Dhaka, 2011: Cancer has turned out to be the number one killer of women in childbearing age in Bangladesh. According to Bangladesh Maternal Mortality Survey 2010, which was not aimed at estimating cancer deaths, got the shocking results while looking for causes of death of women in childbearing age.  It showed cancer accounts for 21% of women’s deaths between 15 and 49 years of age, followed by cardio-vascular diseases – 16%.

Cancer experts agreed with the findings and said, it was a wake-up call for women and they needed to upgrade their prevention efforts. United Nations Population Fund (UNFPA) has suggested that campaigning should start against cancer in Bangladesh instead of training health workforce.

The experts blamed lack of awareness among women, which led to the delayed diagnosis of the disease, and the inevitable deaths.

They seek medical assistance at the advanced stage of the disease as most cancer symptoms are painless in the initial. Amongst all other possibly fatal forms of cancer that affect women, breast cancer is the most common.  Every woman above 20 should self-examine their breast for any unusual change of mass every month at a fixed point of time, according to the experts.  Adhunika Bangladesh Society (ABS) has launched an awareness campaign against breast cancer as this killer disease is widespread among Bangladeshi women.

ABS premise, Sep 24:

The students reached the ABS premise by 2 pm. All the faces looked bright, and happy. Some of them could not hide their curiosity. They were a happy bunch of 20-23 age group of girls. They were worried about today’s health seminar topic as they heard before about this “devil”  that can be found hidden in any woman at any age. However, due to the lack of proper knowledge or opportunity to counsel to know how to deal with the issue, they remain victims as it attacks the most elegant part of body of a woman, her breasts.

The session started at 2: 10 pm. The facilitator, Dr Muna Shalima Jahan started by introducing herself to the audience followed by the students who introduced themselves. Dr. Muna discussed about the significance and meaning of the Pink Ribbon Alliance and the functionalities this Alliance performs to make people aware around the globe. She held a lively discussion with her audience with much of the discourse being overwhelming at times but nonetheless very informative for her audience. The entire session was very interactive followed by many questions and answers in the end. Dr. Muna she was able to capture the spirit of the occasion, and made it very worthwhile for her audience with her easy going charm and friendly nature.

BASELINE INFORMATION REGARDING BREAST CANCER:

The students shared their own understanding regarding breast cancer.  They talked about the symptoms of breast cancer that their relatives and friends had experienced.  Dr. Muna also informed that the etiology of breast cancer is not known yet and that is why breast cancer cannot be eradicated from the world. But it can be cured she said, if it is detected at an early stage. The breast cancer patient has to go through different modalities – variety of treatment afterwards.

ORIGIN OF BREAST CANCER:

• Cancer originates from breast tissue most commonly  found within the inner lining of milk ducts.
• The size, stage, rate of growth, and other characteristics of the tumor determine the kinds of treatment required.
• Treatment may include drugs (hormonal therapy and chemotherapy) radiation, surgery

THE VULNERABLE GROUPS:

• Women over age 40
• Women with  any history of breast cancer or other types of cancer in their family (parents, siblings,  aunt/uncle, first cousin).
• Women who have no children or have their first child late in life
• Women with obesity, shows high BMI (Body Mass Index)
• Women who do not breast feed their babies
• Women who take birth control pills regularly
• Women started first menstrual cycle early, and late menopause

HOW TO CATCH THE DEVIL AT AN EARLY STAGE:

• Self-examination – 2^nd or 3^rd day after completing the menstruation cycle
• Consultation with experts

SYMTOMPS OF BREAST CANCER:

• A lump that feels different from the rest of the breast tissue.
• Lumps found in lymph nodes located in the armpits can also indicate breast cancer
• Changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge.
• Changes in the skin of areola.
• Pain is an unreliable tool in determining the presence or absence of breast cancer

JOURNEY OF A GIRL TO BE A WOMAN:

• Steps in adolescence
• Phases of breast development
• Anatomy of a breast
• The function of benign tumors of breast (the size of these tumors can increase up to 25 years of age)
• Psychological problem the young women have regarding these benign tumors/ breast mouse
• If these benign tumors do not show movement or show high rate of growth then this is suspicious,  consult experts
• Breast Cosmetic surgery: sometimes scars will be visible for the rest of the life

THE LIFE STYLE THE WOMEN SHOULD FOLLOW:

• Avoid fast food
• Consume healthy diet – include vitamin c, calcium, protein, vegetables
• Avoid smoking
• Avoid alcohol
• Avoid drugs
• Reduce fat
• Regular exercise
• Consult before taking any birth control pill
• Conceive within age of 30
• At post natal stage breast feed for 2 years
• Consult before having infertility medicine

The session also included discussions on other cancers:

CERVICAL CANCER:

Cervical cancer will be eradicated from the world soon as the vaccination has been established. The vulnerable group of people is from low tier group. The culprit behind the disease is Human Papillama Virus.

The vulnerable group:

• Early sexual activity
• Multiple sexual partners
• Intercourse during menstruation
• Sex workers
• Drug addicts
• Have polygamist partner
• Smokers
• Poor hygiene

Dr. Muna additionally spoke on – Sanitation, passive smoking, urine infection.  And emphasized the importance of leading a healthy life at the end of her presentation.

CONCLUSION:

The students were eager to learn and their interest in the topic was reflected by the frequent questions they had for Dr. Muna.  Dr. Muna enjoyed this interaction with the students and was able to satisfy the students with all their questions.  I marveled at the fact that these young girls having this wonderful opportunity in their life time has surpassed the once considered taboo issue in our society. At one point found myself envious, these girls are having the opportunity to know and discuss the rather veiled issues that are sometimes considered taboo in our society. With all the support and resources provided to ABS I look forward to create more opportunities for our participants.

Tasmeena Ahmed

Dhaka, Bangladesh

Tasmeena Ahmed  is the Acting Executive Director of Adhunika Bangladesh Society

References:

1.      Adhunika Bangladesh Society ‘Breast Cancer Awareness Seminar’

2.      Publication cancer strategy by WHO and IAEA

3.      Bdnews24.com

4.      Wikipedia

Resource Person: Dr. Muna Shalima Jahan
Photography:  Tamanna Ayesha