By CAROLINE CUNHA
BREAST CANCER is the main cause of death in women in Portugal, with 1,500 dying from the disease every year.
Around 4,500 new cases are identified every year and one in every 12 women in Portugal will develop breast cancer at some stage in their lives.
These were the shocking statistics revealed by gynaecologist and obstetrician Dr Susana Maia from Faro Hospital, who was speaking at a breast cancer debate held at Albufeira Municipal Library on Monday.
The event, Ainda és Mulher (You are still a woman), was open to the general public and was designed to raise awareness about breast cancer among the local population concerning prevention, typical symptoms, breast screening, forms of treatment and the support available for sufferers in the Algarve.
Awareness is the key
Organised by Albufeira Câmara, it began with an introductory speech from Desidério Silva, president of Albufeira Câmara. “Albufeira Câmara is concerned with health and social problems and is paying particular attention to these matters, not only cancer, but other diseases such as diabetes among others. Our aim in organising this event is not to make a big drama and cause panic, but to raise awareness, provide information, concentrate on prevention and respond to any doubts people may have.”
The president also emphasised the importance of the institutions involved and he took the opportunity to praise the “fantastic” work being done by the Associação de Oncológica do Algarve (AOA), which has been responsible for launching the Algarve’s first breast screening service.
Dr Maia spoke next, beginning her talk by explaining the various forms of breast cancer and the background to the disease. She then provided the current picture in terms of the prevalence of this disease in Portugal and, as well as divulging the aforementioned statistics relating to this country, she also offered the global picture.
Worldwide, 400,000 women die from breast cancer every year and one million women are diagnosed with the disease each year. Twenty per cent of cancers found in women worldwide relate to the breast and the prevalence of the disease is growing, with the number of cases increasing year on year.
Dr Maia explained that the cause of the disease is still unknown, but that there are various risk factors associated with breast cancer. It is more common in:
• women over the age of 50
• those with a family history of breast cancer, particularly mother, sister and daughter
• those with a history of benign diseases
• those who began menstruating early (i.e. before 12-years-old)
• those who began the menopause relatively late (i.e. after 55 years of age)
• those who have had oestrogen replacement therapy.
In addition, those who gave birth to their first child after the age of 30 and those women who have not had any children are also deemed to be at a higher risk. Those who have taken the contraceptive pill for a prolonged period, the obese, those who drink excessive amounts of alcohol, have been exposed to excessive radiation are also considered to be more vulnerable to the disease.
Maia also said that breast cancer is more common among Caucasians.
With regard to symptoms, these can include discovering a lump, the shape of the breast changing, discharge from the breast – with or without blood – swelling of skin on the breast or underarm, prominent veins on one breast, inverted nipple or a depression in an area of the breast surface.
Self examination and screening
The doctor could not emphasise enough the importance of early detection of the disease in order for treatment to be effective and urged the women present to make the effort to examine their own breasts on a regular basis.
Dr Maia said women should begin examining their breasts from the age of 20, take an annual clinical exam between the ages of 35 and 40 and have an annual mammogram after the age of 40.
She explained how to examine breasts and also advised when it should be done; once a month, a week after menstruation or for those that have stopped menstruating, at a date that can be easily remembered every month.
She pointed out that nine in every 10 breast alterations identified are not related to breast cancer, but that any suspected alteration must be reported to a doctor.
Dr Maia also mentioned the AOA’s breast screening programme and highlighted the importance of women responding to the invitation from their local health centre to have a mammogram at the mobile unit.
As well as regularly examining their breasts and taking part in screening programmes, Dr Maia said that lifestyle and eating habits also play an important part in safeguarding against the disease. A diet rich in fibre, fruit and vegetables is advised and consumption of fat should be reduced. Alcohol consumption should be controlled and taking regular exercise is also recommended.
The gynaecologist and obstetrician took the time to explain the forms of treatment available to those who are unlucky enough to be diagnosed with breast cancer and emphasised the fact that every case is different.
Treatment can include localised surgery, mastectomy, radiotherapy, chemotherapy, hormone therapy and natural therapy and often a combination of different treatments are used based on the state of the disease, the type of tumour, the patient’s age, general state of health, if they are pre or post menopause and various other factors.
The doctor also outlined the side effects of treatment, which can include fatigue, loss of hair, nausea, lack of appetite, diarrhoea, and alterations to menstrual cycle.
Support for sufferers is available
Next to speak was psychologist, Daniela Balbina of the AOA, who delivered a message of hope and support for the women of the Algarve.
The AOA is a non-profit making institution with branches in Faro and Portimão, formed by volunteers to fight against cancer. It provides human and social support to cancer patients, doing all that is necessary for their rehabilitation into society.
It offers psychological support, relaxation and meditation classes, access to a specialist library and hydro-aerobics at Olhão swimming pool. It also sets up support groups and fun social events such as dinners and dancing for patients to meet others in the same position. It also sells wigs, breast prostheses, specially adapted underwear and swimwear and offers assistance for dealing with colostomy.
Daniela explained that the AOA was responsible for launching a breast screening service in the Algarve in conjunction with the regional health authority and the Algarve University last September.
This has enabled women to have a mammogram at the mobile digital mammography unit, which is visiting health centres across the Algarve (see article in last week’s issue of The Resident for full details of this programme).
She also spoke about the new radiotherapy unit, which opened in Faro this year and the campaign to raise money to build an accommodation centre for radiotherapy patients close to the unit.
Living every day as if it the last!
Last to speak was artist, sculptor and former breast cancer sufferer, Miriam Palácio, who spoke about the power of positive thinking and the therapeutic benefits of art.
A resident of São Brás de Alportel, Miriam has won numerous prizes and awards in her native Argentina and her work has been show in various exhibitions in Portugal and abroad.
Miriam has had close personal experience with the disease, she has had a mastectomy herself and several members of her family have been victims of cancer.
“One day we will all die and because I’m alive, I’m going to live every day as if it is my last,” she said.
Her latest exhibition entitled Ainda és Mulher (You are still a woman), is a celebration of femininity linked to breast cancer awareness and features a series of pastel sketches, some even featuring the breast cancer awareness symbol, a pink ribbon. It is dedicated to her Grandma and her doctor and to all those women who, in some way, are fighting for their lives. “Since I was a young child, my Grandmother showed me the scar from her breast surgery and so I was conditioned not to be afraid. My doctor just told me to pull myself together and live, which was great advice”. Ainda és Mulher is on show now at Albufeira Municipal Library and continues until October 30.
The staging of this debate was particularly timely for the women of Albufeira as the mobile mammography unit will be stationed at Albufeira Centro de Saúde from October 20.