Recent medical advances have made breast cancer a highly manageable disease, especially when detected early, as in the case of stages 0-to-II cancers.
Timely treatment also minimises disruptions to the patient's daily routine and quality of life. Advancements in digitalisation have also greatly benefited women, as they can easily access information through YouTube on how to self-examine themselves and learn about breast anatomy or changes in breast structure that should be brought to the notice of specialists immediately.
Women above the age group of 20 -25 years should examine themselves monthly, and those above 40 years of age should go for mammography at regular intervals. With earlier breast cancer detection, the survival rate increases to 80 per cent (Stage 1 and stage 2), as compared to 56 per cent in Stage 3 and stage 4.
In India, however, early treatment is the exception rather than the norm. By the time most patients are diagnosed, they are already in stage III or IV of the disease, where treatment modalities are more complex. Additionally, the stigma of living with breast cancer can hamper the patients' quality of life in physical, psychological, and social terms.
Mental health counselling, family and institutional support, and new drugs and modalities can help women at all stages of breast cancer to improve life expectancy, health, and overall happiness, thus ticking all the boxes for improved life quality.
Stigma And Suffering
One in 28 Indian women is at risk of developing breast cancer during her lifetime. As per a CII report, the median age for diagnosis is 46 years, and nearly half of all diagnosed women are premenopausal, i.e., relatively young compared to breast cancer patients in Western nations.
The concern, though, is that at the time of diagnosis, around 70 per cent of Indian women are already in stage III or stage IV (known as metastatic breast cancer, or cancer that has spread to other parts of the body). While getting screened early may seem like an evident solution, however, low awareness and culturally ingrained stigmas still prevent many women from getting the timely help they need.
Due to cultural factors and social taboos, women do not get checked for breast cancer or share their symptoms with others, thereby leading to delayed diagnosis. Unfortunately, the pandemic has only amplified the burden of our healthcare system, magnifying these delays.
A QOL-Itative Approach
Focusing on patients' QOL means helping them thrive on the physical, emotional and social parameters by improving their all-around experience of the disease. New hope has also come in the form of targeted therapies that shrink or remove tumours by disabling specific proteins on cancerous cells to block their growth.
These therapies, which can often be taken orally, allow patients to bypass chemotherapy and related harsh side effects. Targeted therapies are proving more effective than chemotherapy in extending the survival rates of patients with stage III or IV cancers up to 5-8 years even if a patient is diagnosed at a metastatic stage.
The rise of non-invasive, chemo-free targeted therapies is opening a new front in the battle against advanced and metastatic breast cancer. By reducing or eliminating frequent hospital visits and the side-effects they earlier took for granted, it is possible to enhance patients' physical and psychological well-being and to help them live longer with dignity and independence.
Breast cancer doesn't mean the end of life. Today, treatment options for breast cancer have advanced, giving hope to patients even in advanced stages. Nowadays, due to government policies (Ayushman Bharat), every woman, regardless of her social strata, can avail of world-class cancer treatment in medical facilities across the country.
Even in advanced stages, families should not lose hope, as newer drugs such as molecular therapy treatment have proven effective for patients suffering from hormone-positive breast cancer, which is the most common form of cancer among Indian women. As many as 60 to 90 per cent of patients respond to these advanced treatments positively, enabling them to lead an enhanced quality of life. With such innovations, cancer can be viewed as a chronic disease that needs management.
Awareness-building and sensitisation are key. Educating women and girls in urban and rural contexts about breast cancer, the importance of regular self-monitoring, and de-stigmatising medical examinations and advanced treatment options, so that they can maximise their chances of identifying and beating the disease.
It would also help address psychosocial impacts like anxiety, depression, or fear by making therapy or psychiatry facilities accessible, affordable, and un-stigmatised for patients. This would also include teaching families and communities to support patients by accompanying them for treatments, helping with chores, spending time with them, and not letting them feel like a "burden".
The late American writer John Diamond said that cancer is "a word and not a sentence". However, for lakhs of women, breast cancer is a life-changing reality. While conventional treatments for breast cancer are constantly evolving and their efficacy is undeniable, life after a breast cancer diagnosis is about more than survival (extending the patient's life) or pain management (alleviating physical discomfort). What's required is a holistic approach towards improving the quality of the patient's life and this is being understood today. (Padma Shri Pankaj Shah, Medical Oncology Haematology, Zydus Hospital, Ahmedabad)
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Before the outbreak of Covid-19, India has the third largest number of HIV patients in the world. As per government estimates, India has around 23.49 lakh people living with HIV/AIDS in 2019, though, the epidemic saw a decreasing trend with estimated annual new infections declining by 37 per cent between 2010 and 2019.While the Covid pandemic is challenging the health infrastructure and systems across the globe, it has caused uncertainty among people living with HIV. Commenting on this, Rajiv Gandhi Super Speciality Hospital Medical Director Dr B.L. Sherwal said, "The number of HIV patients seems to have shrunk during the Covid pandemic as immunity plays an important role in both diseases - HIV AIDS and Covid and people have become more aware of building immunity". "Outdoor activities and other reasons that may contribute for HIV infections like contact with infected blood, semen, or vaginal fluids or others have largely reduced during the lockdown", Dr Sherwal cites another reason for decreasing trend of HIV infections during the pandemic. Talking about the HIV-positive people undergoing treatment during the pandemic, he advised that such people need to take extra care of their health and must avoid taking treatment into home isolation as they have a higher risk of developing severe complications like pneumonia, Septicemia, ARDS and various infections. He said that HIV infection causes immunity deficiency; hence, chances are more to get a severe infection. He recommended parallel treatment of Covid with AIDS in case of infection.Dr Vineeta Singh Tandon, Consultant, Internal Medicine at PSRI Hospital, said, HIV is an immuno-suppressive disease and hence patients will have an increased risk of acquiring any infection including SARS CoV-2. They have a higher risk of developing Covid related complications like pneumonia, septicemia, ARDS and various other infections and are associated with a higher risk of mortality. Several factors like patients' commitments to adhere to ART therapy, CD4 count and viral load, determine the possibility and the risk of acquiring Covid-19 infections. On being asked about treatment protocol, she said, "They should continue their ARV as previously and should not change or stop it in order to prevent Covid-19. For hospitalized patients also, ARV is important. The same Covid treatment regime protocol based on categories of severity is followed for them as for people without HIV infection. Special focus is being given on potential drug interactions, possible overlapping of drug toxicities and managing opportunistic infections".She agreed that decreasing tendency has been seen for HIV patients during the first and the second Covid wave as hardly 10 patients visited the hospital during the pandemic.No evidence has been put forward yet to substantiate the claim that people with HIV will have more side effects due to vaccination than people with no underlying health conditions. With the emergence of effective prevention and treatment strategies, the risk to people with HIV in clinical trials will decline over time. Also, more contagious and pathogenic Covid variants are emerging across the globe and may continue to pose new challenges to all including those with HIV. "In such a situation, people with HIV positive must avoid outdoor activities that may contribute to spreading the infection", counsels Dr Sherwal.(Avinash Prabhakar can be reached at [email protected])--IANS<br>avr/skp/
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Hyderabad, Aug 10 (IANS) Former Indian Police Service (IPS) officer and Bahujan Samaj Party (BSP) leader, R.S. Praveen Kumar on Tuesday tested positive for Covid-19.Praveen Kumar was briefly admitted to the government-run Gandhi Hospital. He was later discharged from the hospital and is now undergoing treatment at home.Kumar, who joined the BSP at a public meeting in Nalgonda on August 8, is suffering from mild symptoms of Covid-19. However, doctors said his condition is stable."I have mild Covid-19 symptoms. Nothing to worry at all," the BSP leader tweeted. He appealed to all people who came in contact with him recently to isolate themselves.Kumar addressed a well-attended public meeting at Nalgonda and joined the BSP in the presence of the party's National Coordinator Ramji Gautam.Ramji Gautam announced Kumar's appointment as the Telangana BSP State Coordinator.The 1995 IPS batch officer on July 19 announced voluntary retirement from service.Kumar has served as the Secretary of Telangana Social Welfare Residential Educational Institutions Society (TSWREIS) and the Telangana Tribal Welfare Residential Educational Institutions Society (TTWREIS) for the last seven years.--IANSms/khz/bg
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