Although it is extremely vital to have a check or screening on every woman over 20 years of age for breast cancer (especially those above 45), a majority of women in Sri Lanka are extremely reluctant to undergo this practice, thus resulting in mounting numbers of patients with breast cancer.
This backward thinking among Sri Lankan women has hampered the early detection of cancer causing agents – carcinogen in breasts.
Dr. Kanishka de Silva, Medical Specialist of the National Cancer Institute, Maharagama (NCIM), said early detection and uninterrupted treatment were the best ways to control and cure this deadly disease, but death was imminent in the event where timely treatment failed.
“The Health Ministry has done everything possible to save women from becoming victims of breast cancer. There are 980 ‘Suva Nari’ clinics island-wide established for women to have check-ups for breast cancer, cervical cancer, Body Mass Index (BMI) blood pressure and so forth. We must all know that cancer of any type can be cured only through early detection and early treatment.
Otherwise, cancer brings imminent death. The husbands and other family members have a responsibility to compel the mother or elder sisters to screen for cancer. Learning to have self-examination on breast cancer by women is also important for early detection,” Dr. de Silva stressed.
Addressing the media at the Health Education Bureau (HEB) at a seminar on breast cancer, Dr. de Silva said all women need to have a check for breast cancer at least once a month.
Explaining some non-modifiable risk factors for breast cancer, Dr. de Silva said being a female, aging, having one or more blood relatives with breast or ovarian cancer, long-term exposure to estrogen hormone (starting menstruation before 12 years or delayed menstruation beyond 55 years) and born with some abnormal genes were non-modifiable.
Excessive weight gain after menopause, Hormone Replacement Therapy (long-term use of estrogen and progesterone hormones), smoking, lack of exercise, use of alcohol, unnecessary exposure to radiation is modifiable. Females who do not have children and have not breastfed were also at a risk of developing breast cancer, he added.
The World Breast Cancer Awareness Month is commemorated across the world by implementing programmes on prevention of breast cancer, early detection, treatments of the disease and palliative care for its victims. The purpose of these exercises is to strengthen the health seeking behaviour among the patients when the disease is at a very early stage.
Breast cancer is the most common cancer among females. The analysis of data on cancer in Sri Lanka reveals that breast cancer accounts for nearly 25% of all cancers reported among females. Nearly 2,500 new breast cancer patients are detected each year. This indicates that approximately 6-7 new patients are detected per day. If identified at an early stage, the disease can be completely cured through less-complicated but efficacious treatment methods. However, data reveal that a considerable number of breast cancer patients have sought treatment at a late stage of the disease.
Breast cancer occurs when a genetic change appears in the breast tissue. These changes may result due to various reasons. They are either inherited or environmental. However, inherited causes account for only 5-10% of the victims while the majority are due to unhealthy lifestyle and other environmental issues. Generally, the cause is multifactoral (a combination of these factors). These are identified as risk factors for breast cancer. However, all the females having these risk factors are not inflicted with the disease. Similarly, absence of any risk factor in a person does not exclude that person from developing the disease.
A nodule or swelling in the breast, recent change of contour or appearance in the breast, asymmetry in the breasts, recent nipple retraction or any other nipple change, dimpling of breast skin, an eczema, wound or any colour difference in the skin, skin of the breast appears like a peel of an orange, nipple discharge other than breast milk and frequent and unusual pain in the breasts are the signs of breast cancer.
It is essential to seek medical advice forthwith, if any of the above symptoms are experienced.
The awareness and attention on own breasts are important for early detection of cancer on the breast. This facilitates early identification of any change in the breast to seek medical advice early. Not all breast changes are due to cancer; however, it is important to exclude it by a medically qualified person.
All females above 20 years should perform a self breast examination at least once a month. Here, the exposed breasts should be examined for any of the aforementioned changes. Any change which was not present during the previous examination needs urgent attention to exclude a cancer.
Well Woman Clinics conducted by MOH offices, Healthy Lifestyle Clinics conducted by the government and private sector hospitals are the centres providing clinical breast examination.
The National Cancer Control Programme also conducts a Cancer Early Detection Centre which is situated at Narahenpita. It operates during weekdays. Services are available for clinical breast examination, Pap smear and other cancer early detection examinations.
If any suspicious condition is identified during the clinical breast examination, then that person will be directed for a mammography or an ultra sound scan.
The Zonta International has come forward to help women who have undergone cancer surgeries –mastectomy - to remove their breast by providing cushion to fill the gap in order to save them from embarrassment.
The breast cushion in U-shape to be worn on the removed breast has been invented by a member of Zonta International, Botany Bay, Australia Anne Selle. However, the programme to assist Sri Lankan women with one breast was inaugurated recently under the theme ‘Breast Cancer Cushion Project.’
Other relief brought by Breast Cancer Cushion is the prevention of ‘haematoma’ or bleeding, pain under the arm pits and pressure surrounding the breast or ‘lipedema.’
Setting up of a Cancer Unit at each and every District Hospital with a cancer specialist, launching a project to establish a centre for bone marrow transplant and providing modern chemo therapy machines to all existing cancer wards were among the measures discussed at the Presidential Secretariat recently for the benefit of cancer patients when President Maithripala Sirisena met a team of cancer experts.
Members of the Sri Lanka Cancer Specialists Association presented a set of proposals to President Sirisena at this meeting in order to mitigate the sufferings of cancer patients, provide modern treatment and control of cancer as it is one of the major killers among non-communicable diseases.
The Cancer Specialists stressed that although cancer treatment was being carried out at the National Cancer Institute, Maharagama (NCIM), and cancer units have been set up at Kandy, Karapitiya, Badulla, Anuradhapura, Jaffna, Batticaloa, Kurunegala and Ratnapura hospitals, it was extremely vital to open cancer units at all district hospitals.
Over 30,000 cancer patients are treated as inward patients at NCIM and other hospitals but the facilities at those institutions are not sufficient to treat all cancer patients in the country, they added.
Health Minister Dr. Rajitha Senaratne announced A ‘National Cancer Policy and Strategy for Cancer Control’ a seven point national action plan to control and prevent cancer. It also contains modern treatment methods on patients, drugs and patient care.
A comprehensive awareness programme is also included to educate the public on how to keep cancer away, food habits and lifestyle that must follow and also how to take care of cancer patients.
Setting up of a Cancer Unit at each and every District Hospital with a cancer specialist, launching a project to establish a centre for bone marrow transplant and providing modern chemo therapy machines to all existing cancer wards were among measures that were on the cards to prevent and control cancer in the country.
