Second part: Fighting the enemy
Third part: Breast Cancer: Fighting misinformation saves lives
BARELY a year after finishing her active treatment for endometrial cancer, Annabelle Cadeliña was clueless that her regular mammogram and breast ultrasound checkup was the start of another battle — breast cancer.
A teacher by profession from Ormoc City, Annabelle was diagnosed with endometrial cancer at the age of 51 in 2021. In less than a year, just as she was about to continue law school, Annabelle was diagnosed with Stage 2 triple-negative breast cancer.
Annabelle recalled that it was after the mammogram was performed and during the breast ultrasound that everything went downhill.
The radiologist was kind enough to explain to me what she was seeing on the monitor, but she was very firm and adamant that I should see a breast surgeon right away. Do not waste precious time, she added.
"My diagnosis hit me like a ton of bricks," Annabelle told an audience of cancer patients, survivors, and medical practitioners during this year's Cancer Chat by the Philippine Society of Medical Oncologists (PSMO) and IcanServe Foundation.
She said the first cancer was easy, but the second one is quite a challenge, so I prayed really hard. “Lord, I will not question my faith; just give me enough strength to power through this. You know, God really is amazing. If I was greatly affected and devastated I had cancer, this time around, God gifted me to accept this second one,” Annabelle said.
Annabelle is just one of the millions of women in the world diagnosed with breast cancer.
Thousands of women continue to lose their lives to breast cancer, a pressing issue that shows no signs of abating, particularly in low-income and lower-middle-income countries such as the Philippines.
Global data from 2020 highlights breast cancer as the most prevalent form of cancer, accounting for a substantial 11.7 percent of the 19,292,789 total reported cancer cases, totaling 2,261,419 new cases.
Moreover, in terms of mortality, breast cancer constituted a significant portion, accounting for 6.9 percent of the overall breast cancer mortalities, which accounted for 684,996 deaths out of a total of 9,958,133 cancer-related deaths.
The data from Globocan, an initiative by the International Agency for Research on Cancer, a division of the World Health Organization (WHO), provided the breast cancer landscape in the Philippines.
Globocan data showed that breast cancer has become the most commonly diagnosed cancer, with 27,163 diagnosed cases, or 17.7 percent of the 153,751 total cancer cases in 2020.
In the same period, the Philippines logged 9,926 deaths due to breast cancer, which accounts for 10.7 percent of the total cancer deaths at 92,606.
What is breast cancer?
Dr. Arnold John B. Uson, immediate past president of the PSMO, said cancer is the second leading cause of mortality and breast cancer is the number one cause in women.
Uson said breast cancer is never preventable, but it is easily detectable and curable, particularly in the early stages of the disease.
The WHO defines breast cancer as the most common type of cancer among women. It is marked by the unusual growth and spread of cells that become a cancerous tumor in the breast area.
It may start in the mammary glands — the part of the breast that produces milk — or in the milk ducts leading to the nipple. While breast cancer is most common in women, it may also occur in men.
Dr. Wilfred Liangco of the Medical Center Manila said more than half, or 53 percent, of breast cancers in the country are diagnosed in Stages III and IV, while only two to three percent of cases are diagnosed in Stage 1.
“More than any other cancer, my opinion is that this reflects the health-seeking behavior of patients, for whatever reason they would opt to seek a consultation later that they should have,” Liangco said.
He said stages zero to three of breast cancer can still be cured with complete treatment. One will grow old, die from something else, and be free of breast cancer throughout their lifetime.
Cancer in stage four means it has spread to other parts of the body, like the bones, liver, and lungs.
“Technically, we can no longer cure or eradicate breast cancer completely from the body,” Liangco said.
However, Liangco said treatment to palliate or control to improve the quality of life and hopefully prolong life can still be provided.
Symptoms to watch for
Dr. Dawn Lynn P. Guardiario of the PSMO, in a recorded presentation during a cancer chat, said there are a number of symptoms for breast cancer.
Guardiario stressed that one should not assume the worst if they have any of the symptoms, but should not ignore them and should immediately consult a doctor as soon as possible.
"The faster you act, the greater your chances of beating the disease with less effort — and cost," Guardiario said in Bisaya in a recorded presentation during the PSMO's cancer chat recently.
Here are the common symptoms of breast cancer:
Noticeable lumps on your breasts
Swelling in all or part of the breast, including lumps in your underarms
Changes in the color and feel of the skin on your breasts
Changes in breast size and shape
Depressions or indentions on your breast
Inverted nipples (or nipples turning inward)
Blood or pus coming out of the nipple
New and persistent pain in a particular part of the breast
Itchiness, or the appearance of rashes, hives, or scale
What are the risk factors?
It is not exactly clear how breast cancer develops, but medical experts have identified risk factors that can predispose certain people to the disease. Risk factors indicate a higher chance of developing breast cancer.
Liangco said there are also women who have developed breast cancer without any risk factors.
He said being a woman and the woman’s age are already risk factors because breast cancer is a disease of the elderly population if you look at the statistics and family history, especially if close relatives such as your mother, child or sister suffered from breast cancer.
However, he explained that there are risk factors that are modifiable, like alcohol, obesity, lifestyle, not having children before the age of 35, not breastfeeding, prolonged use of hormonal replacement therapy and estrogen replacement therapy.
Liangco said consumption of alcohol should not be more than one drink per day. Being overweight after menopause increases breast cancer risk, he added.
There is also growing evidence that regular physical activity reduces breast cancer risk.
At the same time, breastfeeding may slightly lower breast cancer risk, especially if it continues for a year or more.
Family history of breast cancer, early menstruation (before the age of 12), being overweight, late menopause (after the age of 55) are some of the risk factors.
So, what if you have experienced some symptoms of breast cancer?
“Breast cancer is a death sentence; on the contrary, cancer is a life sentence. Why? Because now you know what you have, and you can do something about it,” said Mary Ann Solomon, ICanServe Foundation Cebu coordinator.
(To be continued)
(The story is published with the support of the Philippine Press Institute, Philippine Cancer Society, ICanServe Foundation and Novartis in collaboration with the Swiss Chamber of Commerce of the Philippines and the Pharmaceutical & Healthcare Association of the Philippines.)
Second Part: Navigating Cancer Treatment
Third Part: Survivorship