BREAST cancer remains the second leading cause of death in women worldwide.
The focus has always been on prevention, survival and cure of this disease. However, metastatic or advanced breast cancer, the most severe stage of the disease, is incurable, which means such patients are often left out of the conversation.
What is especially worrying is the increasing trend of advanced breast cancer among younger women.
Our national statistics on breast cancer indicate that a sharp increase can be seen from the age of 30 onwards, rising steeply, before finally reaching a peak after menopause, which is around the mid-50s.
Beacon Hospital's consultant medical oncologist and visiting oncologist of Avisena Hospital Dr Azura Ahmad, says diagnosis of breast cancer in younger women is challenging due to many reasons.
Younger women tend to have dense breasts which can "hide" cancer during routine screening. Some young women may also choose to disregard symptoms as it may seem improbable to them to have cancer at their age.
"While the diagnosis and treatment of breast cancer is difficult for women of any age, younger patients may find it more overwhelming as they face additional anxiety and stress due to a life-threatening disease occurring in the middle of their personal, professional and reproductive lives."
Dr Azura adds that breast cancer is a serious disease, and any delay in diagnosis poses a real risk of tumour progressing from being curable (with near-normal life expectancy) to non-curable (with very reduced life expectancy).
"Regrettably, it is still common to diagnose breast cancer at an advanced stage in Malaysia."
CHOOSING TREATMENT OPTIONS
Knowing as much as you can about your advanced breast cancer can help you work better with your doctor to optimise treatment.
The makeup of your tumour will help your doctor define your cancer and guide decisions about which treatments are the best. Treatment decision is largely dependent on the cancer subtype, explains Dr Azura, particularly hormone receptor and HER-2 (human epidermal receptor-2) status.
However, cancer research is a rapidly-changing field with expanding treatment options, particularly in areas of targeted drug therapy and immunotherapy, she adds.
"Being younger does not mean more aggressive treatments. There are options for kinder and gentler but more effective treatments which are transforming how we treat breast cancer."
Given the unique psycho-social issues younger women face, they must be guided and supported in a sensitive manner during treatment.
The oncologist will be able to guide them in choosing the appropriate treatment plan while factoring in issues such as side effects management with a focus on quality of life, coping strategies (personal or professional) and linking them to support groups for additional psycho-social support if needed.
Some women may need to continue working while undergoing treatment. Balancing between work and cancer treatment can be tricky. It is important to inform your healthcare team as treatment schedules to minimise the impact of treatment-related side effects can be arranged. Strategies can also be placed to ensure necessary medications such as anti-sickness medications are adequate and tips on helpful lifestyle modifications particularly dietary changes and practical ways to cope. However, expect that you may need to take some time off and make adjustments to your work routine. Your employer with the help of understanding work colleagues can be extremely helpful here.
Also, keep a detailed work journal with a running to-do list. Take detailed notes during meetings and appointments so you're able to remember important details and still manage your workload.
A PATIENT'S STORY
Breast cancer patient Fara Aida Farid was diagnosed with the disease 10 years ago, but instead of conventional medicine, she opted for herbal remedies.
"I couldn't accept my doctor's recommendation to go through chemotherapy. I heard many horror stories about it, and I was influenced by these stories," she says.
By 2014, her cancer had spread. But her oncologist assured her that there was hope to slow down the disease.
"She introduced me to another patient who had done chemotherapy. Her bravery in going through those extraordinary experiences as a cancer patient gave me the courage to walk through my own fears. I finally accepted that I needed to trust this process,"
"Today, although I am on medication, I am a positive person and I look forward to the beauty of my journey. I love horse riding and enjoy being in natural surroundings. I share my perspective with positivism and surround myself with people and gain new knowledge by reading health publications. My advice? Do not give up. Investing in your health is the most significant move you will ever make. You can still lead a good life as a breast cancer warrior. Early detection, regular check-up, and seeking professional medical advice should be a ritual."
WHEN SEEING THE DOCTOR
HOSPITAL visits and treatments can be overwhelming and draining on the patient. Here are some tips to help you navigate the journey.
During A Visit To The Doctor
*Bring someone with you - for emotional support/to keep track of important information.
* Take notes - to better help you understand what the doctor is saying.
*Always ask the doctor to explain using simple words.
Before or After A Visit To The Doctor
*Talk to a nurse/social worker/patient hotline to help you explain what the doctor said.
*Find a breast cancer group in your area to share experiences and resources.
*Write down all side effects from therapy before meeting the doctor so he or she can help you manage them.
*This article was brought to you by Novartis.