Breast Cancer Awareness Month: Your guide to diagnosis, treatment and support in Malaysia

From how to self-examine to where to find social support and your options for financial aid, here’s your guide to navigating breast cancer.

According to the Breast Cancer Welfare Association of Malaysia (BCWA), one in 20 Malaysian women are at risk of developing breast cancer. In any case, it’s important to get diagnosed as early as possible to optimise the positive outcomes of your diagnosis.

However, even if early detection is not possible for you, there are also plenty of treatment avenues for you to explore. In light of this, we’ve consulted both the BCWA and a consultant oncologist to create this guide for Breast Cancer Awareness Month.

Find the answers to all your burning questions ahead.

How do I self-examine?

If you aren’t already, you should be conducting a self-check at least once a month. According to the National Breast Cancer Foundation of America, “Forty per cent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”

How to do it? Ideally, you should be feeling your breasts in a multitude of different positions; click here to find the full scope of what the Breast Cancer Welfare Association of Malaysia (BCWA) recommends. In their article, they cover how to perform the self-exam, the different positions you should check your breasts in, and what to look out for.

As for all you lads out there—don’t think you’re exempt from this, either. You have mammary tissue too; although it’s uncommon, it’s definitely possible. In fact, Dr Malwinder Singh Sandhu, the consultant clinical (medical and radiation) oncologist at Sri Kota Specialist Medical Centre, says that around one per cent of all breast cancer cases happen in men.

READ: Your step-by-step guide to a breast self-examination

Should I get a mammogram?

In addition to your regular self-examinations, you should also be getting a mammogram annually after the age of forty years, or if you suspect you may be part of the high-risk population. Specifically, the ‘high-risk’ group includes women with a past history of breast or ovarian cancer, women with a family history of one or more first or second degree, relatives with breast cancer before the age of 50 years, women in the age group of highest incidence, above 40 years, and women that are on Hormone Replacement Therapy (HRT), as stated by the BCWA.

The key to a positive prognosis with breast cancer is early detection; essentially, you want to find the disease before it has a chance to spread. Mammograms are indispensable in the early detection of breast cancer, as they are able to detect lumps two to three years before they are palpable.

I have been diagnosed with breast cancer—what are my treatment options?

It depends on the type of breast cancer you have, but generally, your options include chemotherapy, radiation therapy, hormone therapy, immunotherapy, targeted therapy and breast cancer surgery.

Consult your doctor to assess your options—no one treatment is universal. Your treatment needs to be personalised to your needs.

READ: Breast augmentation: What to know about one of the most popular cosmetic surgeries in Malaysia

What do I do if I cannot afford treatment?

Ms Ranjit Kaur, the President of the BCWA and a breast cancer survivor herself, took us through a few of the available options, stating: “If you have been working before, SOCSO can be one of the resources that you can go to to get financial aid. You could also withdraw money from your EPF. Further, organisations like Zakat and MAKNA provide support as well.”

On the other hand, there are some pre-emptive options to look into such as a solid health insurance plan, or hospitals that are providing patient-assistant programmes that provide support.

“Ultimately, our mission is to improve the quality of life for breast cancer patients, and reduce the risk of premature mortality by driving awareness, early detection, medical treatment, and timely treatment.” — Ms Ranjit Kaur, president of the BCWA

What is the difference between breast cancer and metastatic breast cancer?

Metastatic breast cancer (mBC), also known as Stage IV breast cancer, describes when the cancer has spread from the breast to other organs in the body. The most common sites for breast cancer to metastasise include the bones, the liver, the lungs and the brain. It can occur at diagnosis, or even months or years after the breast cancer has been treated.

What are the symptoms of MBC?

The symptoms depend on where your cancer has metastasised:

Brain: It depends on the area of the brain that is affected, but you may experience headache, nausea, fatigue, weakness, confusion, memory loss, speech problems and seizures.

Lungs: Sometimes, breast cancer cells spread to one or both lungs through the blood or lymph system—in this case, you may experience symptoms of breathlessness, coughing, pain and loss of appetite.

Liver: The symptoms include pain, nausea, loss of appetite, hiccups, jaundice, exhaustion and itchy skin.

Bone: This kind of metastases occurs in around two-thirds of women with mBC, and it is the most common site causing cancer-related pain. With this kind of metastases, you may experience pain, bone fractures from bone weakening, spinal cord progression, anaemia, and fatigue.

If you do not show symptoms, how do you diagnose breast cancer?

Typically, your healthcare provider would be conducting serial investigations such as chest X-rays, CT scans and PET/CT scans. Your best bet is to ensure you’re going for regular medical checkups.

Is mBC a death sentence?

Unfortunately, mBC is incurable, however, the right treatments allow for long periods of remission. Dr Malwinder says “we can provide long-term duration of remission, which means that we are trying to make mBC as chronic as possible. We are trying to make it so you can live another five to 10 years. Take something like diabetes and hypertension, where you can live many, many years with it; we are trying to take mBC into the same position as that.”

With regards to your local mBC treatment options, you can either opt for surgery or radiotherapy, which won’t cure your cancer, but will palliate your symptoms.

Ms Ranjit Kaur also highlights that the Thrive website has funding resources that you can refer to, as well as information about mBC, treatment options, support groups, financial assistance, video stories of courageous mBC patients that would help those living with mBC feel less isolated, as well as the upcoming #UnPause patient handbook.

What puts me at a higher risk of developing metastatic breast cancer?

The development of breast cancer is strongly linked to the hormones in a woman’s body; specifically, this refers to increased oestrogen exposure. Early menarche (the first occurrence of menstruation) and late menopause will mean that your body is exposed to oestrogen production for longer.

Similarly, hormone therapy with oestrogen further perpetuates exposure and increases the risk of breast cancer. Finally, in obesity, adipose tissue is converted to oestrogen, which further increases your risk of breast cancer.

Are there any dietary restrictions once I start treatment?

Dr Malwinder suggests that instead of eating three meals a day, you eat smaller, more nutritious portions more frequently throughout the day.

Further, he advises that you try to avoid raw food, because raw food may have organisms inside that may pose a slight risk of infection for your newly immunocompromised body.

Mostly, however, he says you should “just eat whatever you want, but make sure you exercise to burn it off later.”

READ: Can exercise prevent breast cancer? Here’s what we know

I feel isolated after my diagnosis—is there anyone I can reach out to?

“You need a strong social support network of care for all breast cancer patients, but especially for late-stage cancer patients. Those are the most vulnerable patients,” Dr Malwinder says.

This support community can be found through the BCWA—Ms Ranjit Kaur prides herself on her organisation’s well-established “signature peer support and community outreach programmes that work to provide psychosocial support, access to treatment and advocacy.”

She elaborates that “communities can relieve the fear and uncertainty through their experience, encouraging words and accurate information.” Find out more about the BCWA’s wonderful services here.

For more information about Breast Cancer Awareness Month, click here.