ONE of the most devastating group of Non-Communicable Diseases (NCDs) to plague humanity on a global scale are cancers. The American Cancer Society (ACS) in its 2017 Report of Cancer Facts and Figures stated that cancer accounts for approximately one in every seven deaths worldwide, and in 2012, an estimated 14.1 million cases of cancer were diagnosed around the world which resulted in 8.2 million cancer deaths. The ACS also states that more than 60% of these deaths occurred in low and middle-income countries. The global cancer burden is growing at an alarming pace: in 2030 alone, about 21.6 million new cancer cases and 13.0 million cancer deaths are expected to occur, simply due to the growth and aging of the population. The World Health Organization (WHO) reported that in both developed and low and middle-income countries, breast cancer is the most common cancer in women, resulting in approximately 1.38 million new cases and 458,000 deaths from breast cancer each year. The 10-year Cancer Profile 2003-2012, of Guyana, reported that breast cancer was one of the leading causes of death in Guyanese women.

October 1 marked the beginning of Breast Cancer Awareness Month in most parts of the world, including Guyana. According to the WHO, Breast Cancer Awareness Month is used to increase awareness of early detection and treatment and palliative care of patients suffering from breast cancer.

Breast Cancer Defined
According to the ACS, breast cancer occurs when breast cells grow and proliferate at an abnormal rate and develop into a tumour that can be observed (seen or palpated) as a lump or detected on an X-ray. Breast cancer cells grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer principally occurs in women, but can also occur in men.

Modifiable and Non-Modifiable Risk Factors

The Centers for Disease Control and Prevention (CDC) stated that the non-modifiable risk factor for breast cancer includes aging (most breast cancers are diagnosed after 50 years of age); genetic mutations (such as inherited mutations to genes such as BRCA1 and BRCA2); reproductive history of early menstrual periods before are 12 years of age or menopause after 55 years of age; and family history of breast cancer. The modifiable risk factors of developing breast cancer according to the CDC include lack of physical activity; being overweight or obese after menopause; use of hormonal replacement therapy during menopause; use of certain birth control pills; consumption of alcohol; or a reproductive history of having become pregnant for the first time after 30 years of age, not breastfeeding a child, or never having a full-term pregnancy.

Signs and symptoms observed during self or clinical examination of the breast

According to the literature on cancers, it is stated that the most common symptom of breast cancer is a new lump or mass in the breast which can be painless or painful, hard or soft, possess irregular edges or round. Other symptoms of breast cancer are swelling to all or part of the breast, skin irritation or dimpling, breast or nipple pain, nipple retraction, redness, scaliness, or thickening of the nipple or breast skin, and nipple discharge that is not breast milk. Occasionally, lumps can be felt or observed under the arm or around the collarbone, indicative of the spread of cancer to the lymph nodes. It is vital that women perform regular self-examination of their breasts; detection of any of the signs and symptoms mentioned above should be immediately reported to a duly qualified medical practitioner for further investigation.

The Ministry of Public Health in Guyana is working assiduously to meet the United Nations Sustainable Development Goals (SDGs), specifically Goal Number 3: Good Health and Well- Being: Ensure healthy lives and promote well-being for all at all ages and its associated targets, especially 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. The ministry is aiming to reverse the current statistical trends observed amongst Guyanese women as it relates to breast cancer, a non-communicable disease (NCD). The prevention and treatment strategies currently being utilised by the Ministry of Public Health to combat the scourge of breast cancer among the Guyanese populace include, but are not limited to, the following:

1. Enhancing screening programmes and providing more effective breast cancer surveillance programmes to aid in early detection of the disease. These activities, coupled with the installation of state-of-the-art technologies to provide the highest-quality images possible, to be interpreted by radiologists who specialise in breast imaging, will form an essential part of our ministry’s plan to take the fight to breast cancer.

2. Commissioning of a building by the Georgetown Public Hospital Corporation in its compound, to house the new Oncology Department on 29th June, 2018, in an effort to ensure that the best possible treatment and care are offered to our cancer patients.

3. Drafting and executing a robust public education programme designed to spread awareness of the risks of getting cancer and the necessary steps to be taken by individuals in significantly reducing those risks. This public education programme will also point out the benefits of screening as well as, the intrinsic value of early detection. It will also contribute to raising the level of cancer literacy and awareness.

4. Engaging our international partners like the Pan American Health Organization/World Health Organization (PAHO/WHO) to assist the Ministry of Public Health with the development of a comprehensive strategic plan for combating cancer in Guyana.

5. Working continuously at the primary-care level to encourage and promote healthy choices and healthy lifestyles, especially among those persons living in the hinterland regions of Guyana.

The Ministry of Public Health will continue to intensify national efforts to reduce the morbidity and mortality associated with breast cancer. This includes initiatives to increase awareness, including the publishing of information on ways to reduce the risk of developing breast cancer, as well as the benefits of early detection.

For more credible information on breast cancer, please visit the following websites:
– The American Cancer Society
– Centers for Disease Control and Prevention
– World Health Organization
– Pan American Health Organization