Years of pink-themed campaigns, community outreach and awareness walks complete with fun and merriment have heralded some progress in breast cancer indices in Nigeria. However, more needs to be done as the number of women who get appropriate care remains dismally low. In the first place, there are an urgent need to ensure fewer women get breast cancer in the first place.
Breast cancer in numbers
Currently, no other cancer is more common in women around the world. Even as this disease claims the lives of thousands of women each year, the possibility of men getting is still largely unrecognized.
In 2018, there were 26, 310 new cases of breast cancer in Nigeria according to Globocan ( a project of the International Agency for Research on Cancer) with 11, 564 deaths from it recorded in the same year.
From a global perspective, it is estimated that around the world, 42 cases of breast cancer occurred in 2018 per 100, 000 people while 19 lives were lost to it per 100, 000 people.
Risk factors for Nigerian women
The race is an important factor in determining who gets breast cancer and who dies from it. Black women are more likely to die from breast cancer even in places where the chances of getting stares the same across races. This is partly due to the fact that black women get diagnosed later than other groups, and will likely get treatment later than other women. The presence of other disease conditions like obesity and the type of breast cancer found in them also contribute to the lower survival rates among black women.
General risk factors are
Increasing age - the older a woman is, the greater her risk of getting breast cancer.
Family history - having a close relative who has this disease is a strong risk factor.
Weight-- being overweight is associated with a high risk of breast cancer, especially after menopause.
Not getting enough exercise i. e. at least 50 minutes of physical activity 5 times a week.
Diets poor in vegetables and fruits and high in unhealthy fats, sugars, processed and smoked food.
Being exposed to oestrogen from hormone replacement therapy for example.
Symptoms and complications
The following symptoms should raise the suspicion of breast cancer and need to be reported to a doctor as soon as possible.
Lumps - which may be painful or painless. They could feel hard or soft, smooth or with irregular edges.
Colour changes: this includes any abnormal colour change like redness of the nipple, areola (darker areas between the nipple and the remaining part of the breast) and other parts o the breast.
Inward turning of the nipple known as nipple retraction.
Orange peel appearance where the skin of the breast becomes pitted like the outer skin of an orange.
Other swellings of the breast or parts of it.
Pain in the breast or nipple
Discharge from the nipple which is not breast milk in a breastfeeding mother.
-Swelling of the lymph nodes in the armpit.
-All of the symptoms above can be picked up by a woman when she examines her breasts regularly except the lymph node swelling that is identified by a doctor.
-When left untreated or undiagnosed, breast cancer spreads to other areas of the body. The common organs these cancer cells go to are the brain, lungs, liver and the brain.
-Depending on the cancer type, the spread pattern and the form of treatment being used, there could be other complications. Primary among these is pain. The pain from breast cancer is intense and is often described as sharp. This is due to the pressure of the abnormal growth of different organs and internal structures in the body.
changes in vision, memory and behaviour from brain damage,
breathing problems from damage to the lungs,
jaundice (yellow discolouration) from liver damage.
Prevention and Treatment
Prevention starts with adequate awareness. Getting accurate information about the disease has helped to reduce the number of cases. Eating a balanced diet, avoiding smoking, cutting back on alcohol and junk food, doing regular check-ups and breastfeeding are among lifestyle choices that reduce the chances of getting this cancer.
Mammography is a breast scan which has been shown to detect cases at an early stage when treatment can. If you are over 45years, you should book an annual mammogram with your doctor
Another form of screening is the clinical breast examination. CBEs involve a skilled health worker examining the breasts and surrounding areas for lumps and other abnormalities.
Making screening available for women across the board is a crucial step to reducing the number of women who get breast cancer.
The self-breast examination is a key aspect of screening as women sometimes get to pick up early signs while checking their own breast at home. To avoid confusion with the lump-like changes in the breasts that come with the monthly cycle, it is advised to check the breasts 3-5 days after your period starts and to do it at the same time each month. To examine the left breast,
-Put your left arm behind your head and gently press down in circular or outward motions to check every part of the breast for lumps.
-Inspect for any colour or texture changes.
-Next, sit up and feel for lumps in the armpit on that side, then squeeze the nipple for any abnormal discharge.
-Repeat the same for the other breast.
Read more about the self-breast examination here
If you notice any of these things, please visit a doctor immediately.
Treatment is taken care of by a team of specialists made up of oncologists, surgeons, radiologists, psychologists, social workers and other medical experts as they are all needed. The success of treatment depends on how early it was diagnosed, how early treatment was commenced, the presence of other existing diseases, having adequate funds for treatment, access to quality healthcare, compliance with treatment modalities and the type of cancer.
Many breast cancer survivors exist and they lead the awareness efforts for early detection, prevention and treatment. Women who have had a cancerous breast removed can be assisted to get back to their normal life with adequate support and prosthetics.
How men can help
In many low and middle-income countries, men remain the primary decision-makers for women's health. As such, little progress can be made in treatment and prevention without involving them. It is thus imperative for us all men and women alike to get involved in stemming the tide of this disease.
Ways in which men can help include
-Reminding their female relatives, acquaintances, friends, colleagues and social media followers to go for screening regularly.
-They can support breast cancer campaigns by sharing information about awareness and screening programmes.
-Male heads of households need to support their wives who get a cancer diagnosis. This includes financial support in settings where the woman has no economic support of her own and being involved in the care. The wider dependence on out-of-pocket payments and a lack of health insurance bodes ill for women who do not have a source of income.
-It could be agonizing and scary news for the entire family with many women experiencing neglect or outright abandonment on the part of their husbands and other male relatives who have the financial resources to get treatment for them. Therefore, these men need to be supported psychologically and educated. Support groups could be set up to share experiences and coping mechanisms.
-They also need to take cognizance of the fact that men do get breast cancer too (even if at a lower rate than women) and it could turn fatal if left untreated or is detected too late. They must be included in campaign efforts not only for the sake of women but for their own benefit.
Minimizing the burden of breast cancer is dependent on all of our efforts as it affects us all in the end.