By See Foon Chan-Koppen
There is much in talk and print in the media today on the prevalence of cancer around the world. Breast cancer in particular appears to hog the headlines and many medical practitioners are sounding alarm bells about the need for early detection. In the UK alone the statistic is an eye-opening 1 in 9 women diagnosed with breast cancer in their lifetime while in Malaysia, where actual numbers are not available, the figures are equally dire.
According to the latest information from MD Anderson Hospital, Texas, “the overall 10-year survival rate for all types of breast cancer improved significantly over 60 years from 25% between 1944 and 1954, to 77% between 1995 and 2004.”
Ipoh Echo spoke to Kinta Medical Centre’s Consultant Radiologist Dr. Ranjit Singh who deals with the diagnostic aspect and Dr. Perdamen Singh, Consultant in Radiotherapy and Clinical Oncology (Cancer) who handles the therapeutic options of breast cancer.
Both concur on one important point in the management of this disease and that is that early detection is the key to higher survival rates. Both specialists recommend women to perform self-examinations every month a few days after their menstruation when hormone levels are stable. Ninety per cent of all breast lumps are found by women themselves, hence the importance of this monthly ritual.
According to Dr. Ranjit, the next line of defence is for women to have mammograms annually for those aged 40-50 and every two years for those over 50. It has been found that more women in the 40-50 age group develop breast cancer than those who are older and that younger women also have more aggressive cancers. Mammograms can pick up tumours that are not palpable in a physical examination and have been proven to lower death rates by 30%.
For women under 40, with no familial history of breast cancer, Dr. Ranjit recommends ultrasound examination while those with a strong history are urged to reduce their risks with a combination of ultrasound, mammogram and MRI. While this may be more expensive and time consuming, an MRI can detect cancer not visible on mammograms and ultrasound.
The next step in the process of managing breast cancer is to have a biopsy of any breast lumps that are detected to ascertain if the lump is malignant and this is where Dr. Perdamen steps in.
Dr. Perdamen, a native Ipohite, offers therapeutic options once a lump has been found to be malignant. As a seasoned oncologist and the first Malaysian to become a Fellow of the Royal College of Radiologists in London, he was the head of the Cancer Centre at Hospital Kuala Lumpur and in Ipoh Specialist Hospital (ISH) where he treated his first radiotherapy patient in 1989. Today Dr. Perdamen practices from his clinic in Kinta Medical Centre in Jalan Chung Thye Ping with radiation treatment facilities made available to him at ISH as visiting consultant.
According to Dr. Perdamen, the 5-year survival rate for breast cancer patients depends on the stage at which the cancer is detected. At stage 1, the survival rate is 90-95%; stage two 70%; stage three, 50-60%; and stage four 15-20%. When asked if tumour markers especially the one for breast is useful for early detection, Dr. Perdamen said, “Tumour markers like the CA 153 are good indicators for further diagnostic options. It is a simple blood test which if found to be high, will be indicative of a need for further testing with either ultrasound, mammogram, MRI and finally a biopsy.”
“When a confirmed cancer diagnosis is reached, then treatment options can be discussed with the patient. Today we have a plethora of treatment options ranging from simple lumpectomy, to chemotherapy and radiotherapy. In early stages you have a good option to have your breast conserved just with lumpectomy followed by radiation and chemotherapy. The sooner a patient is diagnosed, the faster and better the chances of full remission,” he added.
Both Dr. Perdamen and Dr. Ranjit agree that women should be more alert to the signs of breast cancer and take preventative measures to examine themselves regularly as well as go for mammograms and ultrasound testing on an annual and bi-annual basis.
Kinta Medical Centre will be having a promotion through the months of February and March to promote awareness of breast cancer screening. Special rates will be available during this period.