Dr Sanjoy Chatterjee

Try stopping a forest fire- it takes months, often years and damages many lives, destroys plantations, pollutes the ecosystem and by the time it stops ‘it is all over’. On the other hand if we can prevent the fire or stop it prior to becoming a raging flame, we save the catastrophe. Breast cancer is no different.

Mass screening programs using Mammography in the west, although controversial, has allowed smaller size cancer detection. Such programs may not be cost effective in our country. But self-breast examination and behavioral changes towards breast cancer are the likely strong and effective alternatives. Awareness of breast cancer as a treatable, often curable condition needs to be highlighted in awareness programs. The very fact that most breast cancers are chronic and slow growing should help in achieving the goal.

Aberrant changes in certain cells in the breast leads to loss of regulation of controlled cell growth, which can be compared to the analogy of lighting the spark. Unchecked, these cells will become like the forest fire. Breast cancer research has allowed us to understand the mechanism of such change in details.

Current research in breast cancer has allowed us to identify targets or switches that turn the cancer cells ‘on’ and this leads to cell proliferation and spread, known as ‘metastases’. These targets can be switched ‘off’ using various modern tablets, which include hormone tablets. Targeted therapy in breast cancer also increases survival rates and reduces the agony of advanced cancer.

Small cancers of the breast can often be taken out using surgery allowing breast conservation. Otherwise, the entire breast may need to be removed.

Current advancement in breast cancer surgery have allowed lesser side effects especially by using advanced techniques to identify lymph glands that may harbor any breast cancer that could have moved to glands in the arm-pit. Bigger surgeries may be followed by excellent ‘onco-plastic’ procedures that could allow excellent cosmetic outcomes giving the cancer survivor the chance to retain her femininity.

When cancers are identified as ‘aggressive’ following analysis of their type, size, grade or spread within the body, chemotherapy could be employed. The thought about going through chemotherapy does make one panic. Hair loss, nausea, lack of appetite and risk of infection are definite side effects with many of the chemotherapy regimes. Modern treatment by experienced teams does guide the patient through these side effects. Compassionate counselors allow the breast cancer sufferer to tide through the treatment effects.

Breast cancer research has allowed most patients to get cured when identified early. Even locally advanced diseases can be cured using modern treatment regimes. But, awareness of detecting the disease sooner is of utmost importance. On the other hand, for the advanced cancers modern treatment allows prolonged survival with preservation of quality of life. Survivorship issues are of utmost mportance and needs special focus. Breast cancer survivors are examples of how the “blazing forest fire” cannot burn the courage of human mind!!