Ever since the much-publicised double mastectomy by the famous Hollywood star in May 2013, there has been quite a bit of confusion by women as to whether removing both breasts surgically is the only answer to avoid getting breast cancer. Even today, my colleagues are still being asked this question frequently.
Here are some facts regarding this:
- Most breast cancers (90%) are not inherited.
- The inherited form, due to alteration in the BRCA genes, account for 5-10% of cases.
- Routine screening by BRCA testing is not recommended. The blood test is expensive, costing anywhere between USD 1000-4000 and takes about three weeks before results are known.
- BRCA testing is usually done where there is a related history of breast cancer. Indeed, there are specific indications for doing this test, e.g for women with two first-degree relatives with breast cancer below 50. For a full list of indications, see here.
What happens if the BRCA test is positive? As such people have a very high chance of getting cancer of the ovaries and breasts, there are a few options available. It does not necessarily mean that double mastectomy is the only way out. Other options include taking medications, more intensive and regular breast cancer screening and having both ovaries removed before the age of 40. The right decision involves the patient being fully informed and playing an active role in the decision-making process.
Whatever the decision, its important to execute it immediately as procrastination is the worst enemy. Jolie’s case highlights the importance of knowing one’s family history and learning one’s cancer risks in order to address them proactively.
At one time, hormone replacement therapy (HRT) was routinely prescribed to any woman reaching menopause and asking for it, in an effort to prevent fractures,osteoporosis, dementia and other chronic diseases.
That was fine but recent developments have advocated the reverse – only women with severe symptoms of menopause like flushing,headaches and excessive sweating are given a short course to relieve the symptoms. Otherwise, HRTs are now not advised at all.
What is the evidence for the change in stance? The US funded Women’s Health Initiative, known as WHI, was halted in 2002 when initial results showed women taking a combination of estrogen and progestin had a higher risk of breast cancer, heart disease and stroke than women who received a placebo( or ‘dud’ pill). This marked a drastic shift in opinion, so that now, these combination pills are no longer advocated. Indeed, even oestrogen-only pills are now taboo.
You can find more facts about HRT here:
For alternatives to hormone therapy, see here: http://www.nhlbi.nih.gov/health/women/pht_facts.pdf
There has been countless quotes, poetry and songs on the virtues of a good friendship. In the song co-written by Burt Bacharach What Are Good Friends For? , these lyrics that often keep repeating in one’s mind:
Knowing you can always count on me,for sure
That’s what friends are for..
The video below shows how Dionne Warwick, Stevie Wonder, Luther Vandross and Whitney Houston appreciate what good friends are for..
And now, medical researchers are finding a powerful weapon to help fight illness, depression, hasten recovery, slow down aging and prolong life…your friends. An Australian study on older people discovered that those with a large circle of friends were 22% less likely to die in the 10 years of the study. A similar Harvard research showed that strong social ties will promote brain health as one ages.
I agree. The role of friends to one’s health has been under-appreciated, compared to marriage and family. Sure, there can be rotten apples in the barrel, but with good friends, they can bring a positive psychological impact on one’s well-being, as the above studies demonstrate. Another study of 3000 nurses with breast cancer even showed that friendship had an even greater positive effect on health than a spouse or family member.
Exactly why friends have such a big effect on health isn’t too clear – could it be the ‘feel-good’ factor? Or the physical and psychological support which lessens one’s stress levels? Whatever it is, the message that these studies point out is that friends do make your life better and healthier.
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If your doctor were to recommend a jab or a pill that will prevent you getting some cancers, would you? Its surprising, but not everyone would take it up!
The truth is that there are quite a few readily available and relatively inexpensive ways which have been proven to prevent some cancers.
Take for instance stomach cancer, the second most common cause of death among cancer-sufferers. It is now known that a cause of stomach cancer is a bug well-known for causing stomach and duodenal ulcers, called Helicobacter pylori (H pylori). Now, researchers have shown that if they were to eliminate this bacteria from those suffering from early stages of this cancer, they were able to effect a cure. Read more of this here. Eliminating H pylori from the stomach involves swallowing a 2-week course of antibiotics.
Primary liver cancer, the fifth most common cancer in the world, is a deadly cancer for which the outlook is bad as, by the time someone has symptoms, the cancer is far-advanced and has spread to other organs. Again, a bug – the hepatitis B virus-has been identified to be the cause in 50% of primary liver cancers aka hepatocellular carcinoma, aka hepatoma. To prevent the virus from entering your body, one needs to immunise oneself by receiving three jabs of the Hepatitis B vaccine.
Latest research on prostate cancer seems to indicate that taking finasteride(Proscar) may prevent this cancer.
There are many other ways that specific cancers can be prevented, some of them anecdotal. Heard of the complementary herbal medicine, the Chinese mushroom, Lingzhi ? I met a cancer survivor last night who swears this herb provided the cure and not the treatment at Sloan-Kettering! As to whether daily consumption of this herb will actually prevents cancer..well,there’s no strong evidence at the moment, for sure. The role of foods too must not be dismissed.
However, my attention was recently drawn to a news report about high-risk women who refused to take a pill a day known to be effective in preventing breast cancer. A woman is considered to be at high risk for breast cancer if she is over 40 and has a mother, sister or daughter with the disease, or has a history of atypical cells on a breast biopsy. A pill, tamoxifen, has been proven to be effective in preventing breast cancer in such women, but there are many who will not take it for fear of the side-effects (which are many but not as serious as actually getting the cancer). See here.
In cases like this, human psychology is to be blamed – people are more concerned about losing a little bit than they are about gaining something more.
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Spotted in a Hong Kong newspaper – an ad warning against breast cancer.