Columnists

Understanding breast cancer

MUSOWOYA

Analysis: JOSEPH MUSOWOYA
ONE of the most not frequently asked questions is: what is cancer? With the focus mainly on the type of cancer one is suffering from. It is hence imperative to understand what cancer is.
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumours (swellings or lumps), which do not spread. The possible signs and symptoms include a lump, abnormal bleeding, unexplained weight loss and prolonged cough as the cancer advances.
While these symptoms may indicate cancer, they may also be due to other non-cancer causes. Numerous types of cancers affect human beings and can arise from any tissue or organ.
As we commemorated the National Health Week last week, we narrowed it down and turned our attention to one particular kind of cancer called breast cancer.
This year’s National Health Week was being commemorated under the theme: Promoting health and well-being towards universal health coverage: My responsibility.
Breast cancer is a cancer that forms in the cells of the breast. The cells begin to grow abnormally and divide more rapidly to form a lump. Breast cancer is among the most diagnosed cancers in Zambia ranking number two after cervical cancer.
Genetics (heredity, inheritance), hormonal, lifestyle and environmental factors tend to interact to increase the risk of developing breast cancer.
It is, however, not clear why certain people without identifiable risks develop breast cancer and why some with obvious risk never do.
It must be noted that cancer does not affect females only. Men also develop breast cancer although over 99 percent of patients are female. It is rare before the age of 20 but the incidence increases with advancing age.
The risk actually increases in women with history of breast cancer in the family, those that have had no pregnancies, those that begin having periods at a younger age and those that have delayed menopause. Other risk contributors to varying degrees include alcohol, obesity and lack of regular exercises.
HOW CAN ONE KNOW THAT THEY HAVE BREAST CANCER?
One of the most frequently asked questions is, how can one know that they have breast cancer? First and foremost, a significant number of people with cancer of the breast in its early stages may not actually be aware about the disease.
Among the signs and symptoms that can be noted when one has breast cancer include a breast lump, unusual discharge from the nipple, changes in size, shape or appearance of the breast, changes in nipple or skin texture such as puckering, dimpling, rush, flaking or redness.
The cancer spreads via three methods. The first is by encroachment of adjacent tissues as it grows. It may eventually affect the muscles and the part of the chest wall where the breast sits.
The skin may get fitted into the tumour and get damaged. It can spread through the tissue liquid (lymph) to the armpit lymph nodes. It can also spread with the blood to the lungs, the liver and bones, among other tissues.
The diagnosis of the cancer can only be made with certainty after getting a small tissue sample (biopsy) that is examined in the laboratory. Other examination and tests help increase the suspicion.
WHAT HAPPENS WHEN ONE VISITS A DOCTOR?
When one visits a heath facility, a doctor will ask a series of questions and later on examine both breasts for any signs stated above. They will also examine the armpit, the chest, the abdomen and the back to ascertain the extent of the spread.
They may ask for ultrasound scanning or mammography (X-ray to the breast) and other tests depending on age, background and examination findings. Eventually they will seek consent for a biopsy.
HOW IS BREAST CANCER TREATED?
Treatment is dependent on the extent of the spread and the aggressiveness of the cancer. Generally, the earlier the stage of the disease, the better the outcome.
Treatment options include surgery, radiation therapy, chemotherapy, hormonal therapy and other rare targeted therapies. A combination of two or more treatment modalities often gives a better outcome.
Survival rates for breast cancer have increased due to early detection, availability of personalised treatment and better understanding of the disease.
EARLY DETECTION
Women of reproductive age group and the post-menopausal women need to be undergoing periodic screening. One can either visit a health worker, or can do self-breast examination. Women ought to be familiar with their own breasts so that it’s easier to pick any new changes to the breast. As soon as there are unexpected changes, one needs to visit a health practitioner immediately.
PREVENTION
There is no absolute method of preventing the cancer. Nevertheless, the risk can be minimised by not taking alcohol or moderating its intake, regular exercises, avoiding obesity, avoiding hormonal treatment, etc. These have contributory effects to the cumulative risk.
For more information, do visit any health worker or a nearest health facility.
The author is Ndola Teaching Hospital senior medical superintendent.

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