Breast cancer: The battle continues

While significant progress has been made in awareness, detection, and treatment, breast cancer remains a leading cause of death, particularly in low- and middle-income countries like Jamaica.

According to the Jamaica Cancer Society and the Ministry of Health and Wellness, over 1,000 Jamaican women are diagnosed with breast cancer each year, making it a leading cause of cancer-related deaths.

Nonetheless, while the challenges persist, especially in low-resource settings, increased public and private health initiatives and education efforts are helping to move the needle in the fight against breast cancer.

And so, breast cancer warriors, women and men, continue the often long and difficult personal battle for survival - a fight that is physically, emotionally, financially and mentally taxing on them and their families.

Breast cancer is the most commonly diagnosed cancer among women worldwide, affecting millions every year. It occurs when cells in the breast grow uncontrollably, forming a lump or mass. If left untreated, these cancer cells can spread to other parts of the body.

Below are important breast cancer tips, facts, and how the disease impacts Jamaica specifically.

GLOBAL BREAST CANCER FACTS AND FIGURES

• Prevalence: Breast cancer is the most common cancer in women globally, accounting for nearly 25 per cent of all cancer cases. In 2020 alone, more than 2.3 million new cases were diagnosed worldwide.

• Survival Rates: The survival rate for breast cancer varies widely based on the stage at diagnosis. When detected early (stage 1), the 5-year survival rate is over 90 per cent. However, survival drops significantly when detected in later stages, making early detection crucial.

• Gender Consideration: While breast cancer is predominantly a female disease, about one per cent of all cases occur in men. Men tend to be diagnosed at later stages due to lack of awareness.

• Risk Factors: Age is a significant factor, with most cases occurring in women over 50. Family history, genetic mutations (like BRCA1 and BRCA2), prolonged hormone replacement therapy, obesity, alcohol consumption, and smoking also increase risk. Some factors, such as age and family history, are beyond control, but lifestyle changes can help reduce risks.

BREAST CANCER IN JAMAICA

Jamaica, like many developing countries, faces a unique set of challenges when it comes to breast cancer. The disease is the leading cancer among Jamaican women, contributing to a high mortality rate. Several factors, including late diagnosis, limited access to medical services, and cultural attitudes, contribute to these troubling statistics.

Key Breast Cancer Statistics in Jamaica:

• Incidence: Approximately 1,000 new breast cancer cases are diagnosed annually in Jamaica, according to health authorities.

• Mortality: Breast cancer is the leading cause of cancer deaths among women in Jamaica. The high mortality rate is largely attributed to the fact that many women present at advanced stages of the disease.

• Late Detection: A significant number of Jamaican women are diagnosed in stages 3 or 4, when treatment options are limited, and survival rates decrease. This late detection is partly due to limited access to screening services and a lack of awareness.

CHALLENGES IN ACCESSING CARE IN JAMAICA

In Jamaica, the healthcare system faces numerous challenges, including financial barriers, resource limitations, and cultural factors that delay timely care.

Here are some of the key barriers:

• Financial Constraints: While breast cancer screening services are available, many women, particularly those from rural areas or lower socioeconomic backgrounds, cannot afford regular mammograms or medical consultations. Although some public hospitals offer free or subsidised services, long wait times and accessibility issues remain problematic.

• Awareness and Education: Cultural attitudes and a lack of widespread education about the importance of early detection contribute to late-stage diagnoses. Many women avoid seeking medical advice due to fear, stigma, or misinformation about the disease.

• Limited Treatment Options: Once diagnosed, patients often face challenges accessing the full range of treatment options. There are limited oncology centres, and many patients in rural areas must travel long distances to receive chemotherapy, radiation, or surgery. Some patients may also experience delays in accessing these services, which worsens outcomes.

IMPORTANCE OF EARLY DETECTION

Early detection through regular screenings and awareness of symptoms is key to improving survival rates for breast cancer. Women should become familiar with the following early signs and symptoms:

• Lump in the Breast: A hard lump or mass in the breast that feels different from the surrounding tissue is one of the most common early signs of breast cancer.

• Changes in Breast Size or Shape: Sudden changes in breast size or shape, dimpling of the skin, or changes in the appearance of the nipple can be warning signs.

• Nipple Discharge: While most nipple discharge is benign, any unexplained discharge, particularly if it is bloody, should be investigated.

• Swelling: Swelling in the breast or underarm can be another indicator, even if no distinct lump is felt.

Tips for Prevention and Early Detection

1. Regular Breast Self-Exams

Women should perform monthly breast self-exams to become familiar with the normal look and feel of their breasts. The best time to do this is a few days after the end of the menstrual cycle, when breasts are least likely to be swollen or tender. If anything unusual is noticed, such as a lump, thickening, or a change in texture, a healthcare provider should be consulted immediately.

2. Clinical Breast Exams and Mammograms

Regular clinical breast exams by a healthcare provider and annual mammograms starting at age 40 (or earlier for those with a family history) are essential for early detection. Mammograms can detect abnormalities up to two years before they can be felt manually, significantly improving treatment outcomes.

3. Know Your Family History

If there is a history of breast cancer or ovarian cancer in the family, particularly in close relatives, you may be at a higher risk. Genetic testing for BRCA1 and BRCA2 mutations can help identify women who are at increased risk. Knowing this can allow for earlier and more frequent screenings.

4. Lifestyle Changes

Maintaining a healthy lifestyle can help reduce the risk of developing breast cancer. Key recommendations include:

• Exercise Regularly: Engaging in moderate physical activity (like walking or cycling) for at least 150 minutes per week can lower the risk.

• Maintain a Healthy Weight: Obesity, especially after menopause, increases breast cancer risk. Keeping weight within a healthy range is vital for long-term prevention.

• Limit Alcohol: Alcohol consumption increases breast cancer risk. It is recommended that women limit their alcohol intake to no more than one drink per day.

• Avoid Smoking: Smoking is linked to various types of cancers, including breast cancer. Avoiding tobacco can help reduce overall cancer risk.

EFFORTS TO IMPROVE BREAST CANCER OUTCOMES IN JAMAICA

In Jamaica, various organisations, including the Jamaica Cancer Society, have increased efforts to promote breast cancer awareness. October, being Breast Cancer Awareness Month, is marked by numerous outreach programmes, mobile mammography units, and fundraising events aimed at improving access to screening services.

The government has also taken steps to increase healthcare access, but more work is needed to address the gaps in the healthcare system, including improving access to treatment for low-income and rural populations.

CONCLUSION

Breast cancer remains a significant health concern both globally and in Jamaica. Raising awareness, improving access to early detection and treatment, and promoting healthy lifestyle choices are critical to reducing the incidence and mortality of the disease.

Every woman should take charge of her breast health, and communities should continue to support efforts to make screening and treatment more accessible for all.

editorial@gleanerjm.com