Every year in October, the world joins hands to raise awareness of breast cancer. This year's theme is 'Keeping Her in the Picture', a plea for everyone to keep an eye on the well-being of the important women in their lives.
Dr Catherine Nyongesa, Clinical/Radiation Oncologist says: "October being Breast Cancer Awareness Month, we need to raise awareness and promote early detection of this common and potentially life-threatening disease.
This month we are using the memorable slogan 'Pink Together, Stronger Forever' to emphasise the strength that comes from unity and collective action, with the Pink Ribbon Run to show support.
"In 2020, there will be 2.3 million women diagnosed with breast cancer and over 685,000 deaths worldwide, as by the end of 2020, there will be 7.8 million women alive who have been diagnosed with breast cancer in the last 5 years, making it the world's most common cancer," according to the World Health Organization (WHO).
Back home, the Ministry of Health (MoH) says that breast cancer is the second leading cause of all cancer deaths.
"Breast cancer accounts for over 3107 deaths, making it the second leading cause of all cancer deaths in the country, contributing to 12.5 per cent of the total cancer burden," according to the Ministry of Health (MoH).
According to Globocan 2018 statistics, the incidence of breast cancer in Kenya is estimated at 40.3 per 100,000, with a mortality rate of 17.8 per 100,000. The annual incidence of breast cancer in Kenya is approximately 12.5 per cent of new cancer cases and the annual mortality is approximately 7.7 per cent of all cancer deaths.
According to this Globocan 2018 report, the annual incidence of breast cancer is projected to increase by 35 per cent and the annual mortality for both is projected to increase by 35 per cent.
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The radiation oncologist begins by explaining that there are no specific causes of breast cancer, although he does outline some of the factors that can lead to breast cancer.
"Breast cancer does not have a single, specific cause, but several factors can contribute to its development. These include genetic mutations (such as BRCA1 and BRCA2), hormonal factors (such as exposure to oestrogen), family history, age and lifestyle factors such as obesity and alcohol consumption". Says Dr Catherine Nyongesa, clinical/radiation oncologist.
She goes on to explain that breast cancer can manifest itself in a variety of ways and that recognising early warning signs is also very important for timely intervention.
"When one experiences the development of a lump in the breast or underarm, which is a hard, painless lump or thickening is often the first sign, another is the changes in breast size or shape, these are noticeable changes or asymmetry between the breasts. Unexplained pain, that's persistent pain in the breast or nipple area, with also skin changes, that's redness, dimpling or puckering of the breast skin, finally when you have nipple discharge that's not breast milk and it's incredibly bloody". Dr Catherine Nyongesa explains.
She says that men can also develop breast cancer and it is very important to be aware of this and to take preventative measures.
"Contrary to a common misconception, men can get breast cancer. Although it's much less common in men than in women, it's important to be aware. Approximately 1 in 833 men will be diagnosed with breast cancer in their lifetime, accounting for about 1% of all breast cancer cases". explains the radiation oncologist.
Understanding the risk factors can help individuals take proactive steps to reduce their risk of developing breast cancer.
"The risk increases with age, with most cases occurring in women over 50, family history of breast cancer can increase the risk, and finally certain genetic mutations, such as BRCA1 and BRCA2, increase susceptibility." Says Dr Catherine Nyongesa She adds that hormone replacement therapy, which is the long-term use of oestrogen and progesterone hormone therapy, obesity, which is excess body weight, and excessive alcohol consumption and smoking can contribute to breast.
Dr Catherine Nyongesa explains that maintaining a healthy lifestyle, considering genetic testing if you have a family history, limiting alcohol intake avoiding smoking and finally regular exercise and a balanced diet with maintaining a healthy weight are some of the ways to reduce the risk of breast cancer.
"There are different types of breast cancer, the most common being invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC). Other types include ductal carcinoma in situ (DCIS), inflammatory breast cancer (IBC) and triple-negative breast cancer, each of which requires specific treatment approaches". explains Dr Catherine Nyongesa, clinical/radiation oncologist.
She concludes by explaining the stages of breast cancer, which help to determine the extent of the disease and guide treatment decisions.
"Stages range from 0 to IV, with 0 being non-invasive (DCIS) and IV indicating advanced cancer that may have spread to other parts of the body.
In conclusion, understanding the causes, symptoms, risk factors and types of breast cancer is crucial for early detection and effective treatment. Breast Cancer Awareness Month is a reminder to prioritise regular screening, spread awareness and support ongoing research to combat this disease. Together, we can make a difference in the fight against breast cancer. Concludes Dr Catherine Nyongesa, Clinical/Radiation Oncologist
Dr Daniel Ojuka, Breast Oncoplastic Surgeon, begins by explaining the treatment options, which he says depend on the stage and type of breast cancer, giving each a different approach in its treatment processes and options.
"Surgery can involve the whole breast or part of the breast that has a tumour. It can leave the skin with the nipple or the whole skin, or it can remove most of the skin. This skin-sparing is mainly done when you want to reconstruct immediately. says Dr Daniel Ojuka, a breast oncoplastic surgeon.
He says the second treatment option is chemotherapy, which can be given before or after surgery, again depending on the type and stage of breast cancer.
"Radiotherapy is usually given after surgery and chemotherapy, it may be omitted depending on the stage and type. It is usually omitted in early breast cancer unless only part of the breast is removed in surgery, it can be given in a number of ways including during surgery and can be given over 5 weeks, three weeks or one week". The breast oncoplastic surgeon adds.
Dr Daniel Ojuka explains that "hormone therapy is given when you have over-expression of a hormone receptor, usually oestrogen. The type of drug depends on whether you still have periods or not. Can be given for 5 or 10 years, and finally, the targeted therapy immunotherapy, which usually depends on overexpression of growth factors or other factors."
"Some of the side effects of radiotherapy are immediate, burns and fatigue are the most common side effects that patients have to deal with."
"Long-term cancer can also metastasise and affect other organs in the immediate area such as bones, lungs, and heart, on the other hand, chemotherapy, and immunotherapy usually come with side effects such as vomiting, diarrhoea and being prone to anaemia and recurrent infections." Dr Daniel Ojuka explains.
He goes on to explain that surgery can also lead to bleeding, haematoma formation, seroma formation, especially where the new tissue and dead tissue flap off, and finally hormone therapy, where there is an increased risk of blood clotting and stroke.
Dr Daniel Ojuka, Breast Oncoplastic Surgeon, explains that prevention requires a good diet to improve one's immunity.
He goes on to explain that a good diet and lifestyle can improve immunity, thus helping in recovery, although no change in treatment options.
"Patients with breast cancer should see experts, not just anyone. Experts include oncologists, surgeons and others who work in a multidisciplinary way to ensure optimal care.
Also, all women should start clinical breast exams and ultrasound from the age of 35 and annual mammography from the age of 40," advises Dr Daniel Ojuka, Breast Oncoplastic Surgeon, Breast Oncoplastic Surgeon.
He concludes by advising the government to look at ways of funding screening, diagnosis and treatment of breast cancer patients.