‘THE cancer cells in my brain have been reduced significantly since my radiation program three months ago. I’m off chemo for a whole month.” That was what award-winning filmmaker Marilou Diaz-Abaya posted on her Facebook site in 2012. The month: September.
A week before that, she even quoted Albert Einstein with this post: “There’s only two ways to live your life; either by believing that nothing is a miracle, or by believing that everything is a miracle.”
But in October 7, 2012, the well-loved director whose film credits included Brutal, Moral, Karnal, Alyas Baby Tsina, Muro Ami, and Bagong Buwan lost her battle againist breast cancer. According to her son Marc, his mother passed away at 6:30 p.m. at the St. Luke’s Hospital in Taguig City, after a five-year battle with cancer. She was 57.
Abaya was diagnosed with breast cancer in 2007. Her health improved in 2008 but returned the following year. It was gone again in 2010 and recurred in 2011. “On bad days, she relied on painkillers. On good days, she used her time to show support for her sons’ numerous endeavors,” Marc said.
Around the world, breast cancer is the leading killer of women ages 35 to 54. More than a million develop the disease without knowing it, and almost 500,000 women die from it every year, according to the International Agency for Research on Cancer.
In Asia, the Philippines has the highest incidence rate of breast cancer. Not only that, it is among the top 10 countries with the most cases of breast cancer, according to a document released by the Asian Hospital and Medical Center (AHMC).
The Department of Health (DOH) and the Philippine Cancer Society Inc. (PCSI) considered breast cancer as the most common form of cancer in the country—particularly among women. “One out of every 13 Filipino women is expected to develop breast cancer in her lifetime,” the AHMC document stated.
Breast cancer can strike at any age, but it usually affects women over 35. “Age is the strongest risk factor for this disease,” wrote Sue Ellin Browder in a special report for Reader’s Digest.
Family history is another high-risk factor. This is when a member of the family (mother, aunt, sister, or cousins) has had a breast cancer. A woman who has had certain kinds of non-malignant tumors removed from her breast is also at risk.
Other possible candidates for the disease are women who menstruated early (before age 12) or had a late menopause (after age 50). A woman who is childless or has her first child at age 30 is most likely to develop breast cancer.
Lifestyle also plays an important role in the development of breast cancer. Those who consume diet high in animal fats (pork, for instance) can also get the disease. A Harvard University study showed that women who gained 20 to 25 kilograms after age 18 almost double the risk of developing breast cancer following menopause, compared with those who had gained only a few kilograms.
Women who drink alcoholic beverages, watch out! The risk of breast cancer increases by 11 percent if a woman regularly drinks once a day, 24 percent with two drinks and 40 percent with more than two, according to a research by Lenore Kohlmeier, a professor of epidemiology and nutrition at the University of Carolina.
The risk of dying from breast cancer, according to the American Cancer Society, goes up by 25 percent among smokers. This figure increases in proportion to the number of cigarettes smoked per day and the number of years as a smoker. Those who smoke two packs a day or more have a 75 percent higher risk than nonsmokers.
Unknowingly, there are more than one kind of breast cancer. For instance, a few rare malignancies are so aggressive they’ll kill the victim even if they’re identified on a mammogram when they’re still small. Other types are so “slow-growing” they won’t be fatal even if they’re not diagnosed for years. Still, others start out as treatable tumors that can become more dangerous and difficult to treat as they grow.
How does a woman know she has a breast cancer? The Family Health Guide lists the following symptoms: lump in the breast or armpit, dark discharge or bleeding from the nipple, retraction of the nipple, dimpled skin over the lump and abnormal change in the size and shape of the breast.
Generally, it is the woman herself who may discover that she has a breast cancer, like Swedish actress Ingrid Bergman. She was reading an article on breast self-examination and followed the instruction. Then, she felt some lump in her breast.
The Geneva-based World Health Organization (WHO) suggests that women should examine their breasts regularly—at least once a month.
“Women should check their breasts a week after the menstrual period,” advises The Woman Almanac. “After menopause, check your breasts on the first day of each month. If you have had a hysterectomy (a surgical removal of the womb), check with your doctor or clinic for the appropriate time of the month to check your breasts.”
PCSI on how to practice breast self-examination (BSE):
- In the shower or while taking a bath: Examine your breasts. Your hands will glide easily over wet skin. Fingers flat, move gently over every part of each breast. Use your right hand to examine the left breast, the left hand to examine the right. Check for any lump, hard knot, or thickening.
- Before a mirror: Inspect your breast with arms at your sides. Next, raise your arms high overhead. Look for any changes in contour of each breast—a swelling, dimpling of the skin, or changes in the nipple. Then, rest palms on hips and press down firmly to flex your chest muscles. Left and right breast will not exactly match—few women’s breasts do. Regular inspection shows what is normal for you and will give you confidence in your examination.
- Lying down: To examine your right breast, put a pillow or folded towel under your right shoulder. Place right hand behind your head—this distributes breast tissue more evenly on the chest. With the left hand, fingers flat, at the outermost top of your right breast, make small circular motions all the way around the outer edge of the breast until you reach the top again, pressing gently all the while. (Don’t panic if you find a ridge or firm tissue in the lower curve of each breast; it’s normal.)
Then move in an inch toward the nipple and repeat the procedure. You will probably have to circle your breast three additional times so that every part— including the nipple— is examined. Now, slowly repeat the whole procedure on your left breast with a pillow under your left shoulder and your left hand behind your head. The whole time, take note of how your breast structure feels. Finally, squeeze the nipple of each breast gently between the thumb and index finger.
Early detection, doctors claim, is a key factor that can increase a woman’s chances of surviving breast cancer. “Learn how to examine your breast today and do it regularly,” the PCSI says. “The simple procedure could save your life.”
Dr. Diana O. Cua, a breast surgeon who studied at Standford University in the United States and is now practicing in the country, recommends a monthly BSE for women 20 years old and older.
“If you discover a lump, dimple, or a discharge, see your doctor immediately. Don’t panic,” points out The Woman Almanac. “Only doctors can make the diagnosis. They will perform a biopsy to see if the lump is cancerous.”
Most lumps, says Cua, are benign, which means not malignant.
Curiously enough, men are not spared from breast cancer. “Many people associate breast cancer only with women,” says Dr. Kevin D. Maupin, a specialist in internal medicine. “This may be because male breast cancer is rare.”
Men are usually older than 60 when they are finally diagnosed with breast cancer. “The delay in detection may be because men seek a doctor’s care later than women, feeling that breast cancer is a female problem,” Maupin thinks. “They may also be embarrassed to have their symptoms checked out and may wait up to 18 months before going to a physician.”