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The need for eternal vigilance

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By Michelle Anne P. Soliman, Reporter

ACTRESS MARITONI Fernandez had just turned 30 when she went to the US, accompanying her mother who was to take tests for an illness.

“While I was there, I had an uncle who is a doctor and I just mentioned it out of the blue that I feel a lump on my right breast,” Ms. Fernandez said. She got it checked and she was told she had Stage 2A breast cancer. “I went through four rounds of chemotherapy and 26 cycles of radiation therapy, and I was on Tamoxifen for five years.”

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Entrepreneur Tony Abad was living in the US. She recalled that back then, the trend of breast augmentations was popular among her peers.

“I was convinced by a friend to get breast augmentation… I left the breast implant in without being vigilant in checking it every year,” Ms. Abad said.




Back in Manila, during a day with her family at a hotel, she felt a sharp pain in her breast. “I felt a really painful throb on my breast, [so bad] that I had to go to the restroom and really cried out. It was so painful,” she shared. “Para kang sinaksak (It felt like I was being stabbed).”

She thought her implants had burst. She went to see a doctor and was diagnosed with Stage 1 breast cancer.

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Journalist Alya Honasan was busy with work and various responsibilities which delayed her regular breast checkup. When she took the time to have herself checked and a lump was found, she had everything done within one week. The lump was found on a Tuesday; on Wednesday she went to see a breast surgeon; she had a biopsy on Thursday; and the following week, she was diagnosed with Stage 2A breast cancer.

A WORLDWIDE PROBLEM
According data published by the International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), this September, an estimated 18.1 million new cases of cancer will be reported this year — 2.1 million of which will be breast cancer cases. Breast cancer is the most common cancer among women worldwide.

The Philippine Cancer Statistics and Estimates reported in 2015 that breast cancer was the leading cancer in both sexes with 20,267 cases.

According to the American Cancer Society, the most common symptom is the presence of a painless and hard lump. Other symptoms include swelling on part of the breast, nipple or breast pain, skin irritation, and redness.

Due to the prevalence of the disease worldwide, October has been designated as Breast Cancer Awareness Month, an international campaign to spread information, mount activities, and raise funds for research on the disease.

In 1992, cosmetics company Avon began its support for breast cancer awareness. Since then, Avon and the Avon Foundation for Women have educated women about the disease and funded breast health screenings for almost 20 million women.

“As part of our Avon Breast Cancer Promise, we are committed help women know the risks, the signs, and ways to take action against breast cancer, starting with the breast self-exam,” Razvan Diratian, general manager of Avon Philippines told BusinessWorld in an e-mail.

In 2017, Avon Philippines started the Pink Minute campaign — encouraging women to perform regular breast self-exams which just take a minute to perform.

For this year, Pink Minute integrated the campaign with the Pink Light Project, using pink light as a symbol to amplify awareness. Avon will be lighting up selected landmarks around Metro Manila in pink “as a reminder to make the breast self-exam a habit.”

Beginning Oct. 20, Avon Philippines will be lighting the Quezon City Memorial Circle in pink. Other landmarks include: SM MOA Globe, the PET Plans Building, Eton Centris, St. Francis Square, Manila City Hall, and the Philippine General Hospital.

“In the future, Avon hopes to bring the project to even more areas across the country,” Mr. Diratian wrote.

As a fund-raising effort, company is also releasing a limited edition Live, Love, Laugh Necklace for women fighting breast cancer. Part of the proceeds will go to the Avon Breast Cancer Fund for the maintenance of the Avon-Philippine General Hospital Breast Care Center. The center provides free breast health guidance, consultations, and check-ups to about 150 women a day.

“Our efforts over the years have allowed us to build the Avon-PGH Breast Care Center, which offers assistance and guidance to approximately 150 women per day. Our efforts benefit the patients here, as well as allows us to do regular breast cancer sessions with survivors to provide support and care. During last year’s Pink Minute campaign, we started a Pink Minute Hotline so that people could talk to someone in case they had any questions or concerns about their breast self-exam. In less than a month, we received over 200 calls from women,” Mr. Diratian wrote.

“Avon Philippines remains committed to the cause of spreading awareness about breast cancer in the future, with the goal to reach 100 million women every year and make sure they all know the risks, signs, and ways to take action when it comes to this disease,” he added.

BREAST CANCER REGISTRY
According to Victor K. Gozali, M.D., president of the Philippine Breast Cancer Society, Inc. (PBCS) — an organization of medical professionals focused on serving breast cancer patients in the country — they aim to “give awareness and expand the noise about breast cancer.”

The organization conducts regular forums and has specialists travel to various cities in the country to talk about breast cancer.

In an interview with BusinessWorld shortly after the Pink Ribbon Day program on Oct. 2 at SM North EDSA, Dr. Gozali said the organization plans to work with the Department of Health (DoH) in creating a comprehensive breast cancer data registry in the Philippines. The registry will be used to keep track of the cases of breast cancer.

PBSC also hopes to conduct further training and education for its doctors about standardized treatments.

Since 2017, the PBSC has collaborated with SM Cares, the corporate social responsibility arm of SM Prime Holdings, in spreading their advocacy through the Pink Ribbon Day when it conducts free breast examinations and consultations.

To catch the disease earlier, Dr. Gozali, urges patients to go through a mammogram. “The purpose of mammography is to detect non-palpable breast tissues,” he said.

ADVANCEMENTS IN DIAGNOSIS AND TREATMENT

Dr. Mark Richard C. Kho, vice-president for Medical Service Operation at the Manila Doctors Hospital, stressed the importance of getting regular mammographs for early detection.

During the launch of the new Mammomat Revelation system, Dr. Kho told the press that women at the age of 40 are advised to start undergoing regular mammography. Women aged 45 to 54 are advised to have it annually, while women at 55 and above should undergo it once every two years.

This month, the Manila Doctors Hospital acquired the new Mammomat Revelation HD Breast Tomosynthesis system from Siemens Healthineers. With a 50-degree wide-angle, the system provides 3.5 times higher depth resolution compared to narrow-angle resolutions. It is built with PRIME Technology which reduces radiation dose “up to 30% without compromising image quality.” The system also provides ease during examinations due to its soft compression feature.

“The machine offers better imaging of the breast, giving a better visualization of the hidden breast masses that were not delineated in conventional mammography and with essentially the same amount of radiation dose or even less,” Dr. Manuel Tuazon, vice-chairman for the Department of Radiology at Manila Doctors Hospital told the press.

“The machine also allows the user to provide better outcome of the biopsies of the suspicious breast masses due to the superior localization of lesions compared to the previous mammography.”

Elizabeth de Guzman-Dantes, Manila Doctors Hospital president, said that the cost of the treatment is comparable to the conventional mammogram.

In August, Siemens Healthineers launched a radiotherapy system at St. Luke’s Medical Center — Global City called the TrueBeamTM Radiotherapy System, created by Varian Medical Systems. The machine treats cancer with 60% faster image-guided radiotherapy. Compared to previous treatments that may last for 15 minutes, the system allows the patient to lie still for two minutes, giving the patient less exposure to radiation.

CONQUERING THE FIGHT
Alya Honasan, Maritoni Fernandez, and Tony Abad emphasized the importance of undergoing mammography and said that being diagnosed with breast cancer does not hinder one from keeping a positive mind-set and living a healthy lifestyle.

“It will save your life, money, and effort. Don’t be stubborn to get yourself checked and get your regular mammogram,” Ms. Honasan said, talking about the importance of early detection. “Take care of your body. Take care of what you eat, and half the battle is won.”

It has been five years since Ms. Honasan survived breast cancer and she is an active member of the ICanServe Foundation, a breast cancer support network.

For Ms. Abad, it is important to be vigilant. “Huwag natin isipin na, ‘hindi naman ako tatamaan.’ Hindi natin alam ang buhay (Let us not think ‘I will not get it.’ We do not know what will happen in life).” Ms. Abad has been cancer free for 12 years.

Ms. Fernandez also stressed the importance of putting yourself first. “Put checkups first before anything else,” she said. “Kung hindi ka magiging medyo selfish, lahat ng mahal mo kawawa (If you are not slightly selfish, your loved ones will suffer),” adding that our loved ones depend on us too.

During one of her treatments, Ms. Fernandez’s doctor shared encouraging words. She was told that, “Of all the cancers to get, breast cancer is probably the best one because a breast is removable,” she recalled.

In a mixture of English and Filipino, she added, “When you have [breast] cancer, it is such a relief to know that removing one’s breast gives you a chance to survive.”

Ms. Fernandez will be 18 years cancer free in November.