When mentioning the name “cancer”, it is believed that no one is not afraid because it is currently considered one of the most serious diseases. Once diagnosed, the chance of complete cure is low or may be none at all, depending on the severity and the location of the cancer. The most common cancer found in men is liver cancer, but for women, the number one cancer that takes the lives of Thai women is breast cancer.
How does breast cancer occur?
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital explains the cause of cancer in the human body as follows…
“It is a process caused by abnormal cell division, resulting in the body being unable to control it, and spreading along the lymphatic pathways in the body.”
Although breast cancer can be found in both females and males, it is mostly found in females, especially women aged 50 and above, who have the highest mortality rate from cancer among women. In males, the incidence rate is very low.
Risk factors for breast cancer
Currently, the medical field does not know the exact cause of cancer, but the following risk factors have been identified:
- Increasing age
- Family history of ovarian or breast cancer increases risk compared to the general population
- Hormonal factors such as taking female hormone pills or continuous contraceptive pills
- Long-term use of contraceptive pills
- Early menstruation before age 12 and late menopause after age 55
- Having the first child after age 30 or never having children
- Previous history of ovarian or breast cancer
- Smoking, lack of exercise, being overweight, and alcohol consumption
What are the symptoms of breast cancer?
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends observing abnormal symptoms that may indicate breast cancer as follows:
- Usually painless in the early stages
- Palpable lump in the breast or armpit
- Skin of the breast has wrinkles or dimples resembling orange peel
- Inverted nipple or nipple retraction
- Discharge of lymph or blood from the nipple
At which stage of breast cancer can it be cured?
It is well known that when cancer is diagnosed, doctors will inform the patient of the “stage”. The cancer stage is important for determining the severity and the chance of complete cure as follows:
- Stage 0: Cancer is small and has not spread to tissues, with a survival rate of 95-100%
- Stage 1: Cancer grows and spreads to lymph nodes in the armpit on the same side as the tumor, with a survival rate of 90-100%
- Stage 2: Cancer grows larger than stage 1 and spreads to a few lymph nodes, with a survival rate of 85-90%
- Stage 3: Cancer is large, may ulcerate or adhere to chest muscles, spreads to many lymph nodes, with a survival rate of 65-70%
- Stage 4: Final stage, cancer spreads through the bloodstream to other organs, generally survival is less than 3 years, with a survival rate of 0-20%
Breast cancer diagnosis
Dr. Anirut Niranat, a surgical oncologist at the Breast Clinic, Phyathai 1 Hospital recommends that all women regularly check for abnormalities in their bodies or consult a doctor if suspicious symptoms are found for diagnosis. The diagnostic methods include:
- Medical history and family history review
- Physical examination by palpation for lumps
- Mammogram, an X-ray imaging of the breast using low-dose radiation
- Ultrasound examination
- Magnetic Resonance Imaging (MRI)
- Biopsy for laboratory examination
How to treat breast cancer for a cure?
The best approach for treating breast cancer, as well as other types of cancer, involves planning together between the medical team (multidisciplinary) and the patient and family. Treatment methods include:
1. Surgery, which has 2 types
- Partial Mastectomy where the doctor removes only the cancerous lump as much as possible. The criteria for this surgery include:
- The lump should be small
- The breast should be of a reasonably large size
Not suitable for breasts with multiple lumps, large cancerous lumps, or small breasts. This surgery may also involve removing lymph nodes if cancer spread is detected.
- Total Mastectomy where the doctor removes the entire breast including the nipple. If cancer has spread to the lymph nodes, the lymph nodes in the armpit will also be removed. In some cases, both breasts may be removed if the patient is at high risk of cancer spreading to the remaining breast.
Complications after breast cancer surgery
- Change in breast shape, which can be corrected by using breast prostheses or reconstructive surgery. Consultation with a doctor is recommended before the initial tumor removal surgery.
- Wound infection or bleeding; observe the wound for swelling or redness
- After complete removal of lymph nodes in the armpit, the affected arm may swell and feel tight, with numbness on the inner upper arm. Physical therapy or arm and shoulder exercises are recommended
- After complete removal of lymph nodes in the armpit, the affected arm may swell and feel tight, with numbness on the inner upper arm. Physical therapy or arm and shoulder exercises are recommended
2. Radiotherapy or radiation treatment uses high-energy radiation to destroy cancer cells
- Patients who undergo partial tumor removal should receive radiation therapy as well
- Radiation is given to patients who have had total mastectomy with large tumors or cancer spread to lymph nodes in the armpit
Side effects of radiation therapy and care
- Feeling tired during radiation; rest well and eat nutritious food
- Skin in the radiation area may darken, become irritated, and sometimes painful. Care includes avoiding water on the skin, not applying creams or soaps, avoiding sun exposure, and not scratching
- Swelling of the arm and shoulder stiffness; arm and shoulder exercises are recommended. When using a pillow to support the arm, keep it elevated to reduce swelling
3. Chemotherapy uses drugs to destroy or inhibit the growth of cancer cells, available in injection and oral forms
Goals of chemotherapy treatment
- To make surgery easier; some patients may receive chemotherapy before surgery to shrink the tumor, then undergo surgery
- To cure cancer; chemotherapy is given as adjuvant treatment after surgery to control recurrence
- To prolong life and provide palliative care in cases where cancer has spread to other organs or has recurred after previous treatment
Side effects after chemotherapy and care
Some patients may have no side effects, but others may experience severe symptoms because chemotherapy not only destroys cancer cells but also affects normal cells, such as bone marrow which produces white blood cells. Common side effects include:
- Nausea, vomiting, mouth sores, dry throat; care includes eating soft foods like porridge or ice cream, eating small frequent meals, rinsing mouth often to prevent infection, and drinking 8–10 glasses of water daily
- Increased risk of infection due to low immunity; avoid crowded places or polluted environments
- Hair loss, which is temporary and hair will regrow later
4. Hormone therapy: Some breast cancers grow faster when exposed to estrogen, so doctors treat by giving anti-hormone drugs to reduce estrogen levels
Care for breast cancer patients
In fact, whether a patient has breast cancer or other types of cancer, basic care is not very different. The guidelines are as follows:
- Maintain strict hygiene as infections can occur easily
- Do not take any medications other than those prescribed by the doctor, or if needed, always consult the doctor
- Get enough rest and avoid overworking
- Quit alcohol, smoking, drugs, and avoid caffeinated beverages
- Maintain strong mental health, avoid stress and depression
- Engage in activities with family to build morale to fight the disease
- Know how to care for yourself during low white blood cell counts
- Follow the advice of doctors and nurses strictly
- Attend all medical appointments
- Limit intake of very sweet and salty foods as they affect blood sugar and kidney function
- Try to eat as much as possible; if appetite is low, eat small frequent meals
- Eat nutritious food with all 5 food groups
Breast cancer screening
- Self-breast examination by palpating for lumps about one week after menstruation; can be done monthly
- Mammogram, especially for women over 40 years old, should be done annually
- Breast examination by doctors and nurses
Although breast cancer is frightening and is one of the cancers in women, it can be prevented by maintaining good health, avoiding risk factors, and importantly, regularly having annual health check-ups, especially “breast cancer screening”, which helps detect the disease early before symptoms appear, thereby reducing the mortality rate from breast cancer.
Dr. Anirut Niranat
Oncology Specialist
Cancer Center (Cheevisuk), Phyathai 1 Hospital
