According to ParkCity Medical Centre consultant breast surgeon Dr Azlina Firzah Abdul Aziz, the general awareness about breast cancer – from the importance of self-exams to identifying symptoms – has increased over the years.
“However, the fact remains there are still numerous misconceptions that stop women from seeking treatment, even if they find themselves having the symptoms,” she opines.
One misconception is that undergoing a biopsy would accelerate the growth of the tumours, but Dr Azlina explains: “Biopsy is an important part of breast cancer diagnosis, along with mammogram and ultrasonography.
“While a mammogram and ultrasonography can identify the presence of tumours, a biopsy helps detect if the tumours are cancerous and thus assist in identifying the type of breast cancer.”
Recognising the type of breast cancer in each patient is crucial to the process of treatment since some types are more aggressive than others. In this context, Dr Azlina mentions another misconception women have – that the only treatment is the removal of the breast (mastectomy).
“Healthcare professionals decide on the course of treatment based on the type of breast cancer. For instance, if there is just one large cancerous tumour, chemotherapy can be performed to reduce the size so that the breast can be saved by only removing the lump (lumpectomy).
“On the other hand, if there are numerous small tumours in different areas of the breast, a mastectomy may be done before or after chemotherapy.
“Breast saving surgeries are performed wherever possible. However, even if someone does need to go through complete breast removal, reconstruction surgery can be done right away or later on,” assures Dr Azlina.
The third misconception that stops women from seeking proper treatment for breast cancer is alternative treatment.
“People sometimes confuse complementary medicine with alternative medicine. While the former is used along with ongoing treatment to relieve symptoms, the latter is usually done by completely stopping medical treatment.
“For example, if someone undergoes acupuncture to help with knee pain while undergoing treatment for osteoarthritis, it is considered complementary healing.
“But when that person stops treatment and undergoes acupuncture only, then it becomes alternative treatment,” says Dr Azlina.
She stresses that taking complementary medications such as supplements is not advisable, and neither is stopping mainstream treatment for alternative treatment as it can do more harm than good.
“Some alternative treatments can actually accelerate the growth of tumours and sometimes, even if one chooses to switch to regular treatment from alternative treatment, they may have to undergo a waiting period since some herbs, such as ginseng, can interfere with certain procedures, including biopsy,” warns Dr Azlina.
She also reveals the sad reality that there are patients who put faith in alternative healing practitioners because they are convinced these methods can heal them while also eliminating the need for invasive procedures such as biopsy and surgery.
Life is precious
According to Dr Azlina, the survival rate of breast cancer is high if detected at an early stage and treated properly. Unfortunately, when most patients decide on consulting a healthcare professional, it can already be too late.
“This fear is a big barrier women need to overcome. It does not help that there are currently less than 55 breast surgeons (in both public and private hospitals) in Malaysia and several states don’t have breast surgeons.
“Patients may end up visiting doctors too late because of the drawn-out referral process in the public hospitals or getting misdiagnosed,” she says.
Although there are many awareness campaigns and there is indeed increased consciousness, women need to also understand the repercussions of not getting treated early and differentiate between myths and truths.
To find out more, look up the National Specialist Register at nsr.org.my. For more information, call 03-5639 1212.
When common is not necessarily normal
As our bodies age, we start noticing changes in our body functions that may not be life threatening but could present slight inconveniences in our lives. Urinary incontinence in women is one such condition and it occurs in approximately 30% of women aged 30 to 60 worldwide.
However, Subang Jaya Medical Centre consultant obstetrician and gynaecologist, Dr Pauline Pue Leng Boi stresses that the notion of urinary incontinence as a normal part of ageing is untrue.
While you may notice your pre and post-menopausal peers experiencing the same condition, urinary incontinence should not be ignored and is treatable with simple procedures.
Getting to the root of the condition
According to Dr Pue, there are two common types of urinary incontinence in women – stress incontinence and urge incontinence.
While both types can cause a woman’s bladder to leak involuntarily, the first occurs when she coughs or sneezes, while the second inflicts an unavoidable, constant need to visit the toilet.
The causes of urinary incontinence are multifactorial. Some examples that cause the weakness of the muscles that support the urethra in stress incontinence are:
♦ Trauma, usually from vaginal birthing.
♦ Low hormone levels, especially in post-menopausal women.
♦ Familial collagen disorders, which can be hereditary, despite the woman having none of the other risk factors.
♦ Chronic increased pressure in the abdomen, sometimes present in obese women, chronic constipation, manual labour and those with chronic coughing, such as smokers or people with poorly controlled asthma.
Taking quality of life into your own hands
Dr Pue says the causes for urge incontinence are largely unknown and are therefore unavoidable. However, urge incontinence can still be treated successfully with a fairly high success rate of 60% to 70%.
For stress incontinence, there are various forms of prevention and treatment methods. To reduce the risk of stress incontinence, women can opt for an elective caesarean delivery to protect their pelvic floor muscles. Another way is to make sure they are not overweight or obese.
For women already experiencing urinary incontinence, Dr Pue says they can choose between lifestyle changes or surgery depending on severity.
Examples of lifestyle changes are:
♦ Monitoring fluid intake: There is the possibility that urinary incontinence is caused by excess fluid intake in comparison with body size.
♦ Maintain a healthy weight: Obesity increases the pressure on the abdomen.
♦ Reduce caffeine intake: Caffeine causes an overactive bladder.
♦ Practise pelvic floor muscle exercises (Kegel exercises): Muscle strength is determined by how much you use the muscle.
Dr Pue assures patients they should not fear the surgical procedure for urinary incontinence. “It is a minimally invasive surgery where we insert a sling to hold the urethra. This sling will support the pelvic muscles every time the patient coughs, preventing leakage.”
She says that the success rate for this surgery is very high at 80% to 90% with a relatively easy recovery, and that it is a permanent procedure and over time, the sling will blend with your muscle tissue.
Break the silence
There is nothing to fear when getting your urinary incontinence treated. Dr Pue says some patients may fear surgery because they are unaware it is minimally invasive. Some defer treatment because it is not life threatening.
Nevertheless, she encourages treatment as it can increase your quality of life.
She advises Malaysian women: “Women should not suffer in silence from urinary incontinence because this condition is very much treatable. As for women who do not have this condition, start Kegel exercises before menopause to prevent this condition early.”