- Contributed
A woman receives her mammogram.
Avia Ustanny, Freelance Writer
A LUMP. A bloody discharge. A discoloured nipple. Rashes. Orange peel skin.
A mammogram which discloses an unwelcome abnormality.
For those who have been there, any or all of these signs of cancer of the breast was the start of a radical change in their lives. But it was not the end. This week in Outlook, we examine in detail the consequences of a breast cancer diagnosis and look at the methods and results of treatment. With so many treatment options, it is no longer necessary to go into terminal shock when you find out that you have the abnormality.
Cancer surgeon, Dr. Derrick Mitchell; pathologist Dr. Gillian Warfe; and radiation oncologist, Dr. Venslow Greaves discuss these issues with us.
According to Dr. Greaves, the probability, as one ages, of getting cancer increases appreciably. It would do women well to be more accepting and watchful of the condition. The real deal of women who get cancer in the western world is as follows:
Age Ratio
30 - 1 in 2212 60 - 1 in 23
40 - 1 in 235 70 - 1 in 14
50 - 1 in 54 80 - 1 in 10
"A lot of women are not being educated to believe that they are that susceptible. Seventy per cent of those who do get cancer are spontaneous occurrences. They have no family history of the disease at all. Any woman is potentially at risk."
The oncologist also notes that locally, a third of women with the disease are in the intermediate stage and one third are in the advanced or metastatic stage. The remaining number fall into a special group whose chances of successful treatment are much reduced.
He advises that because breast cancer and prostate cancer are so common in this part of the world, regular self-examinations have to be carried out by individuals, their spouses and their doctors. They should be concerned about any or all symptoms, including painful or painless lumps, a nipple discharge and/or lumps under the armpit.
A small lump may mean that cancer is present in its early stage. In stage two, the disease will have spread to the lymph nodes under the arm. In stage three a large tumour is present that involves the node under the arm. The nodes are now fixed and no longer movable. In stage four, cancer will have metastasised and spread, going to nodes at the base of the neck and/or other organs.
Diagnosis and treatment may involve surgery, systemic treatment (chemotherapy and hormonal therapy) and/or radiotherapy.
It is up to the patient to aid his or her doctor to act swiftly to rein in the effects of the disease. Even in the worst cases, proper management will ensure a reasonable quality of life. Having cancer is not the end of the world.
Getting necessary support
SOME OF the most common symptoms associated with breast cancer and its treatment are fatigue, nausea, and pain. Difficult emotions, such as shock, anger, fear, and denial may also make their presence felt. Before beginning any course of treatment, try to learn as much as you can about the different treatment options available and talk to your doctor and other healthcare professionals about all the possible alternatives. The Jamaica Cancer Society provides support and information in the effort to control and prevent cancer in Jamaica, also providing diagnostic services at a subsidised rate.
Ongoing programmes include:
Cancer screening programmes for breast, cervical and prostate cancers and related clinic services
Mobile screening for breast and cervical cancers
National health promotion and public health awareness campaigns
Counselling and support for cancer survivors and their families.
The JCA has erected the Hope Institute a 32-bed hospital on lands in the vicinity of the University Hospital. The function of the institute is to provide cancer treatment in conjunction with the Oncology department of the Kingston Public Hospital and the University Hospital. They also continue to lobby for increased aid to those affected by cancer. The achievements of the cancer society in the past include the creation of a special wing at the University Hospital for the treatment and rehabilitation of cases of recurrent and advanced cancer in 1972. Cancer screening is now carried out by the JCA at its headquarters in Kingston and five branches island-wide.
Empirical evidence suggests that people, who have had cancer, live longer after diagnosis, if they belong to a support group. The local support group Jamaica Reach to Recovery was created in 1977. Reach is a voluntary group of mostly breast cancer survivors and friends a subsidiary of the Jamaica Cancer Society. Their goals have been to increase public awareness and to inform that early detection does save lives. They offer support to breast cancer survivors, their families and friends. The group is also active in providing funds for research. Group members are available to each other through telephone and personal visits. They share and teach each other the coping skills and strategies developed in dealing with emotions, feelings from the illness itself and from the treatment protocol (chemotherapy, radiation etc.) prescribed by the doctors.
Reach volunteers visit and counsel newly diagnosed breast cancer patients in their homes and in hospitals, leaving with then educational material. Group members also demonstrate the exercises necessary for the regaining of flexibility in the arm that is affected by surgery. Reach also provides, free of cost, temporary breast padding for those who have had mastectomies to wear until the swelling recedes and they can then be fitted with a permanent breast forms. As part of the effort to make women feel whole and well again, they import these breast forms and special bras which are sold at cost to persons needing them. Reach to Recovery can be reached through the Jamaica Cancer Society.
