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Breast Cancer



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Breast cancer is most women’s biggest fear. However, the outlook for breast cancer patients is better than ever before.
 
By Netanja van der westhuizen

When Michele de Jager discovered a lump in her breast while taking a shower, she wasn’t too concerned. She was a healthy 35-year-old, and had no family history of cancer. Just to be sure, however, she made an appointment with her doctor. This appointment lead to a mammogram, breast ultrasound (sonogram) and eventually a needle biopsy that confirmed what Michele was beginning to fear. She had breast cancer, one of the most common cancers in South African women.

Michele decided that she was going to do what it would take to survive. That meant following her doctors’ instructions, taking care of herself and living her life as normally as possible – from going to work to taking her daughters (then 10 and 12) to school. Now, six years after her diagnosis, this 41-year-old credit manager at Old Mutual Healthcare is living proof that breast cancer can be beaten.

Michele and other survivors’ victories confirm current optimism about this illness. Thanks to early detection and medical advancements, the outlook for breast cancer patients is better than ever before.

The c-word

After the initial shock of her diagnosis, Michele realised that she needed to learn all she could about breast cancer. "My surgeon explained the details pertaining to my case, but the day after my diagnosis I headed straight for Old Mutual Healthcare’s oncology department for information and advice. The more you know, the easier it is to look at the situation realistically," she says.

She learnt that although breast cancer is often thought of as a single entity, it really is a general term for different types of cancer that can start in almost any area of the breast. It develops when abnormal (mutated) cells divide abnormally and rapidly, and form a tumour or growth. It may also spread to the lymph nodes or other parts of the body via the blood.

But why does it happen in the first place? Medical science doesn’t have a clear-cut answer to this question, but it has identified some risk factors. These include: age (your risk increases with age), a family history of cancer, genetic predisposition, excess weight, early onset of menstruation, late menopause and hormone therapy. However, in many breast cancer cases these risk factors don’t come into play. The bottom-line, according to the experts, is that every woman is at risk of developing breast cancer.

Breast cancer can manifest in various ways – from lumps to unusual swellings, puckering of the skin, sores, pain and rashes in the breast area. So any unusual discharges or changes in the colour or texture of a breast need to be evaluated.

Treatment action

In addition to dealing with a potentially life-threatening illness, Michele also had to make complex decisions about her treatment. "Luckily, I had an excellent medical team who helped me to learn as much as I could about my treatment options. My advice is to always trust your instincts. If you have to cope with a serious illness and feel uncomfortable with your doctors, rather go for a second opinion."

Every cancer patient is unique. Treatment will therefore depend on the specific patient and a variety of factors like the type of cancer, the site, tumour size, how much it has spread and how it affects normal body functions. Most women with breast cancer have surgery and additional therapies like chemotherapy, radiotherapy or hormone therapy.

Within 15 days of her diagnosis, Michele had a full mastectomy of the right breast, accompanied by the removal of the lymph glands and a reduction of the left breast. The latter was needed in preparation for the planned reconstruction of her right breast and to ensure that her breasts would be even-sized. Six rounds of chemotherapy and 25 treatments of radiotherapy followed. And almost nine months later, her right breast was reconstructed.

"While many women may equate their breasts to their femininity, I don’t believe that my breasts make me a woman. I am a woman because of who I am and how I feel inside. The surgery wasn’t about losing my breast – it was about removing the cancer. And there was another positive – a tummy tuck. There are various breast reconstruction options, but I had a TRAM (transverse rectus abdominis muscle) Flap operation, where tissue from my tummy was used to reconstruct my right breast," she says.

The positive approach

Various studies indicate the difference a positive outlook can make when dealing with a serious illness. Michele would agree. She tried to see the silver lining of every dark cloud. Losing her hair as a result of chemotherapy meant she could ‘trade’ her naturally curly shoulder length hair for a wig with funky short, straight hair. The tummy-tuck has allowed her to wear low-rise jeans with confidence. And the whole experience has taught her that people, even strangers, can be very supportive.

But despite her ups, Michele also experienced the downs of dealing with a serious illness. For example, chemotherapy left her nauseous and sometimes depressed, and radiotherapy exhausted her. She was also worried about her two daughters. "You just have to focus on the task at hand – the next stage of your treatment – and get through that," she explains. Michele also credits her strong support system – her daughters and parents, as well as her colleagues – whose motivational comments and caring gestures, she says helped her to carry on.

Taking action

The earlier breast cancer is detected, the better the prognosis. So, take heed of the symptoms and examine your breasts and underarms thoroughly every month, a week after your monthly period. "If you are not sure what to look for then ask your GP to carry out the exam at regular intervals," advises Michele.

While you may not be able to change any existing risk factors, you can lower your chances of getting breast cancer by taking care of your health. Eat a diet that is low in animal fat and animal protein, and high in fibre. Get active, keep your weight in check and limit your alcohol intake to one drink a day (better yet, if you can avoid it all together). By breastfeeding your baby and steering clear of hormone therapy you could also reduce your risk.

The future beckons

Although Michele was successfully treated, cancer medication now forms part of her daily routine. Like most breast cancer patients, she also has to go for regular medical check-ups. "Cancer will always be part of my life. It helped me to realise that I am worth a lot more than I ever thought, and that life is precious. I am now more comfortable with myself than ever before. When I started treatment, my GP said that it will be a good few months of agony, but at 35 I could be adding another 35 years to my life. That’s what I’m aiming for," she says with a smile.




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