How to prevent breast cancer

Health experts have urged Nigerians, especially women, to be mindful of the factors that cause the ailment, which is said to be a disease of the genes. Some of these factors include lifestyle, exposure to some chemicals and radiations, heredity and some viruses, all of which can trigger changes in a cell’s genes.

Breast cancer is one of the most common in Nigeria, and often occurs in women, although men can also develop the ailment. Some of the common symptoms of breast cancer may include a lump in the breast, bloody discharge from the nipple and changes in the shape, size or texture of the nipple. Metastatic breast cancer, also known as Stage four or advanced breast cancer, is one that has spread beyond the breast and nearby lymph nodes to other parts of the body; most often the bones, lungs, liver or brain.

Executive Director, CancerAware Nigeria, an NGO based in Lagos, Tolulope Falowo, explained that breast cancer is not a death sentence.

She said: “The important thing is early detection with the right treatment. Women should check their breasts regularly. And if you see anything unusual, go to the hospital immediately. If you are not satisfied with a particular hospital/clinic, get a second opinion.

“There is a rise in the cases of cancer in Nigeria, especially breast and cervical cancer. Most of these cases are present at the hospital at the advanced stage. There is a huge disparity in the area of cancer care in Nigeria. Indigent and low-income individuals facing a cancer diagnosis in the country usually do not have good outcomes. There are several reasons for this. These include poverty, ignorance, cultural beliefs, inadequate referral systems, inadequate diagnosis, fear of diagnosis, ill-trained health workers, lack of national cancer screening programmes and a dearth of well-equipped treatment centres, among others.

“Also, there is no national cancer screening programme to help with prevention and early detection of such common cancers as breast and cervical cancer. There are inadequate funding resources available to help patients with the huge costs of cancer treatment. So, many people are left on their own with no succour.”

She explained that all hands must be on deck to reduce the incidence and fatalities from cancer in the country, as the ailment does not discriminate.

“We must be aware of the risk factors for common cancers,” she said. “The awareness and information drive must reach every nook and cranny of the country. But it must not end at just awareness; action must follow. Women must do regular breast checks monthly and annually. Women aged 40 and above should have mammogram screening every year. If there is a history of breast cancer in the family, you should speak to your doctor about starting personalised breast cancer screening earlier.”

She stated that to address the lack of information and knowledge around metastatic breast cancer, CancerAware Nigeria and a group of oncology professionals in the country developed the MobiPINK Metastatic Breast Cancer Project in 2019. The project is supported by the Union for International Cancer Control (UICC).

She said: “The goal of the project is to deliver better outcome for both metastatic breast cancer patients and their caregivers, by providing information and support for treatment navigation and care to them, thereby improving the quality of life of patients in addition to providing resources and support for their caregivers in the course of the patient’s treatment journey.

“Cancer cells can break away from the original tumour in the breast and travel to other parts of the body through the bloodstream or the lymphatic system, which is a large network of nodes and vessels that works to remove bacteria, viruses, and cellular waste products. And though metastatic breast cancer spreads to another part of the body, it is still breast cancer and treated as such. Breast cancer can come back in another part of the body months or years after the original diagnosis and treatment. Nearly 30 per cent of women diagnosed with early-stage breast cancer will develop metastatic disease. Some people have metastatic breast cancer, when they are first diagnosed. This means that the cancer in the breast was not detected before it spread to another part of the body.

“In Nigeria, about 50 per cent of women who develop breast cancer present with Stage four metastatic disease at diagnosis. Dealing with metastatic breast cancer presents many challenges for the person diagnosed, the caregiver and the medical team”.

Dr. Modupe Akinyinka, Senior lecturer and Consultant Public Health Physician at the Department of Community Health and Primary Health Care Lagos State University College of Medicine (LASUCOM), said men are more prone to prostrate cancer, while breast cancer is common in women. However, only one out of 100 men develops breast cancer.

She said: “Among women, the commonest are breast cancer, cervical cancer, ovarian cancer and vaginal cancer, among others. We advise that men under 40 years go for prostrate specific antigen (PSA) cancer screening, because between the age of 40 and 50, the chances of having prostrate cancer is high. And when a person tested positive, he should try to see a doctor for treatment.”

She explained that treatments include radiotherapy, chemotherapy and surgery, among others. And there are specialists in all these fields, though there might be challenge of inadequate equipment in hospitals.

She said: “Because people cannot afford cancer treatments, the National Health Insurance Scheme (NHIS) should cover the cost of some of these drugs. Therefore, government should try to implement NHIS to reduce cost of treatments.

“We encourage non-governmental organisations (NGOs), which have been very supportive, to donate drugs and cash gifts to patients. We also advise people that, as they grow older, they should eat balanced diets, avoid red meat, reduce intake of alcoholic beverages and smoking.

“There are also occupational hazards, which we advise people to avoid. These include chemical industries, among others. Exposure to these chemicals leads to having one cancer or the other and people need to be protected.

“People should educate themselves and others about the link between certain lifestyle behaviours, including smoking, poor diet, and lack of physical activity and cancer risk. They should also dispel rumours and myths that lead to stigma and discrimination against people with cancer in some communities. Government should also encourage schools and workplaces to implement nutrition, physical activity, and no smoking policies that help people adopt healthy habits for life.”