CHEARS

For every two women who are newly diagnosed with breast cancer, one woman dies in India. This is according to the National Institute of Cancer Prevention and Research (NICPR) based on estimates of World Health Organization (WHO). For 2015, there have been an estimated 1,55,000 new cases of breast cancer and about 76000 women in India are expected to have died of the disease, making it one death for every two new diagnoses. With the incidence of the disease rising by more than 20% since 2008, India is expected to have a whopping 200,000 new cases of breast cancer per year by 2030.

This despite the fact that breast cancer is curable, especially when detected in the early stages. “Cancer incidence is rising across the country with the change in our lifestyle and the focus is on early detection of breast cancer,” said Dr Suresh Advani, Director, Cancer Department at Jaslok Hospital in South Mumbai.

The pioneering oncologist believes that while there have been a lot of changes in the four decades that he has been in the field, early detection still needs emphasis. “Not all lumps are cancerous but women must see a doctor the moment they notice one in their breasts,” he added.

Neelam Kumar, who is a two-time cancer survivor has written a book about her experience called ‘To Cancer, with love.’ She says, “During my first cancer treatment I was in the ‘why me’ mode. The second time around when the cancer relapsed, I shifted from the victim to the survivor mode.

Cancer is no longer a death sentence. It is a mind game and you have to make your body cooperate.”

Doctors say that any notable abnormality in the breast should be immediately reported and evaluated for further investigation. Late stage detection and lack of screening programs are the biggest concerns in India, with more than 60% of the patients diagnosed in later stages of the disease. The good news is that breast cancer is curable if detected timely, and only increased awareness and better screening practices can ensure improved survival rates.

“Clinical evidence suggests that the percentage of early diagnosed patients is still abysmally low in India, with less than 10% diagnosed in stage 1 and less than 20% diagnosed in stage 2. This means that as many as 60% of the patients present at stage III or stage IV when it is too late to treat the disease or prolong the life of the person,” said Dr Deepak Dabkara, Consultant Medical Oncologist, Tata Memorial Centre, Kolkata.

Late marriage and delayed breast feeding are known to be contributing factors to the rise in the incidence of breast cancer. Dr Advani warns that excess intake of food that is high in fat, lack of exercise and environmental factors are only going to make matters worse.

Not just urban areas, the rural areas need attention too. Dr Deepak Sawant, Maharashtra’s health minister said that the government is taking steps to ensure awareness levels rise. “We have included breast cancer awareness in our projects in rural areas where women may ignore the condition,” he said.

Oncologists say the cancer in younger women is more aggressive and difficult to treat. Women diagnosed at a younger age also are more likely to have a mutated BRCA1 or BRCA2 genes which present poor prognosis.

“Unfortunately, most young women do not care about regular screening and some even tend to ignore warning signs because they believe they are too young to suffer from breast cancer. In its very initial phase, breast cancer doesn’t present any symptoms; the earliest symptoms that may manifest include a painless lump in the breast, unusual discharge from the nipple, a change in the breast shape or size, or swelling or lump in the underarm area,” says Dr P N Mohapatra, Consultant Medical Oncologist, Apollo Gleneagles Hospital, Kolkata.

Dr Dabkara adds, “Not only are more younger women being diagnosed with the disease, it has also been observed that cancers in younger women are typically more aggressive which do not respond to common therapies and have more chances of relapsing. Among the causes for the surge in breast cancer incidence are factors associated with urban lifestyles such as obesity, lack of exercise, excessive smoking and drinking, delayed age of childbearing and reduced breastfeeding”.

In what is being seen as an alarming medical trend by doctors, the incidence of breast cancer is rapidly increasing among younger women in India, with many patients now below 50 years of age.

“Till as early as 10 years back, breast cancer was largely considered a disease of elderly women. In fact, age is still considered a major risk factor for breast cancer across the world. However, this medical belief is now on shaky ground with the changing features of the disease being manifested in patients today. Unlike a decade back when most women patients diagnosed with breast cancer were above 50, today many women under 50 years of age are being diagnosed with the disease,” says Dr Mohapatra.

Another less talked about aspect of breast cancer is the prevalence of the disease in men. Most of the treatment available in India is adapted for women, but men may have breast cancer too, though the disease is rarer in men but not entirely non-existent, say doctors.

Source : Online news