SHE Carribean Magazine - - CONTENTS - BY DR. CORY COUIL­LARD

Is there a link? We have the facts.

Oc­to­ber is Breast Can­cer Aware­ness Month and there’s no bet­ter way to recog­nise the cause than by ac­tu­ally ad­dress­ing the cause. Genes play a role in breast can­cer but main­tain­ing a healthy body weight and en­gag­ing in reg­u­lar phys­i­cal ac­tiv­ity can pre­vent ap­prox­i­mately 25 per cent of all cases.

On the other hand, only about 5 to 10 per cent of breast can­cer cases are thought to be hered­i­tary or in­her­ited from a par­ent. This is in­creas­ingly im­por­tant in the de­vel­op­ing world as many coun­tries are adopt­ing seden­tary life­styles, eat­ing pro­cessed chem­i­cal-based foods and con­sum­ing or even abus­ing sub­stances such as al­co­hol and to­bacco.

As a re­sult, 69 per cent of all breast can­cer deaths oc­cur in de­vel­op­ing coun­tries, and the majority of cases are di­ag­nosed in late stages. Lack of pub­lic health ed­u­ca­tion, health care ser­vices, and cul­tural in­flu­ences all play a sig­nif­i­cant role in the de­vel­op­ment of breast can­cer.

The prob­lem is there re­ally is a mis­un­der­stand­ing of the role that cul­ture has in the de­vel­op­ment of non-com­mu­ni­ca­ble dis­eases, in­clud­ing breast can­cer. Cul­tural fac­tors of­ten have an in­flu­ence on obe­sity, diet and phys­i­cal ac­tiv­ity trends. For ex­am­ple, in some cul­tures, be­ing over­weight is con­sid­ered to be a sign of wealth and there­fore be­ing obese is a sta­tus sym­bol. In the Caribbean, curves and size have cul­tur­ally been a turn on, to the point where the “roly poly,” i.e. over­weight, even obese, woman has be­come the sex sym­bol of 2014.

How­ever, ex­treme poverty is also as­so­ci­ated with an in­creased risk of obe­sity and its re­lated con­di­tions. The two main rea­sons for this in­clude, firstly, lack of knowl­edge about fit­ness, nu­tri­tion and how to lead a healthy life­style and, se­condly, the higher cost of a healthy diet in­clud­ing fruits and vegetables, which of­ten means that pro­cessed and fast foods are the norm.

The great­est am­pli­fy­ing fac­tors of the obe­sity and can­cer epi­demics have been tech­no­log­i­cal ad­vances and trends to­wards ur­ban­i­sa­tion. Like a per­fect storm of cir­cum­stances, more and more peo­ple work in ‘mod­ern’ jobs with lit­tle phys­i­cal in­put and ram­pant ac­cess to un­healthy take-away foods.

In May 2014, the World Health Or­gan­i­sa­tion stated: “Obe­sity has reached epi­demic proportions glob­ally, with at least 2.8 mil­lion peo­ple dy­ing each year as a re­sult of be­ing over­weight or obese. Once as­so­ci­ated with high-in­come coun­tries, obe­sity is now also preva­lent in low- and mid­dle-in­come coun­tries.” The term “over­weight” is clas­si­fied as hav­ing a Body Mass In­dex (BMI) of more than 25, while “obese” refers to a BMI of 30+.

A re­cent study in the Jour­nal of Clin­i­cal On­col­ogy found obese women to have four times the risk of de­vel­op­ing in­flam­ma­tory breast can­cer. Two-thirds to three-quarters of breast can­cers oc­cur after menopause, the time where women

The great­est am­pli­fy­ing fac­tors of the obe­sity and can­cer epi­demics have been tech­no­log­i­cal ad­vances and trends to­wards ur­ban­i­sa­tion

gain the most weight. Ex­cess fat has been proven to raise lev­els of oe­stro­gen and fuel the de­vel­op­ment of most breast can­cers.

Another hor­mone called in­sulin has also been found to play a sig­nif­i­cant role in the de­vel­op­ment of breast can­cer. Peo­ple who are over­weight can de­velop a con­di­tion called in­sulin re­sis­tance where the body is un­able to use in­sulin and re­sults in its over pro­duc­tion.

Weight con­trol through im­proved diet and phys­i­cal ac­tiv­ity can keep in­sulin and oe­stro­gen at the right lev­els. How much phys­i­cal ac­tiv­ity is needed? As lit­tle as 1.25 to 2.5 hours per week of brisk walk­ing has been found to re­duce a woman’s breast can­cer risk by 18 per cent. Signs of breast can­cer

Ev­ery­one’s breasts look and feel dif­fer­ent, al­ter with age and at dif­fer­ent times of the month. It’s im­por­tant to look­out for changes that are un­usual for you. Common signs of breast can­cer in­clude the fol­low­ing:

Swelling or pain­less lumps in breast tis­sue, of­ten to­wards the nip­ple; thick­en­ing, puck­er­ing or dim­pling of the skin; nip­ples that are ten­der, turned in or pro­duc­ing dis­charge; swelling un­der­neath armpits.

It’s im­por­tant to note that not all lumps are can­cer­ous. Women will ex­pe­ri­ence nor­mal men­strual-re­lated breast changes with their monthly cy­cle that in­cludes swelling, ten­der­ness, nip­ple dis­charge and pain.

Dr Cory Couil­lard is an in­ter­na­tional health colum­nist that works in col­lab­o­ra­tion with the World Health Or­ga­ni­za­tion’s goals of dis­ease preven­tion and global health care ed­u­ca­tion.

Face­book: DrCo­ryCouil­lard Twit­ter: @DrCo­ryCouil­lard

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