October is observed as Breast Cancer Awareness Month each year around the globe in order to raise awareness and to educate masses about the disease. The likelihood of successfully treating cancer is considerably increased by early detection. The two elements of early cancer detection are ‘screening and diagnosis’. Screening is used to test those healthy individuals, who have a disease, but no symptoms have appeared yet. It helps in early detection of cancer even before a lump is appeared. Mammography or clinical breast examination are immensely useful for this purpose. Self-examination of breast is also an effective and time-tested method. During the examination, if any lump or something aberrant is observed then an oncologist (a medical practitioner who diagnoses and treats tumours) should be consulted immediately. Experts advise that this activity should be performed at least once a month. While ‘diagnosis’ concerns with early detection of cancer in symptomatic patients. It includes laboratory tests like urine and blood tests; imaging tests such as CT scan, PET scan, bone scan, MRI, X-ray, ultrasound etc. If anything suspicious is observed in these tests then a biopsy procedure is performed to determine whether the detected mass/abnormality is cancerous or not.
Statistics provided by the World Health Organization (WHO) show that cancer is amongst the leading causes of death around the world as it accounted for almost 10 million deaths in 2020 that included 685,000 deaths of breast cancer patients. Breast cancer is the most common type of cancer, accounting for 1 in 8 cancer diagnoses worldwide. In 2020, 2.26 million cases of breast cancer were reported, followed by lung cancer 2.21 million cases; colon and rectum cancer, 1.93 million cases; prostate cancer, 1.41 million cases; skin cancer, 1.2 million cases; and stomach cancer, 1.09 million cases. It is also pertinent to mention here that breast cancer is not a gender-specific disease. Although, it is commonly found in women yet men are not immune to this disease. Also, both genders share the same symptoms. According to the US’ Centers for Disease Control and Prevention, almost 1 percent of all breast cancers in the US occur in men.
As far as causes of cancer are concerned, there is no single established reason for the occurrence of disease. However, there are various risk factors that escalate the chances of cancer and are considered responsible for about one-third of deaths from cancer. These include the consumption of tobacco and liquor, high body mass index, low intake of fruits and vegetables and physical inactivity. Late-stage diagnosis and the inability of access to healthcare facilities, especially in low and middle-income nations, are just as crucial factors. Extensive treatment is ostensibly accessible to over 90 percent population of high-income countries, whereas it is available to less than 15 percent of low-income nations.
Cancer is categorised into four stages depending upon the size of tumour and how far it has spread. Stage-1 denotes that the cancer is localised and has not spread further. Whereas, Stage-2 indicates that the cancer is grown but has not spread. On the other hand, Stage-3 specifies that the cancer has grown larger and perhaps has spread to the surrounding tissues. Lastly, Stage-4 describes that the cancer has spread to other parts of the body and it is also referred as advanced cancer.
Although, no central cancer registry exists in Pakistan yet Pakistan Atomic Energy Commission (PAEC) has taken an initiative to compile data of those cancer patients, who get treatment from PAEC’s 19 cancer hospitals spread across the length and breadth of the country. According to PAEC Cancer Registry Report, a total of 40,797 cancer cases were registered in 2019. The data shows that Breast Cancer is the most common type of cancer in Pakistan as it accounts for 9,827 cases, followed by cancer-related to digestive organs numbering 7,203; lip, oral cavity, and pharynx cases numbered 5,456. These hospitals share the major burden of cancer patients and are serving around a million patients (existing and newly registered) across the country each year. Breast cancer along with gynaecological cancers accounts for about 60 percent of all female cancers. While, breast cancer alone is responsible for more than 40 percent of all female malignancies.
For a country like Pakistan, there are several challenges that hinder early detection and treatment of cancer such as dearth of awareness, low literacy rate, negligence towards risk factors and bizarre myths. Many people believe that black magic and evil eye are responsible for cancer-related diseases. Some people, who are diagnosed with cancer and are advised by oncologist to undergo a surgery, intentionally refrain from the procedure as they believe that the disease would grow or spread more aggressively if any metallic instrument come into contact with cancerous cells. Other people consider it as a will of God or hold their fate responsible and sink deeper into misery.
Breast cancer is amongst the major causes of death in Pakistani women due to a range of multifaceted barriers that are responsible for late detection. Women are often too shy to visit healthcare facilities and they do not share such things with their family members and even with their life-partners because of female sensitivity and other socio-cultural factors that obstruct women from breast cancer screening, diagnosis and treatment.
It is high time to understand that cancer is a curable disease and ‘time’ is the key determinant as early detection increases the chances of cure significantly. That is why, cancer survival rate in developed countries is more than 80 percent in general cases and in case of breast cancer, it exceeds 90 percent. Conversely, the rate is significantly low in developing countries. So, the precious time should not be wasted in trying unproven and unconventional methods of treatment. In case of any doubt, one should consult an oncologist in the first place and should pay heed to his/her advice. Every healthy person should get blood and urine tests at least once a year. Those, who have a family history of cancer, should remain more vigilant. Moreover, the above mentioned risk factors should be avoided and a healthy lifestyle should be adopted as prevention is better than cure.
The writer is a freelance columnist. He can be reached at [email protected].