Breast cancer: The most common cancer among Jamaican women
Sheray N. Chin, Contributor
Cancer is a major national health concern, with significant impact on human and economic resources. In fact, cancer is the leading cause of death in Jamaica, and breast cancer is the most common cancer among Jamaican women.
Breast cancer is a devastating diagnosis for the significant number of Jamaican women diagnosed with this disease each year. In Kingston and St Andrew alone, 720 women were diagnosed over the five-year period ending in 2007.
Breast cancer not only brings the personal trauma of a serious diagnosis, but also impacts the families of these women. Despite a known association with advancing age, this cancer has increasingly been affecting younger women, many of whom have young children who they provide and care for. Breast cancer, therefore, not only has significant economic implications (exhaustion of limited health-care resources, loss of productivity) but also social implications (loss of mothers, with negative impact on social structure) for the country.
Modern cancer treatment is costly, requiring significant budgetary allocation, and indeed cancer chemotherapy drugs account for a significant proportion of the National Health Fund expenditure. Breast-cancer treatment usually involves surgery, systemic therapy, and in some cases radiation therapy.
There are many obstacles to the optimum management of Jamaican women with breast cancer. Chemotherapy (recommended for the majority of cases diagnosed) and other systemic therapies, which may extend for several years, are expensive.
Many drugs are simply unaffordable to the majority of women who require them to improve the chance of cure. Radiation therapy facilities are limited, and waiting times for treatment can be prolonged beyond the times recommended to reduce the risk of recurrences and improve survival.
Effective treatment is Available
The good news is that despite these difficulties that must be addressed, effective treatment is available, and most women who present with early-stage breast cancer can be cured of their disease. Treatment of advanced breast cancer is more difficult and also more expensive than treatment at an earlier stage. Early detection of breast-cancer must, therefore, be a national priority.
While we address the challenges creating barriers to optimal care in breast cancer, we must also pay attention to breast-cancer research. We must focus on our unique situation, in an effort to understand the biology of breast cancer in Jamaican women, and try to further improve outcomes.
It is known that in populations of African descent, breast cancer tends to be more aggressive, affecting younger women and causing more deaths. There is no local data on whether Jamaican women have a similar response to therapy as North American women, and it is only in studying these disease characteristics that we can make strides not only to improve our knowledge about breast cancer in an Afrocentric population such as ours, but also use this in a meaningful way to improve the chance of cure in our affected women.
In addition to early detection, many women ask about preventing breast cancer altogether. There are no known ways to reduce the risk to zero; however, lifestyle factors such as regular physical exercise, maintaining a healthy diet, and losing excessive body weight have been shown to reduce the risk of many types of cancer, and in fact can decrease the risk of cancer recurrence in a woman who has been treated for breast cancer.
Prevention in cancer is truly better than cure. Unfortunately, however, the reality is that many women who do all the right things may still develop breast cancer. Early detection and effective, timely treatment are, therefore, key.
Dr Sheray N. Chin is a consultant in medical oncology and internal medicine at the University Hospital of the West Indies and a lecturer at the University of the West Indies