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Coping With Cancer

Sakaal Times
14 October 2011

As the incidence of breast cancer keeps growing, women need to be more aware of the changes they need to make in their diet, routine, lifestyle etc to help deal with the problem

Namarata Reddy was taking care of her mom who was a third-stage cancer patient. Miraculously, her mom came out of the disease but as soon as she recovered, Namarata was diagnosed with breast cancer.

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“I still remember the day when I had to go to Jehangir Hospital to collect my mammogram report. When I discovered that the results were positive, I almost went numb. I was all alone and the initial shock was too much to deal with,” recalls Namarata.

Like all other moms, the first thought that crossed Namarata’s mind was: Who’d take care of her son if she had to die?
Namarata’s husband was in the UK then, so she went to the gynaecologist, who’d suggested the mammogram, and discussed the surgery and other procedures.

She did not know how to break the news to her family. “Luckily, my elder sister, who lives in Mumbai, called and I broke down. She called a close friend of mine to take care of me. And once I reached home I started screaming and yelling, but my mom and my 14 year-old son were very patient. Finally, my friend told my son about my newly-discovered illness. He consoled me while taking care that my mother did not get to know about my ailment,” she adds.

It’s very important to get family support when you have to deal with cancer and Namarata was lucky to have very loving and caring people around her. Her husband flew down from London and both her sisters came down to Pune to support her in her hour of crisis. Her mother-in-law, cousins, uncles, aunts, friends and acquaintances also extended their support. “A few of them also commented: ‘Kya paap kiya jo aisa hua’. My response was: ‘Paap to sabhi (knowing / unknowingly) karte hai, but it’s got to do more with my weak body and weak resistance,” she says.

Her oncosurgeon and oncophysician Dr Koppikar and Dr Shona Naag made Namarata’s recovery process less traumatic. “They always assured me that breast cancer was a common illness and 100 per cent prognosis could be achieved. Luckily, it was my first stage and lumpectomy was done. I was given radiation and administered anticancer drugs for five years,” she informs.

Goes without saying that the radiation and drugs had a lot of side effects, but today Namarata is happy that she’s learnt a few important lessons and has emerged stronger. “Now I take care of myself much more. Besides, I have learned to accept problems without making a fuss. I understand that life is beautiful and my doctors have asked me to live life kingsize and I am doing so! I am enjoying every moment!” says she.

“Dr Sharangpani, who also played a pivotal role in my recovery process, said: ‘Don’t keep any hurt in your heart and try to relax. Also, follow a balanced and proper diet, sleep well and, above all, follow a good exercise regime! All this will ensure that the cancer does not recur!’ I am earnestly following the advice,” adds she.

Of course, the fear of recurrence still props up at times but her son and husband take care that she’s never alone in her battle against cancer.

Namarata is a civil engineer by profession and had resumed work within 5 months of her treatment! Quips she, “I feel there is no need to fear. I have learnt to accept things and move on in life. Death is inevitable, so why crib and sulk? Why not enjoy life?”
Point taken, Namarata, and of course, we have a few lessons to learn here as well!
Tania Roy
Senior gynaecologist & infertility consultant at Oyster & Pearl Hospitals Dr Neena Sathe shares with us how breast cancer can be prevented with a few lifestyle changes.

Can breast cancer be prevented?
Breast cancer is a genetic and a lifestyle disease. The lifestyle factors which we could modify to reduce the risk of breast cancer are:

Having your first child before the age of 30
Breastfeeding for 6 months at least
To keep weight in the normal range for your age and built
Alcohol must be cut down, even one peg of alcohol per day increases your risk of breast cancer
Cut out red meat and any diet rich in animal fats must be avoided.
The genetic factors are not in our hands, but those in the high risk group must get a regular screening with a mammogram every year and if your doctor recommends, you must undergo a MRI Scan and a Genetic Testing for 2 breast cancer genes BRAC1 and BRCA 2 to calculate your risk

What are the risk factors (eg genes, obesity, exposure to chemicals...) for breast cancer?
Postponing the delivery of the 1st child beyond 30 years
Breast feeding for less than 6 months
Diet rich in animal fats
Family history
Early Menarche < 11years
Late Menopause > 45 years
Racial factors
Radiation to chest wall — as Rx for Hodgkin’s disease
What are the lesser known types of breast cancer?
More unusual types of breast cancer generally originate not in lobules or ducts, but instead in the supporting tissue of the breasts such as blood vessels, lymphatic system, and fibrous connective tissue. Some rarer forms of breast cancer are:
Phyllodes tumor
Inflammatory breast cancer,
Paget’s disease of the breast
Adenoid cystic carcinoma.
Common fears
Is breast cancer curable?
Yes, if diagnosed early, threat from the disease is negligible.
If a mastectomy is needed, will I be permanently disfigured?
No, breast prosthesis and reconstructive surgery can make you look absolutely normal.
Is chemotheraphy and radiation needed for all patients?
No, this is needed only for patients with an advanced stage of the disease.
There is cheering news for victims of breast cancer who feel disfigured by the partial or complete removal of their breasts. Researchers led by Judit E Puskas from the University of Akron, US, are currently developing an alternative nanostructured material to silicone rubber that will minimise complications.

The new material will also be able to deliver cancer drugs locally to improve the efficacy of treatment and minimise side-effects of chemotherapy, the journal Nanomedicine and Nanobiotechnology reports.

“If successful, our material could be used for implants with drug delivery capabilities,” says Puskas.
Until now, the only option available to women undergoing breast reconstruction and augmentation was based on silicone rubber. But the use of silicone implants creates plenty of complications, including other forms of cancer and psychological disease.

Around 75 per cent of post-mastectomy (removal of one or both breasts, partially or completely) patients choose some kind of breast reconstruction.

Drug counters bone-damaging effects
An osteoporosis drug counteracts the bone damaging side-effects of some breast cancer medications. The study indicates that some breast cancer patients could take zoledronic acid in addition to their anti-cancer medications to maintain bone health.

Drugs called aromatase inhibitors stop the production of oestrogen in postmenopausal women and, therefore, make less oestrogen available to stimulate the growth of certain breast cancer cells, reports the journal Cancer.

Many postmenopausal women with breast cancer are routinely treated for several years with these potentially life-saving drugs, but the agents can cause bone loss and fractures.

Adam Brufsky from the University of Pittsburgh’s Cancer Institute, and his colleagues conducted a study to see if the bone drug zoledronic acid could prevent and treat bone loss in postmenopausal breast cancer patients.

In their five-year study, called Z-FAST, 602 postmenopausal women with early breast cancer who were receiving the aromatase inhibitor letrozole, received zoledronic acid simultaneously with letrozole or only after bone loss or fractures occurred.

Investigators noted progressive increases in bone density in women who initiated zoledronic acid at the start.

A modest amount of walnuts in diet knocked off much of the breast cancer risk among mice. Elaine Hardman from Marshall University’s School of Medicine, compared the outcome of a typical diet and a diet containing walnuts in the lifespan of mice.

The group whose diet included walnut developed breast cancer at less than half the rate of the group with typical diet, Hardman said.

Besides, the number of tumours and their sizes were significantly smaller, the journal Nutrition and Cancer reports. “These reductions are particularly important when you consider that the mice were genetically programmedto develop cancer at a high rate,” a Marshall University statement reported Hardman as saying. “We were able to reduce the risk for cancer even in the presence of a pre-existing genetic mutation,” Hardman added.

Genome News Network had reported in 2004: “Scientists have developed a new technique for growing human breast tissues in living mice. The restructured mice may serve as the best experimental model yet for studying human breast cancer.”

Using genetic analysis, the Marshall study found that walnut-containing diet changed the activity of multiple genes relevant to breast cancer in both mice and humans.

Other testing showed that increases in omega 3 fatty acids did not fully account for the anti-cancer effect and found that tumour growth decreased when dietary vitamin E increased.

One must have critical care policy
Medical expenses are mounting and if one is battling with a critical disease like breast cancer, then the family kitty is left with a gaping hole. What should one do in such circumstances or rather what financial planning must one have to deal with such exigency?

Certified financial planner Sudhakar Kulkarni says, “One should have critical care policy from a life insurance company. This policy can be taken either independently or as rider to the main life insurance policy. It is recommended to go for independent policy, which is for the period of 20 years maximum or up to the age of 50 years. For example, a 35-year-old woman who thinks of buying this policy for Rs 5 lakh cover will get the policy till the age 50 that is for a period of 15 years for the yearly premium of around Rs 5,500. The policy does not have any maturity benefit which means if she leads a healthy life and doesn’t face any medical exigency, she will not get any maturity benefit at the end of the policy period. However, if the policy holder is diagnosed with any type of cancer, the insurance company will immediately make the payment of assured amount to the policy holder, irrespective of actual expenses required for the treatment. After the payment is made, the policy is terminated by the insurance company. This helps the policy holder to meet urgent preliminary expenses.”

Kulkarni also suggests that one should also consider mediclaim policy for reimbursement of hospitalisation expenses because of cancer treatment and follow-up. The policy provides reimbursement of actual expenses or policy cover amount or whichever is less. However, mediclaim policy will not cover cancer and related reimbursement to a woman who is already been diagnosed with cancer. Which is why, one should have a contingency plan — a bank balance of Rs 4-5 lakh or liquid assets of equal amount.

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