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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Although India has, for a long time, battled the incidence of cancer, latest estimates pegs them to be rising at significantly higher rate. Once thought of as an old age disease, cancer is now a cause of concern also among the youth and children.
National Cancer Awareness Day is observed every year on November 7 in India, to increase awareness about cancer prevention and the need for its early detection.
According to the Indian Council of Medical Research (ICMR), there will be an estimated 12 per cent rise in cancer cases in India in the next five years.
Longer life expectancy is a major contributor to the overall cancer incidence. As people grow old, their bodies have longer time to allow faults to build up and the body accumulates more of these faults in the genes, considerably increasing the risk of cancer.
"Larger proportion of older individuals is the first cause of increased cancer numbers. The higher the proportion of older age in the population, the higher is the chance of cancer," Wesley M Jose, Clinical Associate Professor, Medical Oncology, Amrita Hospital, Kochi, told IANS.
Further, males (52.4 per cent) are more prone to the risk of all cancer cases compared to females (47.4 per cent). Tobacco use is the major reason comprising 48.7 per cent of cancers among males and 16.5 per cent among females.
A recent report states that the number of cancers associated with tobacco use in 2025 would be 4,27,273 contributing to 27.2 per cent of India's total projected cancer cases. Initiation of tobacco, known to contain at least 69 cancer-causing agents, in the youth is a contributory factor to the increased burden of cancers associated with tobacco use in India.
"Tobacco cessation will reduce the cancer burden by about 25 per cent. The major contributing factor being tobacco and ghutka consumption that directly accounts for 27 per cent of cancers in India," Murad E. Lala, Oncologist at P.D. Hinduja Hospital & MRC, Mahim, Mumbai, told IANS.
"We all know that oral and lung cancer that affects our male population to the maximum can be prevented by curbing smoking and tobacco consumption. We need to start thinking of some unhealthy foods similar to what we think about tobacco unnecessary, addictive, and harmful," said Anil Heroor, Director-Advanced OncoSurgery Unit, Fortis Hospitals Mumbai.
Apart from tobacco, alcohol, obesity, a sedentary lifestyle and environmental factors also contribute to the increase in cancers.
"The overall living circumstances of the Indian population have improved and that have also led to a larger sedentary workforce, which has access to a high-calorie diet. These factors indirectly have affected the rise in numbers," Jose said.
"Nearly six types of cancers are linked to obesity and are slowly on the rise among people under 50. These are cancers of the colon or rectal, pancreas, kidney, gallbladder, uterine (also called endometrial cancer), and multiple myeloma. These Cancers are often not discovered in younger people until the disease is advanced and harder to treat," Heroor said.
Childhood cancer is also seeing an increasing trend, mainly of leukemia and lymphomas. Childhood (0-14 years) cancers constitute 7.9 per cent of all cancers, according to ICMR.
"The common types of cancers in children are leukemias, lymphomas, CNS tumours, retinoblastomas and Wilm's tumours. While most of the childhood cancers are curable if detected early and treated appropriately, children in India have limited access to tertiary centres that treat childhood cancers. This delay in treatment causes the survival rate to drop," Jose said.
The cancer burden in the country can be reduced by strengthening the government health systems, making universal health coverage, health education, treatment compliance, and early detection centres at the community level.
Besides, vaccination for virus-related cancer like liver and cervix, and improved physical activity, stricter tobacco and alcohol laws can also help, the experts suggested. (IANS)
Read More► Women Can Have A Heart Problem & Not Even Realise It
Many people believe that heart disease typically affects men. Unfortunately, this is far from the truth. Coronary heart disease is the leading cause of mortality not only among men, but also among women. But women are actually at greater risk if not detected early, and this exacerbates the issue.
Signs of poor heart health do not appear as visibly in women as it does in men. What this means is that if a man has a heart issue, there are specific symptoms like angina which can be spotted easily and the right course of action be recommended. The same issue in a woman may not result in a sign or symptom that can be easily spotted. So often, their symptoms go ignored or unrecognised and they do not receive timely intervention to correct the problem. The issue is so acute that today 1 in 3 deaths among women is due to coronary heart disease.
There is also a significant lack of self-awareness among women about risk factors and the prevention of CVDs. Women don't only attend to matters of the home, but they hold positions at leading companies, and continue to rise to the occasion and meet impossible demands on their time. Through all of this, they take care of the emotional needs of their family members and loved ones; and still culturally are predisposed to putting the needs of others before their own. The stress they experience, among other common risk factors, often goes unnoticed by those around them. And stress has a greater influence on CVD risk in women vs men. Along with stress, other factors like diet quantity and quality also have a greater influence on CVD risk in women vs men. Additionally, women are also impacted by female-specific risk factors for CVD like polycystic Ovarian syndrome PCOS, preeclampsia, pregnancy induced hypertension and gestational diabetes.
In such a situation where symptoms of a heart problem do not manifest visibly, it is extremely important for women to be aware of their own risk factors and adopt proactive measures to take care of their heart health. For example, one risk factor, stress has been linked to a greater intake of energy and nutrient-dense foods, mainly sources of sugar and fat, and to poor diet quality. Women can take simple steps like reducing unhealthy fats and products with high content of sugar and salt to improve the quality of their diet. Choose ingredients that are good for the heart, like oatmeal, wholegrains, fiber rich vegetables, blended oils with the right balance of fatty acids, legumes, soy products, and the like. Regular and consistent exercise, adequate sleep, and other such lifestyle modifications can help maintain heart health in the long term.
Furthermore with signs of poor heart health not manifesting visibly in women, it is crucial that they get regular health check-ups done to assess their risk proactively. Self-awareness and early identification of cardiovascular risk factors can lead to better prevention of CVD in women.
This World Heart Day, let's choose self-care. Get a simple heart check-up done and encourage other women in yourselves too, to get the same done. Take proactive steps for heart health today.
(By Brajesh Kunwar)
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London- A team of researchers has discovered that the more severely a mother is infected with Covid-19, the more likely she is to experience preterm birth.
The researchers reported that the rate of preterm birth in nearly 1,000 pregnant women, who tested positive for SARS-CoV-2, the virus that causes Covid-19, was a function of the severity of infection.
"The more severe the SARS-CoV-2 infection, the greater the risk of preterm birth," said researcher Roberto Romero from the Wayne State University School of Medicine in the US.
"There was a dose-dependent relationship between the severity of SARS-CoV-2 infection and the risk of prematurity," Romero added.
For the study published in the American Journal of Obstetrics and Gynecology, the team included data from 14 National Health Service (NHS) maternity hospitals in the UK to assess the effects of SARS-CoV-2 infection in pregnancy.
The excess rate of premature birth, they report, is largely due to medically-induced preterm birth brought about by concerns for health of the mother, such as preeclampsia.
Preterm birth, the leading cause of perinatal morbidity and mortality worldwide, is defined as one that occurs before 37 weeks of gestation.
Two-thirds of preterm births are due to the spontaneous onset of preterm labour. The remaining third is due to medical conditions that affect either the mother or the unborn baby that necessitate delivery.
The more severe the Covid-19 infection, the greater the risk of preeclampsia, a sudden increase in blood pressure after the 20th week of pregnancy.
The condition is responsible for 76,000 maternal deaths and more than 5,00,000 infant deaths every year.
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London- Researchers have identified an anti-viral gene that impacts the risk of both Alzheimer's disease and severe Covid-19.
A team from the University College London (UCL) estimated that one genetic variant of the OAS1 gene increases the risk of Alzheimer's disease by about 3-6 per cent in the population as a whole, while related variants on the same gene increase the likelihood of severe Covid-19 outcomes.
"While Alzheimer's is primarily characterised by harmful build-up of amyloid protein and tangles in the brain, there is also extensive inflammation in the brain that highlights the importance of the immune system in Alzheimer's. We have found that some of the same immune system changes can occur in both Alzheimer's disease and Covid-19," said lead author Dr Dervis Salih, from UCL's Queen Square Institute of Neurology and UK Dementia Research Institute.
"In patients with severe Covid-19 infection, there can also be inflammatory changes in the brain. Here we have identified a gene that can contribute to an exaggerated immune response to increase risks of both Alzheimer's and Covid-19," Salih added, in the paper published in the journal Brain.
To understand the gene's link to Alzheimer's, the team sequenced genetic data from 2,547 people, half of whom had the brain disorder.
They found that people with a particular variation, called rs1131454, of the OAS1 gene were more likely to have Alzheimer's disease, increasing carriers' baseline risk of Alzheimer's by an estimated 11-22 per cent.
The new variant identified is common, and it has a bigger impact on Alzheimer's risk than several known risk genes, the researchers said.
Further, the researchers investigated four variants on the OAS1 gene, all of which dampen its expression (activity).
They found that the variants increasing the risk of Alzheimer's are linked (inherited together) with OAS1 variants recently found to increase the baseline risk of needing intensive care for Covid-19 by as much as 20 per cent.
That is, the microglia cells where OAS1 gene was expressed more weakly had an exaggerated response to tissue damage, unleashing what they call a 'cytokine storm,' which leads to an autoimmune state where the body attacks itself, the team said.
OAS1 activity changes with age, so further research into the genetic network could help to understand why older people are more vulnerable to Alzheimer's, Covid-19, and other related diseases, they added.
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Our heart is the key organ in the circulatory system pumping oxygenated blood to various organs. People mostly ignore or are not aware of the symptoms of an approaching heart attack or cardiac ailment. With an increasing prevalence of a sedentary lifestyle, monitoring heart health becomes even more essential. Hence, one should be aware of the newly observed symptoms and complications that signal towards an unhealthy heart.
Chest Pain is Just One of The Many Overlooked Signs
Chest pain is one of the most common signs of an approaching cardiac ailment. Uncomfortable pressure, squeezing, fullness, burning, tightness, or pain in the centre of the chest should be reported to the doctor. Many times these symptoms are confused with gastritis and heartburn.
Snoring and interrupted sleeping patterns
Snoring and sleep-related problems like insomnia and sleep apnea, a disorder where breathing get disrupted while you sleep, have a direct link with heart diseases and other cardiovascular ailments.
Shortness of Breath
Unexplained shortness of breath while doing small amounts of physical activity, at rest or while sleeping (that can wake you up) may indicate an underlying cardiac ailment. Women are more likely to suffer/report shortness of breath when dealing with heart troubles.
Waking up tired, restless and noting higher blood pressure levels in the morning, signals towards an unhealthy heart. Though, one should get a clinical assessment done for ensuring a clear diagnosis.
Sweeting more than usual or without any physical activity, especially if one is not exercising or being active can be an early warning sign of an approaching heart-related ailment. If someone is sitting and suddenly starts sweating profusely, it could be a sign of an oncoming heart attack.
An irregular heartbeat or more formally known as "arrhythmias", is a condition where the heart doesn't pump blood at its normal rhythm. Anyone who is relatively healthy and still has an irregular heartbeat, also indicate a chronic heart condition.
Pain in the chest and upper arm area is what most people typically associate with heart problems. However, pain in the neck or jaw is a potential point of angina pain or discomfort when the heart lacks oxygen-rich blood. Women are more likely to exhibit these symptoms than men, but if the symptoms persist it is advisable to consult a doctor.
A persistent cough is not always a sign of a heart problem, as it's a common symptom of various other common illnesses like cold, flu, and bronchitis. But a never-ending cough can be a sign of fluid building up in the lungs, which signals congestive heart failure.
When the heart isn't able to pump efficiently, blood can back up into the veins that take blood through the lungs. When there is excessive pressure in these blood vessels, fluid is pushed into the air spaces (alveoli) in the lungs. Hence, an unending cough can be caused by the irritation and fluid in the lungs, which is similar to what can cause shortness of breath.
With the current lifestyle patterns, it is very important to monitor your heart health. There can be various hidden symptoms contributing towards an unhealthy heart, hence a timely diagnosis and an active lifestyle should be given attention to. The above-mentioned symptoms can be a few of many symptoms denoting an approaching heart ailment, as a reason being aware towards your own health and consulting for timely clinical interventions become essentially important.
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