Breast Cancer Challenges- Sustainable Solutions

Kerala Cancer Crusade and Cancer Literacy Mission and IRIA Preventive Radiology National Program conducted a Webinar Series on “Kerala Cancer Crusade and Cancer Literacy Mission” in association with IRIA Kerala, Swasthi Foundation and Community Oncology, Regional Cancer Centre, Journo Med. The ninth-day webinar discussed “Breast Cancer Challenges- Sustainable Solutions, Saving Lives.” The event was held on 27th October 2022.

Dr Rijo Mathew, President of IRIA, Kerala, discussed Breast Cancer Day and its awareness. Dr Rijo has invited the chief guest Fr Binu Kunnath, Director of Caritas Hospital. 

Fr Binu Kunnath, Director of Caritas Hospital inaugurated this session. He explained his concern towards the webinar. Through a webinar, we are solving to eradicate the cancer through Cancer Crusade Program and Cancer Literacy Mission. Cancer in today’s social condition is most crucial. Through the webinars, we are connecting with commodities and people. IRIA monitors several initiatives towards the program. In the present age, technology is taking a leading role in health. The efforts taken in this field are highly appreciated. There must be a lot of technological improvement in the healthcare sector. During the pandemic, the scope of Telemedicine and Telecommunications has increased drastically. Telesurgeries, Robotic surgeries all came into prominence. Most incidences are happening in the telehealth sector. But the prevention of health detection on early disease diagnosis needs to be checked to promote effective and better treatment to be prepared. The discussion of community-centred program on the prevalence of the disease and its spread was also discussed. The asset to detecting cancer in the early stages is crucial. In Caritas Hospital, there is a cancer institute and a lot of people from the neighbouring districts of Kerala are suffering from Cancer. The early detection or the commodity-centred program could have saved a lot of lives, time and money. There is a long way to go in terms of a cancer diagnosis. Widespread awareness programs and diagnosis programs are essential in this contemporary age. The awareness programs reveal that there is a responsibility of doctors towards the patients. In Kerala, people are approaching hospitals for treatment, and the doctors feel that the treatment should be approached towards home. One should approach the commodity to save the people. Breast cancer treatment is the most challenging in the field of cancer treatment. He stressed that one should work together for the better of humanity. If the human touch in the medical terminology is lost, therapeutic touch, face to face interactions with the doctor are the results of the webinar. Prevention is always a heart cell and prevention is not as dramatic as the cure stories. Prevention has its impact at the community level, and it stages cancer at a very early stage. It’s going to create a huge economic impact, a huge social impact and a huge impact on quality-of-life survival. With that message, IRIA has embarked on several initiatives and Dr Binu Kunnadam has taken an initiative to start up the NCD clinics. Cancer screening centres at Caritas Hospitals serve as a motivation for the private centres to start similar NCD centre which initiates a lot of screening programs. Cancer at a very early stage can be detected through this program. Cancer detection at a very early stage can make a significant difference in the Cancer Crusade. 

Advocate Dimple Mohan, Swasthi Foundation introduced Dr Lopamudra Roy, an eminent speaker. 

Dr Lopamudra Roy, Founder and President of Breast Cancer Hub (BCH), Cancer Scientist and Research Professor and Social Entrepreneur whose dream is to inculcate scientific thinking, and scientific research among the most promising generation of the World. She explained the taboo associated with breast cancer observed among women, breast cancer stages in women i.e., stage 1, stage 2, stage 3 and stage 4. Cancer crusade is so essential, the socio-economic conditions irrespective of the disease. She is a very dynamic, socially committed personality and she has 18 plus years of experience in dream research, teaching and mentoring undergraduate and ph d candidates. She has pursued research in the field of genetics and breast cancer and pancreatic cancer. She received her Ph D in molecular biology and genetics from India. In addition to their research experience in biochemistry at Delhi university, India and Dr Das received her post-doctoral fellowship at Clinic College of Medicine, USA in cancer immunology and therapeutics focusing on breast cancer, pancreatic cancer. At the male breast cancer collision 2019, Orlando, USA is also awarded for outstanding performance leave and welfare activities in India. She addressed that women are still presenting late. In the lab, high-end technologies, and fundamental research is being forgotten. Radiologists are phenomenal people who work on immense change. Stage 4 in breast cancer is considered an advanced stage in breast cancer. The patients can feel the painless lump in the breast which could be the reason for breast cancer. In addition to the taboo, there is ignorance. It is our responsibility to tackle breast cancer. Irrespective of education, women are getting treated late. 

In the breast cancer hub, all teams work together. Men can also get breast cancer but many of them do. Male breast cancer patients are survivors. Unfortunately for men, there are no screening processes, yet which are the regular screening. Many men feel it’s a women’s disease and they feel shyer to discuss it. When the breast cancer crusade is performed, also emphasize the male breast cancer scenario. In Assam, 6-7 men are lost due to breast cancer in the last 6 years. None got diagnosed early. When the statistics are taken into consideration. There was no data on the male breast cancer scenario either from India. Whenever a country grows stronger in cancer scenario, the data publication is equally important to make a country stronger. Kerala can do great because Kerala is the country which is ahead in literacy. In India, the mortality rate is comparatively higher when compared to the US. Though in regular also, there is an estimation of the number of deaths. Due to taboo and ignorance, there is the development of higher rates of cancer and early detection becomes late. Even due to the lack of research, the medical fraternity can come forward to collaborate and there is so much data lying on the table which might not be translated into publication. 

The recommended age for breast cancer screening is 40 years old. 79% of women in the US do not go for a mammogram, because it is not the age yet. In urban India, the mammogram observed, hardly there is any difference. 11% have been going for mammogram screening or ultrasound as they have concerns in the breast. But that doesn’t come under screening and that becomes a diagnosis. Even in urban India, these challenges are being faced along with the VCH running along and other organizations facing challenges. Even with the breast self-examination, there is inconsistency and real-time interviews are done to study the breast self-examination. Patients usually hide from the doctor regarding the treatment they are undergoing apart from the breast cancer screening. These treatments can be related to conventional chemotherapy, radiation or any targeted therapy. That is another problem revealed by several gynaecologists and oncologists is the specificity and the severity is about the early detection and treatment. The sensitivity goes low when one realizes the things going on within the treatment scenario. The conditions which are not brought into the limelight. There are areas too where one faces the concern. In India, parallel with the mammogram, even ultrasound is performed. A lot of research is being gone on regarding the dense breast which is a risk factor too. 

A breast self-examination card is available at PCH for both men and women and the breast self-examination can be performed. The card is available in 24 languages. The cards are available all from scratch from 24 volunteers. When the breast self-examination is performed, never miss the underarm area. A proper protocol must be performed. Teaching the proper methods for breast self-examination is equally important. A sustainable solution saves many lives. A lot of stigmas are observed in women that they don’t approach breast cancer screening too.  Even in the urban community, it works in local languages. Most of the villagers since they are unaware of breast cancer. The main focus is on pictures. The villagers now remain focused even though the panchayats work for the welfare of the Breast Cancer. Trying to collaborate with the local healthcare centres. Taking accountability and also following up and making sure that the treatment is done. Many government schemes are introduced for people below the poverty line. The villagers are not even aware of those government schemes. That information also needs to be aware and taken care of. In the US, based on the target audience, one has to mould their outreaches. Approaching door to door, penetrate obtaining the consolidated data of the patients and performing the training of the breast self-examination. Even training the field workers in the local cancer hospital regarding breast cancer can eradicate the disease to a major extent. Mostly villagers were chosen for training and villagers can approach door to door to perform screening. 

Taking care of each patient: case by case in BCH-adopted villages

• Daily wage earners, no one to accompany them. 
• BCH covers all expenses starting from transport, purchasing medicines, diagnostic tests, and surgical procedures not covered under the government schemes.
• BCH team assists the patients by taking them to the hospital, helping with income certificates, AAA cards, hospital registration to patient communication with the doctor, accompanying them in the full diagnosis process, buying necessary medicines, and dropping them home with follow-ups and counselling. 

Conclusion

Cancer is not a contagious disease though our society has created a significant myth. So much false information or fake news is being spread among the patient’s family which creates panic and fear to a major extent. Spread hope. The fear of social stigma can hamper early detection. Lend support, care and strength. Let the family survive on strength and positivity and not on weaknesses. The support groups were in existence in many cooperate hospitals. Though the population are at different extremes globally, emotionally all get connected with extreme love and care. Breast cancer Hub provides scientific counselling on cancer diagnosis and guides patients throughout their journey. Cancer is curable and early detection of cancer is the key to diagnosis. Cancer care is more focused on palliative care and even on the transgender population so that cancer can be prevented to a major extent.