MADURAI / October, 2020 – Cancer Specialists at Meenakshi Mission Hospital have said the number of breast cancer patients seeking treatment has declined by as much as 70 percent in the last five months as people avoided visiting healthcare facilities fearing the Covid infection or were unable to come to a hospital due to lack of public transport. Such delayed treatment can have serious health repercussions.
Said Dr. KS Kirushna Kumar, Head – Radiation Oncology, Meenakshi Mission Hospital: “Delayed treatment has a serious impact on morbidity and mortality of breast cancer patients. A stage II or stage III cancer can turn into stage IV cancer if treatment is delayed by as little as three to four months. While many well-to-do patients could still make it to the hospital for treatment in their personal vehicles, hardly any patient from poor socio-economic background could seek treatment as no public transport was available for them to commute. Attendants are also unwilling to accompany patients to the hospital fearing the Covid infection.”
said Dr. Krishnakumar Rathnam, Sr. Consultant – Medical Oncology, Meenakshi Mission Hospital: “While Coronavirus does not directly impact the outcome of breast cancer patients, those undergoing chemotherapy have low immunity, increasing the risk of infection. In fact, chemotherapy-taking patients have a 20% chance of getting Covid. In such cases, we are trying to administer chemotherapy through tablets instead of injections so that the duration of hospital stay for the patients comes down and they can leave for home quickly.”
Said Dr. R Vijayabhaskar, Sr. Consultant- Surgical Oncology, Meenakshi Mission Hospital: “Awareness about breast cancer is low in India, leading to delayed diagnosis. Only about 35% of breast cancer patients in the country get diagnosed in stages I or II, 50% in stage III and 15% in stage 4. In contrast, in the West, 95% breast cancer patients see the doctor the stage I or II. In early stages of the cancer, there is no need for us to remove the breast to save the patient. The problem is that in early stages of the cancer, patients do not feel any pain, hence they don’t seek treatment. By the time pain comes, cancer is already in an advanced stage.”
said Dr. Krishnakumar Rathnam: “Breast cancer, for long considered to afflict older women in cities, has grown by more than 250% in just a decade, and is now spreading not only across the rural-urban divide, but also among younger women. More than 1.3 lakh fresh cases of breast cancer get reported every year in India now, up from 54,000 a decade years ago. It has emerged as the most common cancer in cities, and the second most common in rural areas. In fact, the disease accounts for more than one-fourth of all cancer cases in Indian females and is the fifth most important cause of cancer-related deaths.”
Said Dr. R Vijayabhaskar: “Breast cancer if detected in time and treated adequately is curable. Every woman who turns 40 should get mammogram done once a year. Surgery for breast cancer has come a long way since radical mastectomy (complete removal of breast) was first described. The most common surgery for breast cancer today is modified radical mastectomy (MRM), which entails complete removal of the breast with or without reconstruction. The other option is breast conservation treatment, which involves removal of only the tumor, leaving the rest of the breast intact.”
He added: Breast conservation treatment has now become the standard of care for early breast cancer in the West. Unfortunately, in India, it is still not popular with doctors or patients. Only 11-23% surgeons prefer it in the country, compared to 60-70% in the West. The advantages of BCS over MRM include better body image, sexual function and psychological adjustment. It is for the medical community to inform patients about BCT and allow them to live a fuller life than they are destined to do with breast removal.”
Said Dr. KS Kirushna Kumar: “At Meenakshi Mission Hospital, we conducted a study involving breast cancer patients to assess their quality of life after breast removal. The study threw up some startling facts. Almost one in three patients said she was being neglected by her spouse. Many of these women had been abandoned by their husbands, probably because men couldn’t reconcile to breast removal of their wife even if they had supported the decision initially. About 38% of the patients reported a negative impact on their attitude towards sex, while 73% said breast removal negatively affected their body image. Most breast cancer patients, their spouses and relatives take a decision in favour of complete breast removal even when the disease is in early stages and curable, due to fear and the false notion that the cancer will not grow back if the entire organ is removed. These patients need to be educated to opt for breast conservation treatment to avoid harming their quality of life later, as we found in our study.”