How to manage a breast cancer journey?

by Dr Amit Jotwani

This Breast Cancer Awareness Month we speak to senior radiation oncologist Dr. Upasana Saxena, to understand aspects of living and coping with cancer.

1. Is breast cancer curable?

Yes, it is curable in the early stages of the disease. Hence early detection is of prime importance. In advanced stages, we can improve the duration of survival but a complete cure might not be possible. Breast cancer awareness and screening for early detection are equally important tasks as the treatment. This helps us in early diagnosis, and a smaller disease size at presentation is the most important predictor (along with biologic subtyping) of the expected treatment outcome or prognosis.

2. According to a recent news article, half of the women diagnosed with breast cancer die every year in India. Is it this dangerous?

In advanced stages, the risk of loss of life is definitely a factor. The loss of life to cancer has reduced with advances in treatment modalities and early detection rates. Nonetheless, it has the potential to be responsible for the loss of life. Quick and prompt action in case of any suspicion is warranted to prevent it from reaching a stage where we are restricted in saving a life. 

3. What precautions should one take while undergoing chemotherapy for breast cancer?

  • Avoid sources of infection – raw/uncooked food, pets, crowds, cuts, and abrasions
  • Try to maintain a healthy wholesome diet by meeting dietician and discussing your food choices and health situation
  • Be alert and observant of any changes or symptoms in your body
  • Follow instructions given by your doctor regarding periodic blood tests
  • It is essential to stick to advised dates for chemotherapy as the interval between two cycles is of importance
  • Do not self diagnose or self-medicate, please visit the treating physician

4. What advice would you give to primary caretakers of breast cancer patients in terms of providing them with the necessary care and support?

  • Serve regular meals, and maintain their intake of food
  • Provide emotional support
  • Engage them support groups to interact with other cancer patients
  • Offer them counseling 
  • Provide a mastectomy bra for the patient to use after surgery as the chest may be sore from the process
  • Proper care for neuropathy (weakness, numbness or pain from nerve damage) and lymphedema (swelling caused by a lymphatic system blockage) – both of which may occur in the arms or legs
  • Understand that the logistics and finances are only the most superficial support expected from the caretakers – even though it is very essential. There is a multitude of support ways that the primary caretaker can identify and engage in. A care provider needs to have an immense amount of patience and does take a toll on them as well. Hence, do not shy away from talking to the right people (not the patient, but other friends and family) about how difficult it is for you to be available and provide for everything. Take care of yourself as well as it is going to be a long and demanding phase where you need to be at your best. In the west, counseling is extended to the whole family along with the patient, in view of the same.

5. What steps must one take post breast cancer treatment in maintaining a healthy lifestyle and avoid risks of recurrence?

  • Stick to prescribed medication like hormone therapy and immunotherapy
  • Exercise regularly
  • Maintain a healthy weight, add fruits and vegetables as an essential component of your diet
  • Avoid red meat
  • Maintain regular follow-ups and investigations as suggested

6. What message would you like to give to patients and families going through breast cancer treatment?

  • The term cancer is a scare, but that is due to the reputation it carries from back when diagnoses were late, less effective chemotherapy and older or inferior radiotherapy techniques. 
  • In the current scenario, there is a much better understanding of the disease and its different biological factors and behaviour. 
  • We are in a much better position today to understand and explain to patients how the tumor is expected to behave and what should be expected from the treatment.
  • While I don’t want to paint a rosy picture and say every patient with breast cancer can be completely cured, I want to emphasize the fact that many can be. 
  • Ask your doctor to explain the type and details of the breast cancer and the prognosis or expected outcome with treatment. 
  • The outcome significantly improved now with advanced medicines and biological agents. Even for stage 4 or metastatic disease (depending on the biological subtype), survival is significantly prolonged nowadays, as compared to before.

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