“Awareness is crucial,” said Baral, former medical director of Bhaktapur Cancer Hospital, adding that the number of patients suffering from breast cancer has been rising. [break]According to Bhaktapur Cancer Hospital, the number of patients during the past three years have soared from 225 during 1999 and 2003 to 381 during 2007 and 2009.
Dr Bishnu Dutta Paudel, Associate Professor of oncology at Bir Hospital, said breast cancer is one of the common cancers in females in Nepal.
“Because of changes in lifestyle and increased life expectancy, the number of breast cancer [patients] is increasing,” he said.
Although 5-10% of breast cancer could be hereditary, the adaptation of modern lifestyle in the urban areas—the increasing trend of smoking, alcohol consumption and even the use of oral contraceptives – has contributed to developing breast cancer, Baral said. He further stated that women who have had early and late menstrual cycles, unmarried women, or the ones who get married late or have late pregnancies are at more risk of developing breast cancer. Also women who don’t breastfeed could be prone to it.
“Breast cancer is a hormonal disease,” Baral said. “There should be some hormonal changes at a certain age, and in cases that don’t happen, there could be some chances of developing breast cancer in women.”
However, breast cancer isn’t a women-only disease. Though the disease affects 99% of women, 1% of the male population worldwide is affected by it, the oncologist said.
Accordingly, women should self-examine themselves and be aware of lumps in their breast or under arms. Other symptoms may lead to discharge of fluid from the nipple, the change in the skin’s texture, and even retraction of the nipples.
“But all lumps don’t lead to cancer,” he said, citing that more than 92% of the lumps in patients could turn out to be tumors, and the remaining 8% breast cancer.
But when it comes to detecting the disease, prevention, awareness and self-examination plays a crucial role, Paudel said. And while urban areas enjoy facilities like mammography and ultrasonography that helps in the detection of the disease, women in rural areas find about breast cancer only when the situation deteriorates.
To spread awareness about breast cancer in remote areas, non-profit organizations like Nepal Cancer Relief Society (NCRS) and Cancer Council Nepal are taking a lead.
Shakti Gurung, program officer at NCRS, said though cervical cancer is more of a threat to women in remote parts of the country, breast cancer is found in a similar ratio. On a recent awareness campaign in Sindhupalanchowk and Taplejung and other camps, she said the group gathered women to educate them about the disease and the self-examination procedures.
“We’re into prevention,” she said.
Shambhu Prasad Kadariya, President of Cancer Council Nepal, agreed. He said during their camps in remote areas for cervical and breast cancer, the ratio is 10:100. And through a voluntary group of members, the team is mobilized to make women aware. Currently, Kadariya said their efforts are concentrated in Dhading area.
While Baral said that local people should be mobilized in villages so that there is a communal effort in making people aware of breast cancer and other non-communicable diseases, Paudel stressed on national screening programs to detect breast cancer at a stage when it is possible.
“As an oncologist, I’d say nobody should die of breast cancer,” Baral said. “If found at stage zero, cure rate is almost 100%.”
DIY: Breast exam
In the Shower
Fingers flat, move gently over every part of each breast. Use your right hand to examine the left breast, left hand for the right breast. Check for any lump, hard knot, or thickening. Carefully observe any changes in your breasts.
In front of a Mirror
Inspect your breasts with your arms at your sides. Next, raise your arms high overhead.
Look for any changes in the contour of each breast, a swelling, a dimpling of the skin, or changes in the nipples. Then rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women’s breasts do.
Lying Down
Place a pillow under your right shoulder and put your right arm behind your head. With the fingers of your left hand flat, press your right breast gently in small circular motions, moving vertically or in a circular pattern covering the entire breast.
Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.
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