Dubai:
The main challenge for women who have coped well with breast cancer and are on their way to recovery is with the possibility of metastatic breast cancer or the recurrence of the cancer in other organs of the body. Metastatic cancer is on the rise and oncologists believe breast cancer survivors need to be educated about this possibility.
Dr Norbert Dreier, Consultant–Oncology at Burjeel Hospital Abu Dhabi explained: “Metastatic cancer occurs when it reappears as a secondary in other organs of the body. It means the cancer cells have metasised or migrated to other organs and secondary symptoms in either the lung, liver, bone, brain or any other part of the body.”
The specialist said this is a serious concern as metastatis is usually the Phase 4 or the final stage of cancer and women need to be vigilant so they can have this condition detected in time.
Causes
There are a host of reasons, Dr Drier said. “There are many factors that can trigger metastasis. It depends on the stage at which the breast cancer was first diagnosed. If the breast cancer was caught early, then the chances of metastatis go down.”
Dr Pranay Taori, specialist medical oncologist at Zulekha Hospital, says that a lot also depends on the age of the patient. “Women in their early thirties who are diagnosed with breast cancer are likely to have metastatis, especially if the cancer is Her2 positive which means it is hormonal and can be a very aggressive kind of cancer which is likely to metastasise.”
A significant worry for oncologists is that women today are vulnerable to breast cancer at a younger age. The onset age is increasingly lowering its bar.
Dr Riyad Bendardaf, Head of Oncology and Head of the Sharjah Breast Care Centre at University Hospital Sharjah (UHS), cautioned that in the UAE, unlike the world average of 40 years for the onset of cancer, women were being diagnosed with breast cancer at 30.
“There is no clear evidence as to why women are getting breast cancer at an earlier age, but this could be attributed to various factors such as obesity, poor diet, smoking, lack of activity and genetic factors. Some girls menstruate very early and that is an indication of a risk factor.”
He also added that an American study which linked cancer to obesity said the last factor is a major cause of cancer and that, along with lung cancer, breast cancer is one of the major causes of mortality in this region. “One can lower the risk of breast cancer by maintaining a healthy BMI (Body Mass Index), exercising regularly, giving up smoking and in case of young mothers, practising breastfeeding.”
When metastasis occurs, it commonly manifests in the lung/lungs and bone while the high-risk sites are the liver and brain, according to oncologists.
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How to detect metastasis in time?
The first six months after the cancer has receded are the crucial months to be vigilant about the possibility of metastasis. “The chances of metastasis depends on the nature of the tumour the patient had. So, after the treatment protocol, the patient must come in for screening every three months within the first two years. High-risk patients must come in every six months for the next five years and once a year for the next 10 years,” Dr Norbert Dreier said.
Symptoms
Patients need to report unusual pain or discharge, first at the site of the original tumour, and other symptoms elsewhere. “There could bone pain, appearance of a lump in the other breast, swelling in the lymph nodes, fluid discharge at the site of the original tumour, dizziness or difficulty in breathing. Such symptoms need to be reported immediately. The doctor will prescribe blood tests and conduct other investigations to diagnose metastasis,” Dr Pranay Taori said.
Treatment
Targeted therapies which attack the cancer cells while sparing the healthy cells are the most effective forms of treatment, said Dr Drier. Herceptin anti-body treatment to treat Her2 positive cancers are also effective in dealing with metastatis.
“Do not ignore any symptoms, be in a state of preparednes,” advised Dr Drier. “It is important to be aware of the benefits of genetic counselling and sign up for one if there is a family history of breast cancer. Regular follow-ups and routine self-breast examinations are critical to detect as more than 90 per cent of breast cancers are cured in the early stages and early detection reduces the chances of metastasis,” Dr Drier said.
40 years
International avegare for onset of breast cancer
30 years
UAE average for onset of breast cancer
