By Catherine Murombedzi

THE year 2020 has been a powerful reminder that we are all in this together and our choices and actions have the power to protect the most vulnerable among us in a big way under COVID-19. 

The same holds true when it comes to Breast Cancer. With your support, we can show every woman that her life is important.

We have to talk more of cancer in order to understand the disease. 

October is  dedicated to breast cancer awareness globally. 

In Zimbabwe, cancer  must remain topical everyday, 24/7 and not just talk of breast cancer in October.

What is cancer? 

Cancer is a group of over 200 diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. 

Comprehensive cancer services range from prevention, screening, diagnosis, treatment, care and support to minimise the risk and lose of life to the disease.

Yes, cancer can be prevented through eating healthy food, maintaining correct weight, remaining physically active, avoiding risky behaviour, regular medical care, protecting oneself from the sun and, for some cancers, getting vaccinated. 

Frequent screening for breast cancer is a prerequisite for everyone, especially women. 

For people with full immunity, screening once in three years is recommended. For people with a compromised immunity, screening ought to be annual. 

Both men and women can get breast cancer. However, the risk of women getting breast cancer is 100 times higher than men.

Men have some breast tissue like that of a developing girl, so yes, men can have breast cancer, but their risk is very low.

In this three-part series, Dr Anna Mary Nyakabau, an oncologist of repute, walks the readers through the need to know their bodies. 

She gives hope to anyone diagnosed with cancer to follow the specialist advice as cancer treatment is a process requiring adherence for successful road to recovery.

“For cancer treatment, an early diagnosis of the disease before it becomes invasive is important. That is why frequent screening is pivotal. Early detection is where one has the disease, the aim is to find the disease in infancy. Breast cancer, like all cancers, when detected early, has a high success rate in getting cured,” said Dr Nyakabau.

“The more advanced disease is more expensive to treat, several modalities are required.

“Treatment is attending to the diagnosed person and some tissue is taken from the patient. This is called biopsy. The sample is taken to a pathologist for assessment to see if it is cancerous or not.

“Treatment can be removal of just the lump, or if need be, the whole breast.

The oncologist discusses with the family and patient on what procedure is to be taken. Treatment differs from one patient to the next. So patients will receive specific treatment suitable for their condition. 

“In cancer treatment, we have what is called staging. This can be simplified to assess and understand the advancement of the disease. In a war situation, an army assesses the enemy’s strength to be prepared for the battle. Same applies to cancer, this is called staging.

“One can have abnormal cells, however, not all growths are cancerous.”

Stage 0 means there’s no cancer, only abnormal cells with the potential to become cancerous. 

The growth is removed, it is said to be benign, non-cancerous, with the opposite called malignant.

● So if the cancer is in its infancy, it means it has not spread, this is Stage I.

● When the cancer has grown but has not yet spread, this is Stage II. 

● When the cancer has grown big and may have spread to the surrounding tissues, this is Stage III.

● Stage IV is when cancer has spread to several parts of the body.

Chemotherapy targets cancer cells. Unlike radiation or surgery, which target specific areas, chemotherapy can work throughout your body.  

It can also affect some fast-growing healthy cells, like those of the skin, hair and intestines. 

That’s what causes some of the side effects from the treatment and many times you hear a patient saying chemotherapy made him/her feel worse. 

However, the chemo is necessary and is administered under an oncologist. The chemicals attack the invasive cells.

Radiotherapy is feared by many patients, however, it is an effective modality that uses radio active rays to attack the cancer cells after surgery in fighting any possible residual cancer cells.

“Not all patients require radiotherapy, the family and patient are informed by the specialist in order to understand. With cancer treatment, it’s not one size fits all; each patient has a tailor-made treatment schedule to suit one. Early detection and treatment saves life,” said Dr Nyakabau.

“Chances of success will be great if the cancer is diagnosed in its early stages.”

There is always something that we can do. The responsibility starts with me.

Is cancer curable?

Yes, cancer is curable if diagnosed at any early stage. 

Even when diagnosed in advanced stages, there is hope and it can still be treated. However, the more advanced disease is expensive to treat as several expensive modalities have to be used. 

Screening is the first step; if any anomaly is found, a sample is taken to the laboratory for testing. If found to be cancer positive, the oncologist then sets out the treatment plan for the patient. 

Risk factor

From age 20 up, every woman must breast self-examine (BSE). Take note, five to seven days before a monthly period, the breast is likely to have lumps, so this is not the best time to self-examine. Usually, every woman must know herself; as the case with most breast cancers, the woman finds out herself. 

After developing breast cancer a patient should be followed and monitored.

Age is a risk  factor for women, as women grow older, the chance of cancer cells grows. 

As the immune system grows old, obesity becomes a risk factor as there is more estrogen production. Non-blacks are more vulnerable to breast cancer. Prior radiation  to the breast before age 30 is also a risk.

If one had lymphoma and was treated using radiation, one gets a higher risk. Alcohol consumption is also a risk factor, so one unit a day for women is urged to reduce the risk. 

Eat healthy foods with physical activity and remain active to reduce the risk of developing breast cancer. 

It is a combination of factors which can take about 10 years. There is, therefore, time to reduce the risk. One may have breast cancer yet show no signs; this is asymptomatic.

Late menopause has been found to be a risk, so is late pregnancy after age 35. 

Late menopause, after age 55, also raises the risk factor.

“Women above 45 are more at risk of breast cancer. 

For example, breast cancer and ovarian cancer run together in families with hereditary breast and ovarian cancer syndrome. 

Cancer can be treated with success and results in longevity of life for the cured patient,” said Dr Nyakabau.

Out of the 2 062 recorded cancer-related deaths in 2019, breast cancer has been responsible for seven percent of the fatalities, with cervical cancer being the highest killer accounting for 13 percent deaths in the country. (Cancer Registry)

The mention of cancer sends shivers down the spines of most people. We have to demystify this. 

National strategy

Currently, the nation has no National Cancer Prevention and Control Strategy, with the last one having been operational between 2014-2018.

Plans are underway to come up with a new strategy.

● In the next installment, a breast cancer survivor walks us through her BSE, the unusual lump she ignored for some months since it was not painful, the fight and road to recovery.