Breast cancer survivor emphasizes on monthly self-examination, says no alternative therapy, magic pill for cure

BREAST CANCER SURVIVOR EMPHASIZES ON MONTHLY SELF-EXAMINATION, SAYS NO ALTERNATIVE THERAPY, MAGIC PILL FOR CURE

MARCH 17, 2019 @6.16 PM

At a glance, no one would suspect Mazwin Mohd Radli, 39 of having battled HER2-positive breast cancer. A bubbly and warm character, the mother of three was diagnosed as stage 2 four years ago.

“I detected a lump accidently one night before going to bed. There wasn’t any pain nor any changes to my breast, but I could feel the lump. This made me do a screening.”

“Nevertheless, I’m fortunate to have found the cancer early, which resulted in a lumpectomy compared to losing the entire breast. This followed with treatment, chemotherapy, radiotherapy and targeted therapy.”

Life before cancer
“Prior to being diagnosed, I led a normal life just as everyone else, wasn’t active and seldom sweat it out. No vitamins or supplements and no traditional medications (jamu) either. I ignored self-breast examination too, as the doctor I work for occasionally did clinical breast examination. So, I thought there was no need for me to do one myself,” said Mazwin.

Today, Mazwin inculcates an active lifestyle into her weekly schedule – jogging and participating in other activities.

Monthly breast self-examination
Women who have reached puberty are advised to do a monthly breast self-examination.

“Cancer is a silent killer. You can’t feel the pain, so you need to know the changes to your breast. That is why you need to do a breast self-examination every month and if you feel there are changes to your breast, quickly go to a doctor for a clinical breast examination. Early detection saves life.”

In addition, she exhorts women who are diagnosed to seek proper treatment and not turn to alternative therapy.

“There are no magic bullet or magic pill that can cure cancer. Treatments are available in all the hospitals – both public and private. Breast cancer does not mean you would lose your femininity. You could still have a happy life after that.”

Breast cancer: a global problem
Breast cancer is the most common cancer among women. In 2018, 2 million new cases were diagnosed worldwide, and over 600,000 women will die of the disease. This means that one woman is diagnosed with breast cancer somewhere in the world every 15 seconds and more than six women die of breast cancer every five minutes worldwide.

Breast cancer in Malaysia
According to the Malaysian National Cancer Registry (MNCR) Report 2011, cancer is one of the leading causes of death in Malaysia today.

The most frequent cancer in Malaysia is breast cancer (17.7%) followed by colorectal (13.2%) and lung cancer (10.2%). Breast cancer is the most common form of malignancy affecting women and the disease burden of breast cancer affects 31.1% of all women living with cancer in Malaysia.

According to the MNCR report 2011, the percentage of breast cancer diagnosed at stage I and II was 57%. At this stage the disease is usually operable and can be treated with curative intent. However, about 25%-45% of patients experiences relapse and those with metastatic or unresectable disease are generally incurable.

Survival from breast cancer has improved in the past three decades. The largest Malaysian population based study of 10,000 breast cancer patients diagnosed between Jan 2000 and Dec 2005 identified from the Health Informatics Centre, Ministry of Health Malaysia, the National Cancer Registry and the National Mortality Registry found that the five year overall survival rate was 49%. Despite the relatively high five-year survival rate compared to other malignant tumors, metastatic disease has long been the principal cause of mortality among breast cancer patients. However, most of the patients still have poor prognosis after metastasis.

Early and advanced breast cancer
With breast cancer, if the cancer is present either in the breast or in the breast and local lymph nodes and if it is considered operable, the disease is classified as early breast cancer (eBC).

The term advanced breast cancer (aBC) can be used to describe progressive or recurrent locally advanced, or metastatic, disease. Locally advanced breast cancer means that the cancer has spread locally in the area of the breast to the skin or chest wall, but not to the distant organs. Metastatic breast cancer occurs when the cancer has spread further to other parts of the body such as the bone, liver, lung or brain. Although more women are diagnosed with early rather than advanced breast cancer each year, most deaths are due to advanced disease. Statistics show that only one in four people diagnosed with aBC will still be alive five years later.

HER2-positive breast cancer: an aggressive disease
Approximately one in five women diagnosed with breast cancer worldwide will have HER2-positive breast cancer, a particularly aggressive form of the disease. HER2 is a protein found in abnormally high quantities on the outside of HER2-positive cancer cells (see Figure 1).

HER2: driving cancer growth
A HER2-positive cancer cell has approximately two million HER2 proteins on its surface, around 100 times more than a normal cell. This HER2 overexpression causes cells to grow and divide more rapidly. Pairing of HER proteins (also called dimerisation) is a vital step in the signalling pathway that leads to cancer cell growth. There are four proteins in the HER family (see Figure 2), and HER2 has been found to pair with other HER family members, including other HER2 proteins. This act of pairing can send additional signals to encourage the cancer cell to grow and multiply.

HER2-positive breast cancer: treatment
In the past, people with HER2-positive breast cancer were expected to have worse survival outcomes than people with HER2-negative disease. Over the years, significant progress has been made, and today people with HER2-positive breast cancer treated with HER2-targeted medicines typically experience better outcomes than people with less aggressive HER2-negative disease.

Treating people with breast cancer early, before the cancer has spread, provides the best chance of preventing the disease returning or reaching an advanced and incurable stage.

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