The Sun News Shame to breast cancer

Survivors tale of global master ravaging women

By JOSFYN UBA AND KATE HALIM

In recent times, breast cancer has become the number one killer of women of all races, defying class and status. Described as the most common cancer in women, experts trace its origin to a malignant tumour that emanates from the cells of the breasts. According to the American Cancer Society, breast cancer is the leading killer of U.S women, after lung cancer.

Over 200,000 new cases of invasive breast cancer are diagnosed each year and nearly 40,000 women are expected to die of breast cancer in 2012. But the good news is that there are over 2.5 million breast cancer survivors in the United States. The strongest risk factor for breast cancer is age.

A woman?s risk of developing this disease increases, as she gets older. Other factors that can also increase a woman?s risk of developing breast cancer are inherited changes in certain genes, a personal or family history of breast cancer, having dense breasts, beginning to menstruate before age 12, starting menopause after age 55, having a first full-term pregnancy after age 30, never having been pregnant, obesity after menopause and alcohol use. The incidence of breast cancer in Nigeria is increasing just like in other developing countries. It has been estimated that between 7,000 and 10,000 new cases of breast cancer develop in the country.

According to the Breast Cancer Association of Nigeria (BRECAN), there is increasing evidence that breast cancer is on the rise in Nigeria. Available data from Ibadan Cancer Registry indicate that breast cancer accounted for six per cent of the commonest cancers recorded between 1960 and 1980. The figure rose to 14.8 per cent between 1980 and 1985.

Breast cancer maintained the lead in all cancer cases amongst Nigerian women, rising from 11.2 per cent to 25.7 per cent during 1960-1980 and 1980-1985. The pink ribbon is the most prominent symbol of breast cancer awareness and, in most countries, the month of October is National Breast Cancer Awareness month.

The aim is to raise awareness and reduce the stigma of breast cancer through education on symptoms and treatment. It is hoped that greater knowledge about the disease will lead to earlier detection, which is associated with higher long-term survival rates.

The breast cancer movement has supported practical, educational, emotional and financial care for women with breast cancer. Support groups, individual counseling opportunities and other resources are made available to patients. Many charitable organisations are involved in breast cancer awareness and support.

These organisations provide practical support, educate the public and raise money for research and treatment. Breast cancer chemotherapy patients may have to take Adriamycin, a bottle of which costs N2, 000 from pharmaceutical stores. But if the breast cancer patient has heart problem, she has to use another variant of the drug known as Eprirubicin, and a bottle could go for as high as N10, 000. A patient is expected to use six courses of this every three weeks.

By the time she is through with this, she must have spent between N80, 000 and N100, 000 on drugs alone. There is, however, a cheaper drug, which costs N400 per tablet known as Cyclophosphamaide but it is rarely prescribed. In the event that the patient needs surgery, the cheapest known as Lumpectomy, costs not less than N15, 000. Mastectomy, which is the removal of affected breast, goes for about N50, 000 [fifty thousand Naira].

As for radiotherapy done through linear accelerator machine for breast cancer, 20 sessions are said to cost about N100, 000 [one hundred thousand Naira] anywhere in the country. The radiotherapy for cervical cancer costs about N50, 000 and above. But a breast cancer radiotherapy done with Cobalt 60 machine, especially in government-owned cancer clinics, could be cheaper. The rate in private cancer clinics is higher. In a situation where the patient is hormone-positive, she has to use anti-hormone drug known as Tamoxifen.

A pack costs N600, which lasts for one month. But the patient who tests positive to this is expected to use the drug for five years for effective result. Women, who have not reached menopause can only use this drug. For the five-year period, a patient needs about N36,000 each year. Those who have attained menopausal age have to use Tamoxifen for between two and three years before combining it with another higher treatment, which is more expensive.

But the financial implications of all these drugs and treatments pale into insignificance when compared to what it costs to use the new wonder targeted therapy for those with HER 2+ breast cancer.

A cancer patient would have to spend N400, 000 to buy enough dosage of the drug known as Herceptin for one month. Such patient is expected to use it for one year. That means to enjoy the enormous benefit of this drug, both before and after surgery, for people with HER2-positive breast, a patient needs N4.8 million. Facts and figures released on 2013 World Cancer Day celebration The Union for International Cancer Control (UICC) and the International Agency for Research on Cancer (IARC) announced that 1.5 million lives, which would be lost to cancer, could be saved per year if decisive measures are taken to achieve the World Health Organisation?s (WHO) ?25 by 25? target; to reduce premature deaths due to non-communicable diseases (NCDs) by 25 per cent by 2025. Currently, 7.6 million people die from cancer worldwide every year, out of which, four million people die prematurely (aged 30 to 69 years).

So, unless urgent action is taken to raise awareness about the disease and to develop practical strategies to address cancer, by 2025, this is projected to increase to an alarming six million premature cancer deaths per year.

The good news is that irrespective of the cost of remaining healthy and beating the monster called breast cancer, many women are fighting for their lives and winning too. Aside from medically crushing the disease, a change in lifestyle makes a huge difference. Below are the inspiring stories from victims, who have survived this disease: MANDY OSOBA-ONAKOMAIYA (Two time-survivor) ?After cancer, one becomes vulnerable Mrs. Mandy Onakomaiya is a living miracle.

She survived breast cancer twice. At 34, she was diagnosed of breast cancer. The diagnosis didn?t come as a shock because her mother sadly gave in to the disease at the age of 44 after undergoing chemotherapy and mastectomy.

Not being new to cancer, Mandy didn?t allow self-pity cut down her resolve to battle the disease headlong. She even went ahead to set up her foundation: Sussie Osoba Breast Cancer Foundation in August 2009 after her second diagnosis.

The aim of her foundation is to promote breast cancer awareness in West Africa. She hopes to educate women on the need for constant cancer detection tests. ?Most women do not do monthly self breast exams since they cost nothing and could be done in the shower.

It was a self-exam that found both my cancer lumps. So, I am passionate about women, who would help themselves fight this disease with early detection.? Recalling some of her experience during chemotherapy, she said: ?There were moments when I would just lie down and cry but one can only cry for so long and the situation remains the same.?

Even though it seemed like the darkest period of her life, Mandy met her husband, Segun Onakomaiya, during chemo when she was looking her worst. With hair loss and drastic weight gain due to steroids, the love of her life found her. So, in every cloud, there is a silver lining.

As a fighter, she also negated her doctor?s verdict that after chemotherapy she would not be able to have a child. Mandy welcomed her daughter, Simisola, in 2005. But the dreaded monster was not done with her yet. Cancer reared its ugly head again in 2009 when she was diagonised the second time. After discussions with her husband, she chose to go through surgery and be done with mammograms. She opted for a double mastectomy with immediate reconstruction. Surgery would involve a unique procedure called the DIEP flap where they remove the fat from your abdomen and use it to reconstruct your breasts.

The thought of a flat tummy took my anxious mind away from the impending 10 and half-hour surgery. Although the surgery lasted for 16 hours, it was successful. It was the best life-saving option at that time because her right breast was already infected. The lump there which mammogram did not detect initially was detected and removed. Now, she is so proud of her figure and living her life to the full with her husband and two kids.

The whole experience has been harrowing as well as humbling for her. ?Before cancer, I was positive and energetic; after cancer, one becomes vulnerable. It made me realise that life is not in anyone?s hands and my heart goes out to every woman, going through this ordeal, they should hold on to hope because God is still working miracles.?

Today, aside from using her foundation to raise money to assist breast cancer victims and also raise awareness about the disease, Mandy runs her own spa skincare by Solachi, her brand of skin care products and makeup (Solachi cosmetics). Betty Akeredolu-Anyanwu ?Nobody wanted to talk about it Betty discovered a lump in her breast and you guessed right, denial followed. The lump eventually turned out to be breast cancer.

In her words: ?The trauma I went through can only be imagined. It was most devastating because I neither knew any survivors nor any place to go for emotional support. Emotions were running riot. Fear and confusion took over my entire self. I couldn?t think! I couldn?t even tell my husband. Confiding in our family doctor was out of it. I was under terrible emotional trauma alone. For one week, I kept to my- self, not knowing what to do.? Her emotional preparedness helped a lot in dealing with the disease. Without delay, on April 29, 1997, she had surgery at the University College Hospital, Ibadan, successfully.

The best part of the good news was that her cancer was at stage 1 with the auxiliary nodes free of cancer cells. However, while in hospital, Betty noted the high level of fear, apprehension and secrecy among breast cancer patients. Nobody wanted to talk about it. Majority of the patients, due to ignorance and poverty, were at the late stages of the disease when little help could be given them. The lucky ones, who had successful treatment shied away from discussing their experience. They simply got treated and walked away with sealed lips.

Even when she managed to engage some of these women in discussions, they disclosed that their husbands would never let them go public about their experience with breast cancer, apparently fearing stigmatisation. Betty sacrificed her family?s privacy to share her cancer story and be an inspiration to others who had the disease. She founded Breast Cancer Association of Nigeria, BRECAN.

Since cancer in general is a word that strikes fear into the heart of everyone, the evidence abound that majority of women whose cancers are detected early survive the disease. In recognition of this fact, BRECAN has been aggressive in the campaign for early detection, promoting Breast Self Examination (BSE) and providing emotional support?to victims and family members. To her, there is urgent need to reach out to all women in Nigeria since breast cancer respects no social class. It can happen to anyone, both the rich and poor.

?We may not by our selves eliminate breast cancer from the face of the earth but we can end its regime as a life-threatening disease, making it possible for survivors to lead normal and productive lives. For me, fighting to defeat breast cancer is a life time commitment.? Juliet Uzoma-Aguwa ?I was young, how could I have cancer?

Two weeks before Juliet found a lump in her left breast, she had gone to the hospital with her husband for their yearly physical exams at a Hospital in Michigan, USA. Everything was okay but after two weeks, she noticed a lump. She went back to the hospital, and after a series of tests, she was told to go for a biopsy where tissue from the breast was removed and examined for signs of breast cancer. By the time she and her husband went back for the biopsy results, she had already done the crying, the flexing anger, and the denial. ?I was young.

How could I have cancer? I didn?t have any family history of the disease. And I just had about a few months left to graduate with a degree in Medical Case Management. When we got in to see the doctor, I watched her. She seemed nervous, like she didn?t want to tell me what they had found. So, even before she said the words, I knew I had breast cancer.

I was only 34. Juliet was diagnosed with stage 3 aggressive breast cancer in September 2008. The shock and disbelief made her world spin out of control. The moment she heard the word cancer, everything else went blank. She thought and acted like it was a death sentence as she drowned in her endless tears.

?I ran a few more tests at the hospital to confirm the extent of damage and was advised the best treatment was to have a surgery, as the only way forward. It was the hardest decision of my life at such a young age, when I had so much plans for the future.? Juliet?s strategy involved letting her family know of her situation and this proved comforting as they gave her the needed strength to fight the disease. Her mom, twin sister, Julia, and other members of her family were such pillars of strength and support. The financial load of combating cancer was overwhelming for Juliet, who was few months away from graduation.

After undergoing surgery, chemotherapy and radiation, her body doesn?t quite feel?like her due to the healing process. ?So, it was a combination of mixed and warm feeling when I heard those words ?cancer-free?.

Tears rolled down my eyes, knowing that I was given another chance of life to walk through the stages of life together with my kids. I can only say that I am proud to be standing today.? Not willing to allow any woman die due to late diagnosis, Juliet kicked off her organisation called ?Courage to Dare Foundation?. Having gone through all the stages of cancer treatment and emerging a survivor, she knew she had to do something for the thousands of people all over the world, who can?t access information and treatment.

When she came to Nigeria to do a research on cancer patients at the Lagos University Teaching Hospital, Idi Araba, she noticed a lot of cancer patients come in after the disease has reached an advanced stage.? Even many didn?t want to talk to her, as they seemed embarrassed about the fact that they had cancer.

Even the ones who summoned courage to speak with her, confessed that their families didn?t know and they didn?t want them to know. She didn?t take that lying low. ?My organisation plans to go all over West Africa, empowering women to speak up about their condition and to seek help. Our lives are stories we must tell to inspire the world and leave a legacy. My legacy is to inspire African women, who seem to have lost hope that there could be life after the diagnosis of cancer, and women in general, who, like me, will change their death sentences to a life worth living to the fullest.?? Through Courage to Dare Foundation, Juliet is determined to ensure that individuals of African descent had access to information about breast cancer and also access to preventive mammogram screenings. These days, Juliet feels like breast cancer gave her a new life.

?Before I had breast cancer, I worked hard on being a mother and a wife and I think one of the things I neglected most were me. So, after cancer, I decided that you only have one time to live your life.? She educates women all over Africa that being diagnosed with the disease doesn?t mean they are going to die. With early detection and quick action, they can survive breast cancer.

Samira Gomwalk ?My friends thought I used breast cancer as a cover for HIV At 24, Samira casually carried out a Breast Self Examination (BSE) and discovered a lump in her right breast. Panic was the least of her reactions, but total horror engulfed her after the doctor she met for a curious appointment told her she had cancer. ?I couldn?t help thinking it was all a big joke. I was only 24, I thought to myself, what the heck would happen to me at 65 if I could get cancer this early? This was how my battle with cancer began.

Not only did I have to battle the disease that had the potential to kill me but I also had to battle the negative treatment I received from friends. For some reason, some of my friends believed I was using breast cancer as a smokescreen to cover up my real ailment ? HIV. That was especially hurtful. I had expected most of my friends to be a source of comfort and not spreading malicious gossip.? Her treatment involved chemotherapy, which was given intravenously. The hair loss, weight loss and depression are better imagined.

She missed her once normal life because of staying bedridden most times. At some point, she started seeing a psychiatrist. ?I thought I was running mad.? ?Hearing the rumours from school that I was HIV positive really did kill me inside. I lost hope and gave up on life. I remember giving away my clothes because I had mentally given myself a private death sentence.

I just kept thinking to myself that there was no way I would get out of my situation alive. I even lost touch with God at one point because I was angry with Him. I felt my sickness was unfair. I remember saying to Him once, Lord, I don?t drink or smoke, how could you let this happen to me?? The next call for Samira was surgery. Initially, her doctors suggested a mastectomy but she was fortunate to have a breast-sparing mastectomy because of her age. After the surgery, came radiotherapy. It wasn?t as painful as the previous forms of treatment she had undergone.

The only side effect was tiredness, which, when compared with past treatments, wasn?t bad at all. With optimism, Samira sounds that there is life after cancer. She is a survivor, who received the ?all clear? verdict from her doctors after six months of a torturous journey with breast cancer. ?It is impossible to explain the way I felt when he told me the good news, to say I was ecstatic was an understatement. One of the nurses even had tears in her eyes when she heard the news. She told me I was a lucky girl because she had lost her husband to breast cancer.?

Her faith is unwavering as she has resolved that even if the cancer returns, she can fight it to the finish again. In Samira?s opinion, one of the keys to beating cancer is possessing a strong and innate desire to live. The only way to do this is to think and live positively, taking life one day at a time and at all times remembering that you can?t do it on your own, except you put God first.

Life is no longer the same for Samira, as cancer has taught her to appreciate herself the more. Today, she is an ardent advocate for breast cancer awareness, who teach people the benefits of early detection as the weapon for defeating cancer. She encourages people, who discover lumps in any part of their body to persist in knowing whether the lump is malignant or not. The quick action can be life-saving in the long run as it was in her case.

Her battle with the disease initiated the birth of ?SAMIRA? a Non- Governmental Organisation, which aims at creating awareness on breast cancer as early detection remains key to surviving this disease. SAMIRA aims to source funds that would go a long way to help those affected by this disease through providing medication and financial assistance where needed.

SAMIRA also hopes to have support groups for survivors and those living with the disease. Mrs. Kehinde Gbelee ?I stared death in the face, but God delivered me Mrs. Kehinde Gbelee?s experience of her close shave with the deadly disease was a like a wake-up call. Fourteen years ago, Gbelee survived breast cancer and has since been an active campaigner against the disease. Recalling the harrowing experience, Gbelee said she had noticed a lump in her breast and was wondering what it was. With her husband being a doctor, she was a little bit informed about breast cancer. This made the difference for her.

?When I first noticed it, I told my husband, and he checked my breast. He confirmed that it was really a lump and we immediately started battling it. Honestly, I stared death in the face, but God delivered me.? Having received a second chance to live, Gbelee has actively calling on all women to build a sisterhood network to spread the message on how to prevent breast cancer. ?I would say that early diagnosis helped me a lot.

That is why I am always excited to attend breast cancer awareness sessions like this one organized by Care Organization and Public Enlightenment (COPE).? Men, beware of breast cancer! Like breast cancer in women, cancer of the male breast is the uncontrolled growth of the abnormal cells of this breast tissue.

Male breast cancer is a rare condition, accounting for only about one per cent of all breast cancers. The American Cancer Society estimated that about 1,970 cases of breast cancer in men would be diagnosed and that breast cancer would cause approximately 390 deaths in men (in comparison, almost 40,000 women die of breast cancer each year). Breast cancer is 100 times more common in women than in men.

Most cases of male breast cancer are detected in men between the ages of 60 and 70, although the condition can develop in men of any age. A man?s lifetime risk of developing breast cancer is about 1/10 of one per cent, or one in 1,000. As a man, you probably never considered the possibility of having breast cancer. Although it?s not common, it is possible. Any new mass in the breast area of a man needs to be checked out by a physician. Dr. Abiodun Popoola, Consultant Oncologist at Lagos State University Teaching Hospital (LASUTH) told Daily Sun that cancer is not a death sentence like some people assume.

Early detection remains key to defeating the monster. He stated that it is not fully understood why breast cancer occurs but there are many factors that can trigger the disease. Cancer is caused when the cells in a certain area of your body divide and multiply too rapidly. Some of the signs and symptoms?of breast cancer include: A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle A mass or lump, which may feel as small as a pea A change in the size, shape, or contour of the breast A blood-stained or clear fluid discharge from the nipple A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed) Redness of the skin on the breast or nipple An area that is distinctly different from any other area on either breast A marble-like hardened area under the skin.

These changes may be found during a?breast self-exam. Popoola added that breast cancer stage is usually expressed as a number on a scale of 0 through IV. Stage 0 describes non-invasive cancers that remain within their original location and stage IV describes invasive cancers that have spread outside the breast to other parts of the body.

Breast cancer stages are also based on four characteristics such as the size of the cancer, whether the cancer is invasive or non-invasive, whether cancer is in the lymph nodes and whether the cancer has spread to other parts of the body beyond the breast. The consultant revealed that women should take the following healthy lifestyle steps to decrease their chances of attracting the killer disease: *Maintain a healthy body weight (BMI less than 25).

Weight gain in midlife, independent of BMI, has been shown to significantly increase breast cancer risk. *Minimize or avoid alcohol. Alcohol use is the most well established dietary risk factor for breast cancer. *Consume as many fruits and vegetables as possible. The super veggies for breast cancer protection include all cruciferous vegetables (broccoli, cabbage, cauliflower); dark leafy greens; carrots and tomatoes. The superstar fruits include citrus, berries and cherries. It is best to eat cruciferous vegetables raw or lightly cooked, as some of the phytochemicals believed to offer protection against breast cancer are destroyed by heat. *Exercise regularly.

Studies have shown that regular exercise provides powerful protection against breast cancer. 30 minutes or more of moderate aerobic activity (brisk walking) five or more days a week keeps you fit. Consistency and duration is key to good results and not intensity. *Minimize exposure to pharmacologic estrogens and xeno-estrogens. Lifetime exposure to estrogen plays a fundamental role in the development of breast cancer.

Also avoid estrogen-like compounds found in environmental pollutants, such as pesticides and industrial chemicals. *Take your supplements daily. A multivitamin, 500-1,000 mg of vitamin C in divided doses. *Maintain a positive mental outlook. Develop rich, warm and mutually beneficial relationships with family and friends. Get adequate sleep (7-8 hours per night). The mind-body associations with breast cancer are significant. Dr. Popoola appealed to women who have been diagnosed with breast cancer to share their status with trusted friends and family members as soon as possible. He added that aside providing the emotional and psychological support that would help them combat the disease, it will also serve as a wake-up call for friends and family to take regular exams and tests to ascertain their own status. Dr Femi Olaleye, MD/CEO Optimal Healthcare Limited added his voice to the ravaging nature of cancer.

He told Daily Sun that the challenge facing cancer sufferers in Nigeria is our healthcare crisis when it comes to cancer care. ?Our public healthcare facilities?are struggling to cope with the challenges of delivering such specialized care within the economic and infrastructural?context of our country.? While the message of creating awareness for cancer remains a sounding cymbal all over the world, Olaleye stated the hope of cancer victims in Nigeria looks unpromising. ?It is a tough battle. It is terrible enough that hundreds of thousands of Nigerians are handed a diagnosis of cancer on an annual basis, and then they are faced with a situation whereby care is not available or priced out of their reach.? Olaleye revealed that for cancer to be reduced to its barest minimum in Nigeria, Men and women alike should take self-examination and screening seriously.

Vaccination against HPV (the virus we now know causes cervical cancer), avoid smoking (both primary and secondary smoking). Early detection and availability of cancer treatment centres for prompt diagnosis and effective cancer therapies (curative and palliative) can help majority of Nigerians afford the treatment geographically accessible to them. According to Olaleye, all the cells of the human body are capable of forming a cancer, with the exception of the hair and fingernails.? He said that the risk of developing cancer is actually 1:3 during the lifetime of any individual.

The commonest ones afflicting Nigerians are Breast and cervical cancer (in women) and prostate cancer (commonest cancer in men ? especially men above 50s). Optimal Cancer Care Foundation marked this year?s World Cancer Day by intensifying its awareness campaign about cancer screening, as well as giving out free cancer screening in two popular markets in Abuja.

Women can also enjoy free cervical cancer screening every Friday throughout 2013 at Optimal Cancer Care Foundation center in Lagos.

Source: http://sunnewsonline.com/new/trending/shame-to-breast-cancer/

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