Even though the rate of breast cancer is rising, more effective and targeted treatments give new hope for the afflicted.
Cancer remains an important and significant health problem globally and in Singapore it is responsible for the largest proportion of deaths. The most common cancer in women is breast cancer. Like other cancers, it occurs when normal cells undergo genetic changes and keep on growing without control, spreading to colonise other tissues.
In breast cancer, cancerous cells can affect various parts of the breast, and often cause changes in the skin, bleeding from the nipple and unusual lumps. Vigilance in observing these signs is important as the later the cancer is detected, the more likely it can spread and affect the whole body.
Risk factors and prevention
The highest prevalence of breast cancer is found in women aged 35 to 65. Research has also indicated that those of Chinese descent tend to have a higher incidence compared to the Malay and Indian populations.
DNA and genetics plays a big role in the occurrence of breast cancer. Those with the breast cancer genes BRCA1 and BRCA2 gene have up to 85% lifetime risk of breast cancer and much higher risk of ovarian cancer. Actress Angelina Jolie decided to undergo a double mastectomy after she tested positive for one of the genes. Besides the obvious inheritance of breast cancer genes, having first degree relatives with a history of the disease will also increase the risk of getting breast cancer. Other factors that increase the risk include:
- Age, as overall cancer risk increases with age
- Early onset of menses or menopause
- Previous use of hormone therapy
- Late pregnancy
- Not having children
- Obesity
Besides these risk factors, research has indicated that exercise and a low fat diet can decrease the risk of breast cancer, while a diet high in beta-carotene is also linked with a lower incidence.
New treatment modalities
The good news is that breast cancer, if detected early, has one of the highest rates of cure, reaching more than 90% rate of cure if detected at early Stage 1. More encouragingly, the side effects of chemotherapy are now much less severe because the drugs are given in conjunction with anti-emetics to reduce feelings of nausea. There are also new targeted ways to deliver cancer drugs so these medicines ‘seek out’ and destroy only the cancer cells. Some of these drugs disrupt the cancer’s ability to bind and grow or attack the supply line of blood vessels that feed the cells. Interestingly, some drugs can be disguised so that the cancer cell is fooled into absorbing them. The drug then attacks the cancer cell from within. Better understanding of molecular and cancer genetic signatures have enabled doctors to better personalise treatment of individual molecular subtypes of cancer for individual patients. Very long term control of the disease can now be achieved with patients continuing fully functional and quality lives.
Hope for the future
As we understand cancer better and learn to target it in more focused ways, survival rates will continue to rise. But it is imperative that all women are conscientious about their screening, breast self examination and mammograms. If cancer is spotted, see a doctor and start treatment early. Cancer evolves over time, so there is time for a cure if it is addressed in a timely manner.
For more information, visit Novena Cancer Centre, #09-41, 38 Irrawaddy Road. Singapore 329563. Tel: 6339 0233.
