At present, one in every eight women worldwide is diagnosed with the deadly disease of breast cancer. Like many countries in the world, the number of breast cancer patients in Bangladesh is increasing day by day. Cancer deaths in Bangladesh are more prevalent among women, with breast cancer accounting for nearly one-fifth of female cancer patients. In medical terms, breast cancer is when some cells in the breast grow abnormally and become a lump through the division of those irregular and extra cells (tumour). It spreads to different parts of the body through blood vessel lymph (cell sap) and other means. This tendency to spread is called cancer.
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According to doctors, breast cancer can occur in women and men regardless of age. Breast cancer can be completely cured if detected in early stage. But in Bangladesh, the detection rate of this disease in the early stage is very low. Most of the patients are diagnosed with stage II and III disease. This lingers the treatment – making it complicated and expensive. For many, it is no longer possible to complete the treatment properly. However, breast cancer can be cured if diagnosed at the right time. Now that breast cancer is rising rapidly here, experts think it’s high time to raise mass awareness to tackle this growing menace.
PAINTING A GRIM PICTURE
Breast cancer is one of the leading causes of death for people under the age of 70 worldwide. According to the World Health Organization (WHO), over two million women worldwide are diagnosed with breast cancer every year. In addition, about 700,000 die every year due to this. Breast cancer rates are high in developed countries, however, the mortality rate is relatively high in underdeveloped and developing countries. In Bangladesh, more than 13,000 women are infected with this growing menace, while over 7,000 die of the deadly disease every year, according to data from the International Agency for Research on Cancer (IARC). In 2020, 2.3 million women in the world were diagnosed with breast cancer. The disease has overtaken lung cancer to top the list of patients affected by it. This information was revealed in a study conducted by the American Cancer Society and the IARC. According to the report, breast cancer accounts for 11.7 percent of the total number of cancer patients.
The second position is lung cancer, in which the number of patients is 11.4 percent. In addition, problems such as excess weight, reduced physical activity and alcoholism among women are increasing, which may lead to breast cancer.
In the research report, it is feared that 2 crore 84 lakh people will be affected by cancer within year 2040. This number is 47 percent more than in 2020. According to 2020 statistics in Bangladesh, 19 percent of women’s cancer in our country is breast cancer, which means it is on the top. It ranked 3 in terms of the number of affected women and men, means 8.3 percent of the total cancer. What’s more alarming is that most of the patients are between 15 and 45 years of age. This means that a large proportion of the working women are at risk of this disease. Another statistic says that 21 percent of premature deaths among women aged 15 to 45 in the country are caused by breast cancer.
The doctors, however, assure that 90 percent of breast cancer can be cured if detected at an early stage. However, most Bangladeshi women are unable to identify symptoms early as well as they feel hesitant to get examined or consult a doctor about changes in their bodies. According to a survey conducted in Bangladesh, only one-third of women know something about breast cancer beforehand. About 20 percent of women have no idea about such cancer, 70 percent of women do not know what the risks of breast cancer are, while remaining 10 percent of women think their breast cancer is due to a past sin. Only 6 percent of women know about mammography, while another 30 percent heard of breast cancer screening; but don’t know how to do it.
FACILITIES FEWER
If the cancer is diagnosed generally at a late or advanced stage, the treatment becomes more complex and difficult with rising cost. A Dhaka University’s Institute of Health Economics and National Cancer Research Institute (NCRI) study reveal that the treatment of a cancer patient in the country costs approximately Tk 6.39 lakh annually. The major areas of expenditure are various tests, operations, radiotherapy, chemotherapy, doctor’s fees, clinic or hospital bed rent, travel cost from home to the hospital, accommodation and food expenses etc. Apart from this, after completing the first round of treatment, there is the regular follow-up and medication costs.
Most patients have to take lifelong drugs or oral chemo, which is quite expensive. On top of that, there is still a huge shortage of facilities for breast cancer patients in the country.
Although there has been increased awareness about the disease and the need for regular check-ups in urban areas, most rural women remain unaware and do not have access to proper healthcare support.
According to a study, we need at least one cancer centre for every one million people. As such, some 160 cancer treatment centres are required to be set up across the country. But at present, there are only 20 centres in the country.
The number cannot be said to be adequate at all. Due to social stigma and prejudices, many women here do not want to talk about their breast problems.
As a result, the disease is discovered in most cases in the third or fourth stage, resulting in their untimely demise.
CAUSES
According to the health experts, there are certain things we do in our daily life that increase the risk of breast cancer. Among the reasons behind breast cancer are:
- Obesity and lack of exercise
- Regular smoking or drinking habit
- Menstruation starting early and ending late
- Childbearing at an older age or childlessness
- Using birth control pills for long
- Not breastfeeding child
- Using hormone replacement therapy
- Hereditary causes
SYMPTOMS
Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all. Some warning signs of breast cancer are:
- New lump in the breast or armpit
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area or the breast
- Pain in nipple or in the nipple area
- Nipple discharge other than breast milk, including blood
- Any change in the size or the shape of the breast
- Pain in any area of the breast
REMEDIES
Experts say, every women should learn to self-examine their breasts to be safe. Some other important things to prevent breast cancer are:
- Participate in breast cancer monitoring or screening
- Keeping weight under control
- Breastfeeding child for up to two years
- Avoid using chemical-rich cleansers, beauty products and pesticides as much as possible
- Avoid taking hormone replacement therapy after menopause
- Avoiding tobacco and alcohol
- Avoiding excess fatty foods and consuming nutritious food
Finally, there is no alternative to raising awareness for tackling breast cancer. October was breast cancer awareness month, but awareness campaigns should run throughout the year. In reality, women’s fate to receive medical treatment depends on their family’s financial stability as well as patriarchal attitudes. Therefore, it is important to change the patriarchal attitude and make men aware of this growing menace. In families where men are more aware, the treatment of women is started at an earlier stage. For these reasons, it is also important for the media and religious institutions to play an important role in changing the existing ideas about women and build resistance through raising awareness. Above all, ensuring health care for all is essential for achieving the Sustainable Development Goals by 2030. For this, research should be increased in the medical sector. Additionally, required infrastructure, equipment, better training and opportunities for doctors should be increased. Affordable treatment should be ensured for all. And, awareness about cancer should not only be for women, but also cover the whole society.
Consultant Oncoplastic Breast Surgeon
MRCS (Edin), PGDipAesSurg (London)
MBBS, London and Bangladesh
Tasmia Tahmid Breastcare is a Bangladeshi enterprise led by Tasmia Tahmid MBBS MRCS (Edin), PgDipAesSurg (London). Tasmia is a consultant breast surgeon working in NHS, UK and a graduate of Dhaka Medical College.
- Currently, more than 13,000 women in our country are infected with breast cancer, while over 7,000 die of the disease every year. Some recent studies have revealed that breast cancer is increasing at an alarming rate in Bangladesh. How terrible is it?
Every year 35,000 Bangladeshi women develop breast cancer, but many never seek treatment. According to the International Breast Cancer Research Foundation, 90% of women diagnosed with breast cancer will die from the condition. Survival rates for women with breast cancer in Bangladesh are too low. By contrast, 55,000 women in the UK are diagnosed and 12,000 (22%) die from breast cancer each year.
- What are the things that need to be avoided to stay safe from breast cancer?
It is very important to be aware of breast health. Self-examination of both breasts monthly or every 6 weeks can detect breast problems early. Women need to have education on reproductive health, taking caution in using long-time contraceptive, I pill or homeopathy, etc. - Observing which symptoms should a patient consult breast cancer specialist?
Women should look for: Feeling a lump, noticing nipple discharge on it’s own, persistent breast pain, any skin change on breast. - Experts say that 90 percent of breast cancer can be cured if detected at an early stage. However, in a patriarchal society like Bangladesh, there are some taboos about women’s diseases. Again, women also suffer from shame while revealing physical problems. What to do in this circumstance?
National-level awareness programs and educating women, family members, and healthcare providers of all levels need to act in collaboration to do this. - What to do to create mass awareness about this growing menace nationwide?
Both Government and Private level, we need to see breast cancer awareness events, educational programs on media, in school, colleges, universities, at work. To seek help as soon as a woman notices any change in breast. - How do you think the treatment system and facilities in Bangladesh for this disease?
- LATE DIAGNOSIS
- POOR RADIOTHERAPY FACILITIES
- UNAVAILABILITY OF A COMPLETE CANCER-SPECIALIZED HOSPITAL
- POOR FUNDING FROM THE GOVERNMENT FOR CANCER
- LACK OF NGOS TO TACKLE THE PROBLEM
- LACK OF CANCER REGISTRIES
- LOW LEVELS OF AWARENESS.
- What do you think is the future of breast cancer treatment in Bangladesh? What can be done to improve it?
- Awareness is increasing. We see Pink October theme to achieve this nowadays. There need to be specialised dedicated Breast clinics in Hospitals, Poly Clinics. National Screening Mammogram and Ultrasound scan program need to be developed. Opportunities for Young General Surgeons and Nurses to be trained appropriately at a standard level need to be set.
- What do you think is the future of breast cancer treatment in Bangladesh? What can be done to improve it?
Awareness is increasing. We see Pink October theme to achieve this nowadays. There need to be specialised dedicated Breast clinics in Hospitals, Poly Clinics. National Screening Mammogram and Ultrasound scan program need to be developed. Opportunities for Young General Surgeons and Nurses to be trained appropriately at a standard level need to be set.
