Catch it early, treat it early and move on

The word cancer is often equated with death, but early detection of the disease can reverse life’s fate.

In the Philippines, breast cancer is one of the most common forms of cancer. It is so prevalent that in 2016, the Philippines topped 197 countries with the highest number of breast cancer incidents, recording an increase of 589 percent over a 30-year period.

Prominent breast surgeon in the Philippines, Dr. Diana Cua-Balcells, said that given the high number of breast cancer incidents in the country, it would seem there is an epidemic “but there’s really none.”

Cua-Balcells, who completed her breast surgery fellowship training at Stanford University Medical Center in the United States, is the first breast surgeon in Manila specializing in breast cancer using breast conservation. She was also the first breast surgeon in Asia to perform sentinel lymph node biopsy.

“I really think those numbers were there before but they’re like walking bombs... silent. Now they’re being identified,” she told Arab News.

Cua-Balcells attributed the Philippines’ rank, which showed the country as having the highest number of breast cancer incidents, to the Filipinos’ level of awareness about the disease,

“We were the first in Asia to come out with a strong breast cancer advocacy, which started around the late 1990s... We were already high but I think there’s an increment increase because obviously it was the overall awareness. It ballooned because of the impact of awareness brought about by prominent survivors talking about it. Everyone who reads or hears about it of course would be affected,” she said.

Also, during the mid-1990s, she said, once a patient was diagnosed with breast cancer, there was a big possibility that “you wouldn’t make it.”

Over time awareness of the disease was trickled down to younger women. Even those from the poorer communities know how to examine their own breasts.

And according to Cua-Balcells, women diagnosed with breast cancer today, especially when the disease is caught in its early stage, have a higher chance of survival.

“Before we had never seen stage zero breast cancer, which is the earliest type of breast cancer. But today even government hospitals are catching stage zero breast cancer.”

Cua-Balcells recalls when she was a training resident in the 1990s, they would always operate on patients. At that time, she said, breast cancer was usually diagnosed, at the earliest, at stage 2, but the majority had already usually reached stage 3. Some even at stage 4.

“So there’s stage zero, 1, 2, 3, 4,” Cua-Balcells explained. “But zero was still unheard of before. Zero is non-invasive so it’s cancer cells, but has no potential to spread.”

She said if there was no potential to spread, it cannot kill. But if it goes untreated it will become invasive and has the potential to kill.

Breast cancer no longer a death sentence
“Subconsciously we equate the word cancer to being terminal. I think things have changed because we have the data. And the women who are diagnosed early are still alive,” according to the doctor.

“So if you see someone living 20 years who battled breast cancer 20 years ago – if someone lives that long, then obviously you’re witness to how it (the disease) can be licked. These women will die from something else and not from breast cancer,” she told Arab News.

She added that “as we are now getting a lot of stage zero, stage 1 which we rarely saw in the past, those numbers are the numbers of women saved.”

With that, Cua-Balcells underscored the importance of catching the disease early. She advised women that if they feel a lump in their breast, instead of waiting for another year to go to a doctor, go and have it checked immediately.

“Don’t panic because the majority are going to be benign. But you just want to make sure – after all what if yours is one of the 20 percent that’s cancer? Then you’re catching it very early, which will definitely translate to a high chance of cure. That for me is most critical,” she said.

“If that were breast cancer and you felt it at a small size, have it checked because if you treat it the cure rate is so high. That’s compared to if it’s not painful, you leave it for one year and then it grows and you wait for another two years before you go to the doctor then by that time it might already be stage 4. There’s not much to offer,” she said.

And while she acknowledged the high cost of breast cancer treatment, Cua-Balcells said there were now many private and government organizations in the Philippines that Filipino women diagnosed with breast cancer can approach for assistance.

“So don’t fear it (breast cancer). It’s really about catching it early and treating it early,” she said.

On the breast cancer awareness campaign, Cua-Balcells said “it’s a good advocacy.”

“It’s really worth pursuing the awareness to save more women because we do have the highest incidence. All these efforts from all sectors for me are all worthwhile because of the data that we have. Here in the Philippines, the numbers are high, it just makes so much sense to write about it. To keep on blowing the horn, pushing it to people’s consciousness,” she said.