It’s October once more, and the breast cancer awareness campaigns will soon be in full swing. But to those living under the shadow of ‘BC’, the disease, even when vanquished, is an omnipresent spectre.
According to the Globocan Project of the World Health Organisation (WHO), 70,218 women died of breast cancer in India in 2012. Nationwide, 1,44,937 women were newly detected with the disease in the same year.
Oncologists say the average age of the incidence of breast cancer is shifting too, from 50-70 years to 30-50 years, which is worrisome, because cancer in younger patients tends to be more aggressive.
While breast cancer is curable in its early stages, the bigger challenge for healthcare providers in India is getting the women to report it in the first place.
“People are willing to admit that they have hypertension and diabetes, but an admission of breast cancer carries a big social stigma,” says Padmaja*, 66, the retired principal of a nursing institute in Tiruchi who underwent a radical mastectomy on her left breast (a surgical removal of the mammary gland and underlying chest muscle and lymph nodes) five years and nine months ago.
“Even after all these years, we still do not know how cancer is caused,” says Padmaja. “You could get breast cancer irrespective of your marital status, childbearing history or lifestyle. Every individual is a different case, with her own variations of symptoms and post-operative side-effects. It is difficult, not just for the patients, but also the doctors, who have to treat each case differently.”
Accidental discovery
The stories of this group of women gathered at a prominent cancer hospital in the city follow a similar narrative arc. Almost all of them discovered the first signs of breast cancer by accident, and their treatment was dependent on their access to oncology services. Says Mangai*, 31, from Kumbakonam, “I felt a small wound while feeding my second daughter. So the initial diagnosis by my gynaecologist in 2011 was that it could be a lump of fat. I spent three months taking tablets to dissolve the lump, but it kept growing. By the time we went for a scan, the tumour had spread over half my breast.”
Stick-thin and frail in her cotton nightie, Mangai is back in hospital after four years because tests seem to indicate the cancer has spread to her liver.
She manages to smile when asked about her baldness. “My hair grew back after my breast cancer chemotherapy. I’m sure it will be the same after this chemo session ends,” she says.
Farmer’s wife Subha* thought nothing of the pain in her leg, nor of the lump in her breast that she had found while bathing. “I kept putting off treatment because my children are studying and there’s nobody to take over at the farm,” says the widow who stays in Alangudi, near Pudukottai.
Operated on just 18 days before, Subha is nervous about the future. “I spent Rs. 20,000 on the treatment, and I do hope I can repay the loans I took for it. I’m not scared for myself, just for my children,” she breaks off as the tears start to flow.
Having seen her aunt and nephew suffering from cancer, Lakshmi N.* was more sanguine when a check-up after a fever indicated that she had breast cancer. Now in her fifth year after treatment, Lakshmi says that a positive attitude and a healthy diet are essential for recovery.
“I went in cheerfully for my operation, saying my Rama Nama prayers till the very end, and I believe women should be brave in facing up to the disease,” she says.
Finding funds
A straw poll around the room indicates that the patients have spent between Rs. 20,000 to Rs. 2 lakhs on their treatment. Some have been helped by the Government-run health insurance scheme, others have had to empty out their retirement savings to fund the trips to the hospital.
“A year after my breast cancer operation, my gall bladder was removed in an emergency operation in Chennai due to high levels of cholesterol. I’ve become convinced now that I got sick because I took out a health insurance policy,” says Lakshmi. “Even though the funds came in handy, I feel superstitious now about investing in policies,” she adds.
For Kamala*, the wife of a retired Prisons Department official, a routine master check-up at a private medical facility revealed the signs of a carcinoma, in January last year. The couple, living in a village near Thuraiyur, took three months to approach oncologists in Tiruchi, because Kamala had no pain in the affected area.
“Because she didn’t have pain, we were not convinced about the need for an operation,” explains her husband. “But what can we do? We have to live it out, even though we’re managing on a very meagre pension after I retired 10 years ago.”
All the assembled women agree that the breast cancer patient needs to have a support network to recover from the worst effects of the disease. “Many women, especially in rural areas, stay away from treatment because they are not comfortable being examined by a male physician,” says Padmaja. “Women must screen by themselves, by breast self-examination. They can find out the cancer in a very early stage when the treatment is simple, and less expensive, with fewer side-effects,” she suggested.
Irrespective of your standing in life, there’s a lot of mental stress involved when it comes to breast cancer, says Padmaja.
“You have to deal with not just the disease, but also learn how to settle your worldly concerns like property and finances when you are faced with a serious ailment. Chemotherapy is also very stressful as it can cause a lot of pain suddenly without any reason. I wouldn’t wish this disease on my worst enemy,” she concludes.
*Respondents’ names have been changed to protect their privacy
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Protect yourself against breast cancer
1. Follow a healthy lifestyle that makes time for regular physical activity and a balanced diet with limited or no intake of alcohol. Several studies have suggested that a high-fat diet may increase the risk of breast cancer, so make sure you cut down on the calories
2. Educate yourself about breast cancer
3. Screen yourself regularly through self-examination, by a healthcare professional, or a mammography
4. Don’t be afraid to get your breasts examined by a professional. It is more important to get a clear diagnosis!
Exercises can help restore movement
No matter what type of surgery you had, it is important to do exercises afterward to get the arm and shoulder moving again. Exercises help to decrease any side effects of your surgery and help you get back to your usual activities.
If you have radiation therapy after surgery, exercises are even more important to help keep your arm and shoulder flexible. Even if you don’t have surgery, radiation therapy may affect your arm and shoulder long after treatment is finished. Because of this, it is important to develop a regular habit of doing exercises to maintain arm and shoulder mobility after radiation treatments for breast cancer.
