#eNCA speaks to Carol Benn of the Breast Care Centre of Excellence. #DStv403
Discussion | Breast Cancer month
Now the curtain may be closing on Breast Cancer month but it remains a persistent and growing problem cancer commonly affect women with one in 27 at risk but prevalence among men is on the rise as well let’s get more insights from a Carol Ben of the brisk’s Care Center of Excellence thank you very much for making time to talk to us about this.
All-important issue let’s start with the prevalence of breast cancer in the country I have mentioned a stat in my intro but I’m sure there are other components to the trends that we’re seeing when it comes to breast cancer in South Africa maybe just give us a broad sense of what that is Carol.
So it’s an absolute pleasure and thank you so much for having me on I think what’s really important is we must understand that we’re seeing more and more breast cancer patients in people who are younger and younger breast cancer is neither ageist racist nor sexist so we see it in young girls in their 20s we sit in gentlemen in their.
20s and 30s so we’re not seeing what we used to see 30 40 50 years ago so it’s the Communist cancer that affects women in up in our country we’ve got an increased incident in Men In fact we’ve got one of the highest incidents in men in the world the usual incident sits at one percent but in men we see in our country about three percent so what do.
We need to know we need to know that 65 percent of people who gift breast cancer have no risk factors whatsoever so you if you think that um oh well I’ve done everything right I exercise eyes and I don’t drink and I breastfeed my children that doesn’t mean to say that you’re not at risk for getting a breast cancer thirty percent of people who get a.
Breast cancer have family history of cancers on their mother and their father’s side so it’s not a maternal inheritance and we’re talking about things like prostate cancer in men we’re talking about cousins uncles aunts you want to know your cancer history and particularly if they’re young cancers in your family and only 10 percent are.
Isolated single Gene genetics so we want to teach people how to examine their breasts and know their Norm because screening is Health economics so it’s not that necessarily here in South Africa we need to have a mammogram screaming campaign but we need people to know how to look check their brace and if.
They feel a problem where to go and what to do and we’ll do that in a moment a Prof before that though you said there’s a little bit of an inheritance that is contributing to the rates of breast cancer that we are seeing but I’m sure lifestyle does play a role you are indicating that younger people are now more prone to it than we would have seen.
Previously and I’m just wondering what Lifestyle Changes anyone should be making not to to prevent it but to perhaps reduce their chances if it’s possible at all so that is a wonderful wonderful question and so important so what do we know we know that exercise decreases your cancer risk by 42 percent we want.
To maintain a BMR under 30 people be under 25 but definitely under 30. so it’s not specifically what we eat or drink it’s how much we eat or drink that’s important obviously we don’t we want to encourage not excessive alcohol consumption and we really want to encourage people not to smoke we so we want a healthy lifestyle but it’s not.
One thing that contributes to getting a cancer so it’s a combination of factors so stressors and stressors at a cell level what we call the cell micro environment pays a large role in how cancers develop so every time one of our cells divides it undergoes it gets a little mutation just one tiny little one and that’s usually fine our bodies can.
Deal with it you can get seven or eight mutations and our bodies can still deal with it but when you get lots more hits on those cells the cells then become you know um they behave like different cells within that family so it would be a family within the breast cells but it would behave with a different division.
Rate than have a different personality and develop them into a breast cancer so that’s how we see with all Cancers and once your immune system is not capable of killing out once you’ve got a cancer you really need to go and seek help because medicine changes all the time and we want to take away this concept of a hostile Hospital environment and.
Realize about multidisciplinary safe careful people irrespective of access to Medical AIDS or not on that point let’s speak about the survival rates Prof and also just to understand are all cancers that will get in the breast benign or malignant or do you find cases where there are vagina not necessarily those that will spread.
Through the body and then with that please just engage us on the survival rates that we are seeing okay you know what you you aren’t you ask the most amazing questions I think I’m going to send my medical students and registrars to you for a rundown on sensible questions so what do we want to know so something that’s not a cancer.
Can’t become a cancer so banan lump in the breast and how do we make a diagnosis with an ultrasound a mammogram and get the cost before you have a needle Barb so you don’t rush into surgery to find out what something is then so something that’s not a cancer can’t become a cancer a sleeping cancer is a family of cancers at their earliest.
Phase some of them we can treat with medicine and some of them we need to take out and then away cancers we have four different Behavior types of awake cancers and they’re each treated differently by picking up breast cancers early today 9 out of ten ladies are alive and well tingers down the line people do not need to rush in to surgery.
And chopping grease or so the survival gets better and better the earlier we pick up Cancers and the more personalized our oncology treatment is so you treat TB with TB treatment malaria with malaria treatment we treat each different type of breast cancer differently so today there’s a lot less chemo there’s more targeted treatments.
And you want your treatment discussed in a multi-disciplinary environment this ensures that we have good survival with breast cancer so saying if people have got big Advanced lumps in their breasts because my worst word is ignorant people are not ignorant they are scared to access health care services please make sure.
That you come in because even in this scenario there are such new and exciting medical changes happening that we can manage people even with Cancers elsewhere they do very very well for many many years with that that you’ve just mentioned Prof the resources that are available in the country for people not only to get.
Screenings if they have done a self-test or screening at home and find that they need to get further consultation do we have enough public resources for people to access but also just the medication once you’ve been diagnosed and you can’t necessarily afford Medical Aid or our Public Health Care Centers catering to those in need.
So so this is a spectacular question because I’ve been in government for 35 years and 17 years of Helen Joseph and actually recently resigned from my Helen Joseph unit because I’m very fussy about it Equitable Equitable and I’m going to talk about that on Monday Cancer Care it means that people who want access should.
Be able to access any environment and get proper access to care so we’re in the concept of setting up a sensible unit where people on low-end schemes and government patients can come and get good care holistic care where it’s not a hostile environment so we have to make sure that we’re working and striving every day for better care so sometimes.
It’s quite difficult in Regional Hospital environments because I mean for example I’m a bit like Cinderella’s ugly sister I don’t quite fit the shoe of of you have to be from here to have treatment here and if there’s not this available you can’t have this treatment for me it’s about everyone having access to good care so what people can do at.
The moment is contact in with Grace Health foundation and they will always let them know what is available in their facility because there are many places in the country where they are very poor and short facility so what we’re trying to do and National Health is set up and today we can have virtual access on How to Train doctors and have units.
Where people have safe care because it’s important that care is available irrespective of Medical Aid to all people and in a way that um patients feel safe so they feel looked after and not in a scenario where we can’t have care so so technically what I’m doing is stepping outside of a regional environment to make sure that.
We can set up bigger holistic Better Health Care Systems it’s critically important and I think from a government point of view it’s very very hard to have um it’s a bit like the Gulliver’s giant you know there’s so many stretches in place that are holding things done I mean I.
Listened to your issue around the water um that it makes it hard for for people who are trying to fix and change to actually get it right so sometimes what we really have to do is realize in this amazing country we have we’ll have lots of other facilities where we can still offer service and what I love about this country is people are so prepared to get.
Involved in home so we’re going to watch the space for bigger and better ways of managing cancer patients because we we need people to know that you mustn’t be scared and it’s horizontal medicine your doctors must be able to talk to you communicate with you you need navigation systems in place so that people who’ve been through cancers or helping people.
Take away the fear of treatment so Prof I’m going to ask you now to perhaps give us a demonstration of how a self-screening would look like for our viewers to get that benefit and while you do that perhaps give us a sense of how often one should be checking on their breasts go ahead doc so I’m going to lower my screen okay so.
You can see and I’m I’m not the most well endowed but you get an idea so what happens is you need to know your Norm so what you need to do is take your bra off and give your breasts a bit of a jiggle You jiggle down and you jiggle up because what you want to see is there anything pulling in the skin any changes on the nipple if there’s a red change on.
The top of the nipple you need to make sure that you um see a doctor when you examine your breasts you use the flat of your hands your three fingers and people often feel they breathe too hard you want to gently gently feel the brace going around all the different little quadrants feeding for lamps and just feel over the nipple.
By pressing on the nipple you never squeeze the nipple because it’s a glorified plug and if you do squeeze it you will produce a liquid out of it when you feel for glands under your armpit do you relax your arm at the side to feel glands people often make a mistake because they see it in the handout to lift their arms up that’s the technique.
We use when we do a breast ultrasound it pushes the structures forward but when you’re trying to feel then you can’t feel so well so you feel softly you will we will all have little glands under there so it’s about knowing your norm and seeing if you have change month by month so we should be doing this at least once a month you can pick a.
Calendar day or if you see your period you can see it’s doing just a couple of days after your period and what you want to do is check and see is it the same all the time if you are not sure you go and see a healthcare provider and ask for something as simple as a breast ultrasound don’t squeeze your nipples remember breast pain is normal lots of.
People get breast pain men have breast tissue too they must check as well on that note thank you very much for that demonstration Prof and just a final thought from you I suppose in all of the chaos and the Stress and Anxiety that may come with a cancer diagnosis it’s important that attitude also matters in this regard as well just for that.
Psychological well-being a positive attitude as best as you can might also contribute to your well-being as you go through the breast cancer Journey would you agree absolutely so mental health is really important surrounding yourself with a group of Navigators and people that reinform the positive that choosing your.
Team correctly and realizing it may be like an extreme event doing the comrades or climbing Mount Kilimanjaro but you will take it one step at a time like we all need to do with any of life’s Journeys and one step at a time with people at your side it means we can make that Journey which can be difficult manageable.
Professor Carroll and Ben thank you very much for giving us some of your time