it possible to prevent it from occuring in a women.
HW. Which age group among women is at more risk? What is the relation between fast food industry and breast cancer?
SS. Younger women in our society are getting affected by breast cancer as opposed to the West. One of the reasons is that we have a pyramidal system of age group distribution as opposed to reverse pyramid which means that we don’t have an aging population but we have a much younger population. Therefore the amount of people exposed to the cancer causing agents do have to be in younger age group.
If you sort of look at breast cancer in the West, it actually mirrors the rise of fast food industry. The same has almost happened in India of you look carefully. People who are at the maximum risk of exposure, to all the vegetable oils, processed foods and sugar that are the bedrock of fast food industries, do have to be in their 20s, 30s, and 40s. The continual DNA damage from all the substances found in these three particular food categories potentially leads to the presence of cancer. Therefore you are seeing a lot of more f this disease in 30s and 40s then it was seen even in the West.
HW. What are the causes of DNA damage?
SS. The two biggest causes of damage to the body’s DNA are sugar and vegetable oils. The latter was sold to us as heartfriendly therefore the best thing in the world you could ever have but we now know that enough literature and science has proved it is the sugar that causes insulin resistance to start. Insulin not only controls sugar but also later on in the body leads to a lot of repair and building blocks being laid down so if insulin is rendered ineffective then there is a lot more damage that’s done and damage to the DNA that’s not repaired will ultimately lead to disease, including cancer. Vegetable oils, when are heated, they contain poly unsaturated fatty acids which become mega trans on heating and lead to free radicals. Free radicals are like terrorists armed with a couple of AK-47 let loose on the streets AK-47; they damage everything that they touch.
So it is really about going back to the way we were and cooking in a way that was very fresh and traditional, eating fresh and seasonal fruits and staying away from the entire fast food industry which depends on lots of sugar and vegetable oils being refried and reheated every single time irrespective of the country you are in.
HW. What are the ways in which women can ensure self-awareness about Breast Cancer?
SS. The best thing to do is to enable young women at the age of 21 onwards because at 21, development which starts from the age of puberty, is said to have been complete.
As a woman you must know what your breast looks and feels like normally. Do every month, with your eyes and hands, you should keep figuring out whether it is normal or not, it’s called breast self awareness. While you are still in the reproductive age of your life, the best time to do this is Day 8 and Day 12 of the cycle, with Day 1 being the day when the periods start. We normally say Day 10 as it’s a round figure to remember. You continue doing that and if there’s any change, however subjective it might be, please see a doctor immediately.
HW. How can a woman get diagnosed with Breast Cancer? Are there any screening tests?
SS.The current recommendation in the West is a mammogram after 50, every year of two year, depending on the country you are in. Every two years is done in the countries where the government is paying for the mammogram. It’s just financially exceedingly challenging to be able to be funded on a yearly basis particularly in an aging populations.
In India, we have advocated now an annual mammogram at the age of 40. If there is a large family history then please consult a doctor as there are other forms of screenings besides a mammogram that can be applied at a much younger age group. But if you don’t have a family history, 40 and above, every woman, every year, must get a mammogram.
A mammogram again, till menopause, should also be done on Day 10 of the cycle as opposed to any other day because the result is most effective at that time.
HW. Given today’s lifestyle, is Breast Cancer preventable?
SS. Yes and No. It is preventable to the extent where, as I mentioned, modifications in lifestyle are there, in terms of what you eat and what to avoid. There are also a group of chemicals called the parabens or polycyclic aromatic hydrocarbons. They are found in a variety of cosmetics, furniture polishes etc. used quite widely and effectively by industries as they make the cost of manufacture much cheaper. So try and ensure that the hand moisturizer, or the body moisturizer or the make-up you buy is paraben free. Most companies that sell paraben free products will readily advertise the fact they are paraben free and you’ll also find that they are more expensive than the ones that are not paraben free. Parabens were introduced to 12 rats in 2003 at Reading University in The United Kingdom, within six weeks, all rats developed breast cancer.
Also ofcourse, exercise, is a must. So if you have got the right eating habits, paraben free products as much as possible, maintain the right body mass index, prevent obesity then these are all measures which can potentially prevent cancer.
Otherwise, while still taking these measures you are still at risk so keep checking yourself and keep getting annual mammogram because this is a disease if caught early, there is a 100% cure.