The Jakarta Post
Preventive measures: A lump growing as the first stage of breast cancer can only be detected by self-examination or through mammography. (Shutterstock/File)
Over the last few years, cancer has become one of the main causes of mortality in many countries. Breast cancer, however, remains the biggest threat for women as it occupies a fairly high position as a fatal disease for that gender. In Indonesia, there were an estimated 48,989 cases of breast cancer in 2012 among which there were 19,750 fatalities.
Cancer incidents keep rising today as people in younger age groups are affected by breast cancer. Minimal symptoms at the initial stage usually allow the disease to be discovered only when it is entering its advanced phase. “There’s no sensation of pain at the early stage of this cancer,” said Bob Andinata, an oncologist at Dharmais Cancer Hospital, Jakarta.
A lump growing at the first stage of breast cancer can only be detected by self-examination or through mammography. Anomalous shapes and painful breasts are symptoms only found at the third stage of breast cancer and beyond. “At this stage the cancer is usually spreading to some parts of the body and is difficult to handle,” explained Bob.
Unhealthy lifestyle and food consumption tends to increase the risk of contracting breast cancer, with younger patients being listed year after year. Breast cancer cases have lately involved people at the age of 30, although the majority of patients are about 50. This young age, however, allows a longer time for treatment, as well as control and care of convalescing patients.
GLOBOCAN, a comprehensive global cancer surveillance database, predicts that in Indonesia 58,799 new breast cancer cases will appear in 2020, with mortality reaching 23,836. In 2030 the figures are predicted to rise rapidly to 74,289 cases with 31,626 deaths, while economic considerations will continue to prevail in the process of cancer therapy, especially breast cancer.
Patients treated in the advanced phase need several medications, which are expensive. Based on studies conducted by the George Institute for Global Health in eight Southeast Asian countries, cancer victims are bringing economic disaster to their families. In Indonesia, more than 70 percent of cancer patients have died as they couldn’t afford to pay medical costs and the rest faced financial trouble a year after being diagnosed.
This situation has prompted research on alternative treatments for breast cancer at reasonable costs and also with milder side effects. So far treatment has relied on chemotherapy, which apart from its fairly high cost, has side effects some patients cannot stand. “Drugs at affordable prices with less severe side effects constitute a challenge to the pharmaceutical industry,” said Bob.
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New hope for breast cancer patients seems to have emerged recently. A new medicine named pertuzumad has been approved by the Food and Drug Monitoring Agency (BPOM) for breast cancer, which is to be combined with trastuzumab and chemotherapy. Pertuzumad and trastuzumad, targeting cancer cells’ DNA, are for breast cancer patients reaching the HER2 (cancer protein) positive stage, an advanced phase with more aggressive cancer cells. “The drugs are also for patients with reactivating cancer cells after being declared clean,” he added.
By targeting the cancer cell DNA, their side effects can be minimized. Research on this therapy in fact still shows patients’ conditions decline, but this effect is more lenient than that caused by chemotherapy. The absence of a drastic decline enhances the strength of patients to undergo treatments. According to Bob, high costs and severe side effects harm patients’ health and lower their spirit, which psychologically also worsens their conditions.
Bob revealed that the monitoring of patients receiving therapy by this method had indicated their survival rate of around 56.5 months. As the drugs directly aim at cancer cells and inhibit their growth, this therapy can be more effective. “Less severe side effects also augment the quality and spirit of life of patients in facing further treatments,” Bob pointed out.
However, cancer survivor Puty Rahmania believes that medical treatment is not enough.
“Adopting a healthy life style is a must for breast cancer victims to increase their life expectancy,” said the 39-yearold, who currently is applying a low carb and sugar diet.
Meanwhile, cancer fighter Almaida Gunawan hopes that the discovery of medicines and therapy that can improve life expectancy can lift the spirits of other cancer fighters.
“Spirit is one of the keys for recovery,” said Almaida, who was diagnosed with cancer in June.
This system of therapy is indeed new in Indonesia, despite its application in many other countries. While it’s more effective, the costs spent are also reasonable so that people of various economic groups can be served. Bob reiterated his warning that in spite of the advancement in breast cancer therapy, self-examination should be continued. “The presence of any suspicious lump can thus be promptly handled,” he said.
The widespread fear among women to be examined after discovering breast lumps themselves poses a challenge to different circles. One of the actions that can be taken is a campaign launched by breast cancer victims to disseminate the true story that by early detection and therapy, the rate of recovery and life expectancy reaches 100 percent.
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