In Pakistan, breast cancer is becoming the leading cause of cancer deaths among women. The fatality rate among breast cancer sufferers is much higher in Pakistan than other Asian country. Contrary to international studies, young women, usually aged between 20 to 35 years, are more frequently reporting with breast cancers, that too at delayed stages, to hospitals in Karachi.
Professor Naheed Sultan, Dean of Surgery, Dow University of Health Sciences, told APP on Tuesday that girls and young women are reporting with breast lumps, often malignant, at different city hospitals including Civil, JPMC, AKU and Liaquat National Hospital. “This is quite alarming and serious, yet we do not know the exact cause,” she said mentioning that almost six to nine patients of every 100 coming with any sort of complaint related to breast are found to be suffering from cancer. “At this point of time the most important message to be communicated is that breast cancer is treatable and also curable if reported in early stages,” she said.Replying to a question, she negated the impression that these young patients must be reaching the doctors at right time or in the initial stages of the disease. “Unfortunately since breast cancer is believed to have a late onset ie, at the age of 40 or later hence they rarely focus on self-examination or other diagnostic options,” said the surgeon.
“Changes in that peculiar part of body, despite being obvious, are largely ignored,” regretted Prof Naheed Sultana and attributed it to illogical shame and embarrassment, besides sense of contrition that prevented them to share their suffering from their dear ones. Another important aspect that prevents women to acquire proper treatment, she said, was the rampant quackery and tall yet fake claims made by certain sections that compel many of the women and their respective caretakers to approach homeopaths, Hakims and so-called herbalists to seek treatment. Incidence rate of breast cancers is already higher in Pakistan, 50 per 100,000 as compared to 20 per 100,000 in India, she said.In our context tragedy is that women report very late at stage three and four instead of stage one and two which turns the prognosis or survival rates low. Dean faculty of Surgery, DUHS, in reply to a question said it was extremely important to establish a “Registry” of cancer patients at national and provincial levels so as to determine the exact cause of its varied types among the people pertaining to different socio-economic groups, areas, age and gender.
“This will help us to formulate an efficient prevention oriented policy coupled with strategy to educate people and improve the survival rates among the sufferers,” said Prof Naheed Sultana. This is extremely crucial, she said mentioning that women referred from interior parts of the province and those from Balochistan were usually above 40 and again mainly at stages three and four of the disease.About palpability of girls and young women to breast cancers, she said that all staff at basic health units, lady doctors, lady health workers must be involved in a public education campaign about the disease, its symptoms and diagnosis.“In our context, it is important that girls assuming puberty are educated to necessarily conduct self breast examination, on monthly basis,” the surgeon said. In reply to another question, she said in case of any unusual growth in the breast or under arms ultra-sound could be conducted. “A positive development during past two years is that women are reaching to us in second stage of breast cancer, although ideally it should be stage one yet this has improved survival rates among our patients,” said the surgeon.
To another query, she said that an integrated approach was required to treat breast cancers that ranged from biopsies to surgeries, radiotherapy, chemotherapies and other modes, which were tailored in accordance to the need of each patient.“Treatment is expensive, yet there are several institutions that are providing cost free or subsidized standard treatment options,” she said reiterating that human life was precious.
The surgeon also mentioned that women must not be reluctant to seek treatment as there was no dearth of well qualified women surgeons in Karachi. Women, suspected to be suffering from breast cancer, must come out of fear syndrome viz-a-viz biopsy as it does not in any case contribute to spread of malignancies.Moreover, presently needle biopsies are mainly performed and these are painless while timely surgical options prevent further spread of malignant cells to other parts of the body. “Women and their caretakers must also understand that referral at first or even second stage of disease prevent complete removal of breast while reconstructive surgeries are also viable options for most of the cases,” said the surgeon.
courtesy: The Nation