Second chance for survivors
BREAST cancer is a disease that can be detected and treated early – despite this, it is the most prevalent cancer among Malaysians. The Health Ministry projects that one in 19 Malaysian women have a lifetime risk of developing breast cancer.
Patients can go on to outlive the cancer, especially those whose cancers are detected in the first stage. According to Dr Chong Kwang Jeat, resident radiotherapy and oncology consultant at Mahkota Medical Centre Malacca, survival rates are improving thanks to increased awareness, early detection and better access to treatments.
He emphasises the importance of reaching out to educate women, especially in rural areas, since quality healthcare is still largely an urban fixture.
“Besides doctors and professionals, the media plays a large part in spreading awareness to rural communities,” says Dr Chong.
A clear example of this is the case of Angelina Jolie’s preventive double mastectomy. In the months after the New York Times published her piece explaining this choice back in 2013, doctors in Austria, Australia and Britain reported a spike in risk- reducing mastectomies and gene testing enquiries following extensive media coverage on the topic.
The influence of her celebrity on the public health issue was undeniable. British health services wrote in the journal Breast Cancer Research that hearing about the first- hand experience of someone so glamorous and famous “may have lessened patients’ fears about a loss of sexual identity post preventive surgery and encouraged those not previously engaged with health services to consider genetic testing”.
Invisible scars
For women around the world, the idea of losing any body part to a disease can be an upsetting one.
Besides the physical side effects, undergoing a mastectomy can put women through emotional and mental strains. It is not uncommon for women to feel a loss of selfesteem and sense of worth as a result of a distorted self- image.
“It impacts a woman’s femininity and sexuality – not just the physical aspect but the psychological confidence of a woman, which is derived from her self- perceived attractiveness and confidence in intimacy,” says Dr Saunthari Somasundaram, president and medical director of National Cancer Society Malaysia ( NCSM).
For many, the support of family and friends, especially a partner, is crucial in surviving this period. Many women feel personally responsible for their condition, and begin to entertain thoughts that they are less worthy of being loved.
“Partners need to be supportive both physically and emotionally. Women need to know that their spouse’s love for them transcends their physicality,” says Dr Saunthari.
As a breast cancer survivor, 43- year- old Lizz Khalid can relate to this situation. “Initially, I did worry that my husband would leave me but he ended up playing a huge part in helping me regain my confidence after the mastectomy with his continuous affection, care and love,” she shares.
Lizz underwent a mastectomy after finding a lump in her breast in 2008. She admits initially going through a denial stage, but wasted no time in seeking the best surgeon, oncologist and treatments. “It was two months before I finally decided to go on with the mastectomy, following the advice of three different doctors,” she says.
Lizz opted to wear a prosthesis after her surgery, a decision that her husband also supported. She says her journey with breast cancer has made her stronger, and taught her to stay positive with the mindset that life will be better postmastectomy.
“Seven years on, I can gladly say I still feel confident. With the help of the prosthetic breast, I look and feel the same and can still enjoy life to the fullest,” she says.
A personal choice
Reconstructive surgery and prostheses are modern- day developments of medical technology that improve the quality of life for breast cancer patients after mastectomy. According to Dr Saunthari, Malaysian women who undergo mastectomy are now more likely to receive prosthetic aid from the Government and non- government organisations ( NGOs).
“Lower costs, greater awareness and accessibility as well as the use of less invasive techniques have helped women get over the fear of surgery and the after effects of reconstruction,” she says.
The main drawback for many women is the cost of reconstruction. However, it is reassuring to have the National Population and Family Development Board ( commonly known as its Bahasa Malaysia acronym, LPPKN) offer a free set of prosthesis and two bras for breast cancer patients under certain terms.
It is interesting to note that some women do not find reconstructive surgery an important part of breast cancer treatment. For 67- year- old Vivien Boey, for example, all that mattered was the restoration of her health and well- being.
“I did not find reconstruction surgery or prosthesis necessary as long as I was able to live on. I just wanted to have my operation done as fast as possible knowing that both breasts had cancerous lumps,” she says.
Boey underwent a double mastectomy with follow- up treatments involving chemotherapy and radiotherapy, which took a toll on her mental and physical well- being.
With support from her doctor and family, she is now able to live healthy and happy while watching her grandchildren grow up.