BREAST CANCER AWARENESS Stomping out the fear
ACCORDING to the latest cancer survival data from the Health Ministry, the five-year survival rate for breast cancer patients in Malaysia diagnosed between 2007 and 2011 was 61%, which is lower than survival rates reported in high-income countries.
Emeritus Prof Datuk Dr Yip Cheng Har, consultant breast surgeon at Subang Jaya Medical Centre, says that this is because most patients seek medical treatment in hospitals at a more advanced stage of breast cancer, which increases the risk of recurrence.
“The survival of breast cancer patients depends on the stage of diagnosis and access to adequate treatment. There are a lot of times when patients refuse treatment and resort to alternatives before coming back with a later stage of cancer,” explains Dr Yip.
According to her, the risk of recurrence among breast cancer survivors depends mainly on the stage of diagnosis, which is obtained from a pathologist.
Known as prognostic factors, the cancer profile provided by the pathology details the size, grade, stage, subtype and aggressiveness of the patient’s cancer.
The subtype is determined by the proteins present in the breast cancer cells, such as oestrogen receptors, progesterone receptors and human epidermal growth factor receptor 2.
“Every woman has to know her cancer profile as it shows the risks of relapse. If there is a high risk of recurrence, chemotherapy is offered,” adds Dr Yip. She says that there are ways patients can calculate their estimated years of survival. For example, patients can use Predict, an online tool, to calculate their own profiles and risk of recurrence by keying in the diagnostic factors included in the reports given by their pathologists.
Depending on the type of breast cancer, the calculator measures a survivor’s risk of dying according to the optional follow-up treatments sought, such as hormonal therapy, chemotherapy or targeted therapy.
When a survivor has a high risk of recurrence, she will tend to be filled with fear, worry, anxiety and depression. Many people will assume that this higher chance of recurrence is caused by stress experienced by the body and immune system.
However, Dr Yip disagrees with this belief as there are no studies that prove this situation and instead advises people to focus on leading a healthy lifestyle to reduce the risk of recurrence.
She says, “Scientifically speaking, we cannot measure stress, because different people handle stress differently. Some people take a deep breath while some others scream and shout.
“The only factor that has been shown to reduce recurrence in all scientific studies is exercise and not putting on weight. If you put on weight, it is not a good prognostic factor. You must be at an ideal weight.”
Nevertheless, Dr Yip understands that cancer survivors may live in fear of recurrence when trying to move on in life. She recommends that patients visit counsellors or psychologists if they are struggling mentally.
While Malaysia is still lacking in resources for mental health, she presents hope for breast cancer survivors as there is a new form of psychologists called psychooncologists, who are slowly increasing their presence in other countries.
“Psycho-oncologists are not medical doctors like psychiatrists, but psychologists who specialise in cancer patients. They take you through your fears with planned activities and material to support you throughout.
“In this country, people don’t like to see psychiatrists or psychologists because it is a stigma. They do not see the need for that because they have family support, but
Psycho-oncologists are not medical doctors like psychiatrists, but psychologists who specialise in cancer patients. They take you through your fears with planned activities and material to support you throughout.
sometimes, what they are going through can be stressful to the family as well,” she says.
For patients who prefer help within a community, aftercare support is provided by hospitals or non-governmental organisations.
With adequate education, mental support and connection with peers who share similar experiences, there is no need for breast cancer survivors to live in fear.
For more information, call 03-5639 1212.