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Pink Ribbon Day
October is “Breast Cancer Awareness Month,” and in several countries, today is observed as Pink Ribbon Day. The wearing of a pink ribbon is to raise awareness of the dreaded disease that appears to be on the increase in Guyana.
We say “apparent,” because there are no register or figures available for us in Guyana to make a rigorous comparison – the “increase” may be caused by increased awareness.
However, The World Health Organisation (WHO) estimates that there are 1.2 million new breast cancer cases every year, with forty percent originating in the developing countries, like Guyana. It is the second most common cancer in the world, and in the U.S. it is the second leading cause of deaths from cancer.
The exact cause for breast cancer is not known, although inherited defects in DNA repair genes have been identified as one reason. Female hormonal imbalance with raised levels of estradiol has been identified as another risk factor in many studies.
Diagnosis of breast cancer is generally done by removing a small piece of the tumour for biopsy using histopathology. Sometimes, a fine needle aspiration biopsy is performed, in which the tissue is sucked out for testing. X-ray mammography, CT and MRI scans show the growth and its spread.
Women at a higher risk of breast cancer include those who are childless or have not breastfed their children; those whose menstruation began at an early age and faced a late menopause; obese older women and those on oral contraceptives; or, as indicated by the inherited DNA theory above, those with a family history of malignancy.
In Guyana, most women with breast cancer consult doctors only after the cancer has progressed to an advanced stage.
Most of the time, this is because women feel awkward talking about the issue, even with their physicians. However, the modern woman may also be so busy looking after the world that she has no time for herself.
Women have to realize that early diagnosis can not only prevent extensive surgery, but can actually save their lives. Every woman should be taught the technique of self-examination and ways to detect early signs.
This is one of the primary goals of “Pink Ribbon Day.” In our society, the body, especially that of a woman, is not to be discussed; but women must rise above this taboo and examine themselves regularly, and raise any suspicions with their doctors or health care workers.
A change in the size of the breast, nipple retraction or discharge from the nipple, and any lumps in the armpit are the initial danger signs. Usually, all lumps are painless, unless they are infected; so the absence of pain does not mean anything. X-ray mammography should be performed every three years in all post-menopausal women. They should avoid smoking, adopt a healthy diet, and exercise to maintain a suitable body weight.
When is comes to the use of oral contraceptives, the views are conflicting. There is a likely chance that it may increase the risk in certain genetic groups and in young women in the reproductive age group. In fact, studies in many countries have shown a significant association between oral contraceptives and breast malignancy.
Treatment normally begins with surgery, and this may involve partial or complete removal of the breast (mastectomy). Surgery is followed by chemotherapy, radiotherapy, or hormone therapy as indicated. This is a continuous battle against the disease and a source of distress for the patient. The only way to play safe is prevention and a very early detection. This requires a high level of awareness in both women and the doctors, as pointed out before.
In a country like Guyana, where we have a large rural population that is mired in tradition in many respects, many myths abound about cancer in general, and breast cancer in particular. For instance, wearing a bra does not increase women’s chances of developing breast cancer, nor are all tumours cancerous, but they have to be checked out rigorously.
It is important that we develop programs in our country to highlight the fact that our womenfolk literally have their lives in their hands when it comes to breast cancer: breast examination must become a matter of routine.
An effective awareness drive is essential to prevent breast cancer.
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