I am going to discuss the issue of breast cancer today. It is a disease that is becoming rather common and leading to unnecessary death. Having breast cancer shouldn't be the end of the world if the right thing is done.
The story I am about to share is fictional though it portrays the usual attitude of a lot of patients in Nigeria to a diagnosis such as cancer of the breast.
Mrs Williams was a very beautiful woman. She was very elegant. Even at 50 years she could still make heads turn. She had won so many pageants as a youth. She had so many trophies and prizes to show for it. Just two years ago she had been the face of a popular magazine. God had been so good to her. She was happily married with three children, all grown now and working. She had a good job with a robust retirement package. Life was good! She hardly a fell ill. She couldn't even remember the last time she was in a hospital.
So, she hated the fact that her husband forced her to come today. She hated the smell of the hospital as well as the arrogant doctors and nurses who seldom had good news for one. While she had been making love to her husband two days before, he had noticed a small lump in her breast and had been so worried that he made her come to the hospital.
She was later ushered in to see a doctor. Surprisingly, the doctor was very nice and examined her thoroughly. He then explained to her that he needed to take sample of the lump for cytology as well as some other tests. She had a Mammogram done, samples of blood were drawn from her and the doctor used one very long needle to take some samples from the breast. It was a harrowing experience. She was glad when the whole thing ended. She was asked to come the following week for the result.
How she survived the past one week was a miracle and she was back again for the result. The doctor's face was too grim for her liking. Was he not the one that was so nice the previous week? He sat her down and told her he had some the test results. He said the mammogram and the Fine Needle Aspiration Cytology tests he did showed that the lump was cancerous. He went on to explain what breast cancer was, the progression of the disease and the treatment modalities. He said he was happy the cancer was discovered at an early stage. There was a good chance that with surgery, all the malignant cells would be removed.
Mrs Williams' face turned white. Did she hear this man right? Her whole world was crumbling. Did he just say surgery? These doctors are terrible o. Cutting someone's breast lo pe beyen. Emi ko! She couldn't wait to get out the office. What nonsense. She was so angry. It was her husband that made her eyes to see this rederede. If he had not made her to go for check up, she wouldn't have heard such. Lump that she would just put ori (Shea butter) and everything would melt away.
SIX MONTHS LATER
The Surgery outpatient department of the hospital was filled to the brim. People were packed on the wooden benches like sardines. Different odors oozing out of different individuals. But there was one distinct odour. It was the smell of decay. It was as though there was a dead dog nearby. Air freshener couldn't do the magic of neutralizing this smell. It was terrible. And it was coming from the one and only Mrs Williams. People passing by her always covered their noses while those that were polite held their breaths. It was as though she was dreaming. She, the once gorgeous woman was now a smelly old woman. All thanks to her fungating breast disease.
She had been devastated a few months ago when she had been diagnosed of breast cancer. She was offered mastectomy ( removal of breast tissue). Who in her right mind would allow them to cut off her breast? So she had turned to the herbal doctors who gave her things to rub on the breast and drink. They told her that she had been attacked spiritually. Won so l'ata ni oyan ni. It was an attack. They told her she would excrete it out which she did or thought she did. When that did not work, she had turned to deliverance pastors and Islamic clerics to gbona . They collected huge sums for saraa (alms). But there was no solution. Instead her case worsened. When the odors did not allow people to breathe again in the house, she decided to come back to the hospital.
The nurse called her case file and was allowed into the doctor's office. The doctor, after interviewing her and conducting an examination subjected her to further tests like CT Scan, X-ray, full blood count and a repeat mammogram. Because of the complications she presented with, the tests were done urgently and the result were discussed with her. The situation was grave. The cancer had metastasized to different parts of her body. The cancer cells were found in the other breast, lungs, liver. She had really deteriorated and needed radical treatment with surgery, chemotherapy, radiotherapy. Her 10 year survival rate was 5% ( this means that if 100 people had the same, only 5 would survive up to 10 years). She was doomed and death was knocking. She humbly submitted to the doctor's orders and was placed on admission.
As she was wheeled into the Female Surgical Ward, there was only one thing on her mind........ If only she had known, she would have had the surgery six months ago. It was a grave and costly mistake and she wished she could turn back the hands of time.
DISCUSSION
Breast cancer is a cancer of the breast tissue. Though it occurs mostly in women, it can occur in males. When it occurs in men, it is usually more fatal.
It is not deadly if it is detected and treated early. The survival rate for early detection in advanced countries is about 80-90%. But the reverse is the case in Nigeria. It is not usually detected early and when it is, most patients do not accept the offered treatment leading to deaths in 90% of cases.
RISK FACTORS
There are some identified risk factors to developing breast cancer as the cause is not known. They are:
- Being female
- Genetics: if a first degree relative has it, there is probability of having it too
- Older age: from 45years though it is now seen in younger people
- Prolonged exposure to the female hormone Estrogen as in early menarche( age of menses), late menopause, lack of childbearing.
- Lack of breastfeeding
- Obesity
- Lifestyle: alcohol consumption and smoking
SYMPTOMS AND SIGNS
The following are the symptoms and signs of breast cancer
- Lump: this is the first symptom. The lump is different from the normal breast tissue. Not painful initially.
- Nipple changing position or shape or becoming inverted
- Skin puckering or dimpling ( of the breast)
- Rash on or around a nipple
- Nipple discharge
- Pain in part of the breast or armpit ( this is a later symptom)
- Swelling beneath the armpit or around the collarbone.
- A wound may develop on the breast in much later stages.
SCREENING
This should be done by every healthy woman to allow early detection. The screening methods are:
- Self breast examination: this should be done the week after menses. Divide the breast into four quadrants (segments) and feel for any lump.
- Clinical examination: done at the hospital by the doctor
- Mammography: in the US, it is recommended that women ages 50-74 have a mammogram every two years.
- Genetic screening
- Breast ultrasound
- Magnetic resonance imaging
SELF BREAST EXAMINATION
1. Stand in front of a mirror that is large enough for you to see your breasts clearly. Check each breast for anything unusual. Check the skin for puckering, dimpling, or scaliness. Look for a discharge from the nipples.
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2. Watching closely in the mirror, clasp your hands behind your head and press your hands forward.
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3. Next, press your hands firmly on your hips and bend slightly toward the mirror as you pull your shoulders and elbows forward.
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Do steps 2 and 3 to check for any change in the shape or contour of your breasts. As you do these steps, you should feel your chest muscles tighten.
4. Gently squeeze each nipple and look for a discharge.
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5. The breasts are best examined while lying down because it spreads the breast tissue evenly over the chest. Lie flat on your back, with one arm over your head and a pillow or folded towel under the shoulder. This position flattens the breast and makes it easier to check.
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Use the pads of the fingers of your other hand to check the breast and the surrounding area firmly, carefully, and thoroughly. Some women like to use lotion or powder to help their fingers glide easily over the skin. Feel for any unusual lump or mass under the skin. Feel the tissue by pressing your fingers in small, overlapping areas about the size of a dime. To be sure you cover the whole breast, take your time and follow a definite pattern: lines, circles, or wedges.
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The important thing is to cover the whole breast and pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone, and all the way over to your shoulder.
PREVENTION
- Maintaining healthy lifestyle: diet and exercise
- Breastfeeding
- Drinking less alcohol and reduction of smoking
- Prophylactic bilateral mastectomy in women who have breast cancer genes
TREATMENT
You must see a doctor for diagnosis and treatment. These include:
- Surgery: lumpectomy ( removal of a part of the breast), mastectomy( removal of the whole breast) with or without nipple sparing reconstruction
- Chemotherapy: use of cytotoxic drugs
- Radiotherapy: use of radiation. Given after surgery to destroy the microscopic cancer cells.
- Immunotherapy
CONCLUSION
Death should not be the end result of this disease if proper care is taken. I admit that such a diagnosis is very hard to accept but early acceptance would lead to early treatment which would make it possible to eradicate most of the cancer cells. This will improve survival rates as well. It is important to note that cosmetic surgery can be done to repair the breast with implants and nipple reconstruction which will make the breast to look good.
PLEASE NOTE
Much younger women who have breast lumps should check it out at the hospital. Usually, younger women have a benign form of lesion called Fibroadenoma. This may need excision. Please do not hide such.
Thanks very much for reading. You can share with your friends. Who knows? Someone may need it.
Very educating. Will share now.
ReplyDeleteThanks a lot
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