BREAST CANCER: FILIPINO WOMEN’S ENEMY NO. 1

“Cancer is really hard to go through and it’s really hard to watch someone you love go through, and I know because I have been on both sides of the equation.” – Cynthia Nixon on her and her mother’s battle with breast cancer

Ingrid Bergman, the Swedish actress who won three Oscars (two for leading roles and another one for a supporting part), was reading a magazine which featured an article on breast cancer.  After reading it, she tried to feel her breast and found out there was a lump.

That was in 1973.  She was 58 years old, and was doing Murder on the Orient Express for Sidney Lumet.  It wasn’t until the following year, when she went to a clinic in London where, under anesthesia, the physician told her what she was afraid to hear: breast cancer. 

“The illness got worst in 1977, by the time of the making of Autumn Sonata,” wrote Rafaella Britto for Medium.  “The remove of the right breast left Ingrid with lymphedema in her arm, impairing her range of movement.”

In her autobiography, My Story, the award-winning actress wrote: “Doctor came and I could read his face as an open book.  I felt sorry for him, because it must be a terrible job tell women they were maimed.” She died on her 67th birthday at 12:00 am.

Bergman may not be a Filipina but the world remembers her as it celebrates Breast Cancer Awareness Month this October. “(The celebration) helps to increase attention and support for the awareness, early detection and treatment as well as palliative care of this disease,” the World Health Organization (WHO) states.

Every 19 seconds, a woman is diagnosed with breast cancer somewhere around the globe, the Geneva-based World Health Organization (WHO) reports.

In the Philippines, breast cancer is one of the deadliest diseases that strike women.  Among the 197 surveyed, the Philippines has the highest prevalence of breast cancer.  Doctors estimate that three out of 100 Filipinas will develop breast cancer in their lifetime.

Data from the Philippine Statistics Authority and the Department of Health (DOH) showed that 16% of all cancer diagnosis are pertaining to breast cancer.  It accounts for 30% of cancer cases among women.  The chances of getting breast cancer increase as one gets older.

“What is unfortunate is that most Filipino women still lack information on breast cancer,” the Philippine Cancer Society, Inc. (PCSI) deplores.  “Some believe that very few survive from the disease.  The perceived cost of medical treatment prevents them from seeking help not knowing that costs are manageable when the disease is detected early.”

Unknowingly, men are not spared from breast cancer.  “Actually, one to two percent of all breast cancers happen in males,” Dr. Lim SiewKuan, a general surgeon at Mount Elizabeth Novena Hospital in Singapore, told Business World.

Among those who succumbed to breast cancer include Liezel Martinez, June Keithley, Marilou Diaz Abaya, and Zorayda Sanchez.  The following are breast cancer survivors: Maritoni Fernandez, Toni Abad, and Melissa de Leon.

Despite the advance in medical science, the cause of breast cancer is still unknown.  “There are only studies to show the risk factors or those prone for breast cancer,” the PCSI states.  “These risk factors can be divided into those that can be controlled and those that cannot be controlled.”

Among the risk factors that cannot be controlled are as follows: gender (it afflicts 100 times more women than men), age (older women are at more risk), genetics (the presence of breast cancer in a family member like mother, sister, aunt or grandmother may increase risk), early menstruation or late menopause, and recurrence (women with cancer on one breast that has been treated may replicate in the other breast).

Risk factors that can be controlled fall under lifestyle choices.  These may include: not having children or childbirth for women over 30 years old; use of hormonal replacement therapy after menopause, cigarette smoking and excessive alcohol intake, and lack of physical activity or exercise which results in being obese or overweight.

Breast cancer strikes without symptoms.  This is the reason why early detection is necessary.  The PCSI shares this bit of information: “While the tumor is growing, one may have: growing lump, not regular in shape and painless; change in the size, shape or sensitivity of the breast or nipple; and discharge on the nipple.”

The symptoms are noticeable when the cancer is already advanced.  The following may be felt: pain in any part of the bone, pain on the breast, swelling on the arm near the breast that has cancer, and sudden loss of weight.

Better safe than sorry, so goes a popular saying.  This can be applied too when it comes to breast cancer.  “If you find lump or other changes in your breast, make an appointment with your doctor for prompt evaluation,” the Mayo Clinic advises.

Data released by the International Association of Cancer Registries showed some 25,000 new cases of breast cancer are reported each year in the Philippines.  When detected, more than half of these cases are already in advanced stages 3 and 4.

There are two early detection strategies for breast cancer: early diagnosis and screening.  “The goal (or early diagnosis) is to increase the proportion of breast cancers identified at an early stage, allowing for more effective treatment to be used and reducing the risks of death from breast cancer,” the WHO says.

On the other hand, screening consists of testing women to identify cancers before any symptoms appear.  “Various methods have been evaluated as breast cancer screening tools, including mammography, clinical breast exam and breast self-exam,” the United Nations health agency adds.

“We highly recommend women to undergo breast cancer screening when they reach the age of 40 because breast cancer is very curable at the early stages,” Dr. Lim was quoted as saying.  “The 5-year relative survival rate of a person with stage 1 cancer is at 100%.  However, if a patient is diagnosed with stage 3 or stage 4 cancer, the survival rate is significantly lower.”

Breast self-examination (BSE) is a method to detect any noticeable changes in one’s breast.  “Early detection of any changes in the breast and seeking immediate consultation will increase one’s chances of successful treatment,” the health department points out.

“We urge women to regularly to self-breast examination and immediately visit the nearest health center should they notice any cause for concern,” Health Secretary Francisco T. Duque III recommends. “Our health care professionals have the confidence to perform breast screening.  For those who are already diagnosed with the disease, we encourage to get treated at DOH hospitals and receive holistic care through advocacy groups.”

Dr. Bill Ramos, vice president of the Philippine Society of Medical Oncology (PSMO), said there are four key factors that need to be in place for patients to be treated successfully. In a Health and Lifestyle feature, he discussed these key factors as follows:

“(The key factors) include disease awareness, because disease and symptoms are essential for screening and early detection; healthcare capacity, since well-trained teams are needed to work together with the right equipment to provide the best chances for patients; diagnosis of the disease, as it can be complex, but is vital to ensuring the right treatment choice; and government intervention, since this is necessary to improve the provision of access and quality healthcare.”

As for treatment, Dr. Ramos said there are multiple therapies available to patients, depending on their type and stage of cancer.  “Current treatments include surgery, radiotherapy, chemotherapy, hormonal therapy, and targeted therapy,” he reckoned. 

Personalized healthcare, he added, is also important to choose the right patient for the right treatment.  “It is always best to consult a physician or healthcare professional,” he pointed out.

It wasn’t decades later that her daughter, actress Isabella Rossellini, revealed to the world the anguish and suffering the family seeing their mother, Ingrid Berman, succumbing to the pain of the disease.  “Mama suffered from breast cancer for nine years and the last three years, when my brother and sisters took turns to be with her in London, were very difficult,” she was quoted as saying by Telegraph.  “The cancer had spread to her lymph nodes; she had an enormous (tumor on her) right arm and was very depressed with the fear of being unable to act.” – ###

(Photos taken from the net)