October is the pink month dedicated to breast cancer awareness; in India, it commands extra significance as breast and cervical cancer are the most commonly occurring among women. There were about 1.15 lakh new breast cancer cases in the country in 2008, according to international cancer research agency Globocan, and breast cancer incidence has nearly doubled in the metropolitan cities between 1982 and 2005, says the Indian Council of Medical Research (ICMR). WHO predicts one in every seven Indian women will be at risk for breast cancer by 2020 — which is on par with the US and Europe scenario.
Contrary to common thinking, older women respond better to breast cancer treatment as cancer cells are more aggressive in younger women, says Dr P.P. Bapsy, Senior Consultant-Oncology, Apollo Hospital, Bangalore. Some of her patients are as young as 25, she says adding that younger patients are often misled by general practitioners. “There have been many instances where doctors have told the patients they can't get cancer at such a young age.”
She cites an ICMR study that shows breast cancer sets in a decade earlier in India than in western countries. “While in the West, people may get cancer in their 60s or 70s, in India they are getting it in their 40s and 50s,” she says.
A yearly check-up is advised, especially when there is a family history of breast cancer. As Dr Bapsy explains, “If breast cancer is detected early through a mammogram, that is, before it shows up visibly as a lump, there is a 95 per cent chance it'll be cured.”
But far too often, the lump on the breast is neglected as it doesn't hurt. “People think cancer is pain. At the earlier stage, it is painless; only at a later stage the pain sets in,” says Dr Bapsy.
Inhibition is equally dangerous as many women hesitate to discuss issues related to the breast. “Many don't go for breast screening and are not open for discussion even with their doctors. Women are shy, particularly in India,” says Dr Shekar Patil, Medical Oncologist, Bangalore Institute of Oncology.
Dr Bapsy, who earlier worked with Kidwai Memorial Institute of Oncology in Bangalore, says, “We did a study long back on why women come late for treatment. It's not that they don't notice the lump — most people view breast cancer as a death sentence and live in denial; they convince themselves it's some sort of infection.”
Early detection can help avert breast removal and reduce the use of chemotherapy. “Nowadays there are more conservative surgeries, more effective drugs and more personalised treatments,” says Dr Patil.
But the doctors hold out hope even for cases where the cancer has reached an advance stage. “I've had patients in advanced stages who have responded very well — many have lived 10 to 15 years after treatment without any disease,” Dr Bapsy says.