World over, the month of October is known as the month for creating buzz and awareness for breast cancer. In an interview with The Guardian, Dr. Matth
World over, the month of October is known as the month for creating buzz and awareness for breast cancer. In an interview with The Guardian, Dr. Matthew Obinna Nwaneri an Associate Professor at Carver College of Medicine and Medical Director, Iowa Oncology Network, medical oncologist at the University of Iowa Health Care (UIHC) speaks on the need for people, especially women to pay attention to their breasts alongside their general wellness.
What is responsible for breast cancer in women?
Breast cancer is the abnormal growth of cells in the breasts. Just as cancer is the abnormal growth of cells in the body; and this can occur in any part of the body, whether bone, brain, skin, breasts, bladder. All the tissues in the body can develop cancer. It is due to uncontrolled/abnormal cell growth. Breast cancer occurs in men (with worse outcomes due to delay in getting medical care). Women have more breast tissue than men; breast cancer ratio is about 100 in women, 1 in men (100:1).
How is breast cancer discovered, diagnosed and treated?
We have three main ways to treat diagnosed breast cancer – chemotherapy, surgery, and radiation. Most women find a breast mass, which is then reviewed with a mammogram and a breast ultrasound. The best way today (as of October 2019) is to first take a very small piece of the breast mass, called a Tru-Cut biopsy. This is evaluated in the laboratory to determine the best treatment options to use. The testing is expensive but is the most important part of the treatment because it tells the doctors the best treatments to use and is used to plan for this. Then for most of my patients, we now recommend giving chemotherapy first to shrink the breast mass so that the surgery (to remove the breast mass) will be easier and much easier to perform. Many surgeons, some of whom are not breast expert surgeons, frighten women to go to surgery first. This is wrong. Any woman or man diagnosed with breast cancer should spend time and money to get a second opinion from an academic (university) centre or a specialist medical centre – even if you will eventually see your regular doctor. This will give you the whole picture and a different perspective of the treatments. It is not an easy thing to have your breast cut off. It is also always good to go with trusted and objective people to see the doctors (good friend, close relative or most importantly, your spouse). Take many notes on all the visits, ask questions, and do your homework.
Are there natural/alternative remedies to tackling breast cancer besides chemotherapy?
Beyond chemotherapy, there are several current biological or targeted therapies (also technically chemotherapy), which have much fewer side effects and hormonal therapies (which still have fewer side effects). The best option I know is that there are many different types of chemicals used, which are generally called chemotherapy – chemical therapy. Most people associate chemotherapy with medicines that cause hair loss and low blood counts, however, chemical therapy is a very general term. There is always a lot of fear associated with chemotherapy, but these medications have changed the outlook for millions of breast cancer patients and survivors today. The term chemotherapy includes your commonly used Panadol, ibuprofen and even multivitamins. There are many alternative therapies, and many are undergoing clinical trials today. Once these have been tested, proved that they work, they are then approved by such organizations like NAFDAC in Nigeria and the Food and Drug Administration (FDA) in the USA. These are then available for general sale and use by the general public. Many people sell all sorts of concoctions/supplements of no proven value. The only thing common about these supplements and varied preparations is that they are not free. They should be bought with caution and carefully assessed before use. It is also best to review these with your doctors before using them. If you cannot discuss these with your doctors then look for doctors you can trust and be truthful with, this is your life.
Breast cancer is the second leading cause of death in women, is there any other form of cancer people should be wary about?
Worldwide, lung cancer kills more women, that is why breast cancer is number two. In Nigeria, cervical cancer is also very common. This can be prevented with immunisation with Gardasil 9. This immunisation is 99 per cent effective for all females and males aged: 9 to 45 years and requires two doses given 6 months apart. Immunisation for Hepatitis B – 3 doses; is also very protective for liver cancer.
You talked about getting proper medical care from a specialist even as cancer treatment doesn’t come cheap, what is the way out?
I agree that this is not cheap. However, I remain of the opinion that any woman or man diagnosed with breast cancer, or any cancer, should spend time and the money to get a second opinion from an academic (university) centre or a specialist medical centre – even if they will eventually see their regular doctor. It is a life and death matter. A cancer diagnosis may be the time to get the best care you can afford. There should be no excuses or regrets for not getting your best care possible. Breast cancer screening should start at age 40 years for most women. All women should perform breast self-examinations periodically, at least monthly annual physical examination by a health care professional properly trained on how to examine and detect abnormalities in the breasts – nurse, midwife, nurse practitioner, medical doctor for women with an average breast cancer risk and who can afford it, a mammogram should be done annually starting at age 40. After 15 years of normal examinations or age 55, consider doing the mammogram every other year, based on discussion with your health care provider. Women with a first or second degree relative with breast cancer should start screening at least 10 years before the relative’s age of diagnosis. For example, if the relative was diagnosed at age 45, start screening at age 35. There are no standard breast cancer screening recommendations for men. Your healthcare provider should check out any abnormality immediately, at any age.
