Breast Cancer and the Importance of Early Detection

Breast Cancer Awareness Month, observed in countries across the world every October, helps to increase attention and support for awareness, early detection, and treatment for the disease. The theme for this year is – Importance of Early Detection.

Breast cancer is by far the most common cancer in women worldwide, both in developed and developing countries and according to International Agency for Research on Cancer (IARC) by the World Health Organization (WHO), breast cancer is the third most common cancer in Bangladesh with 12,764 cases as of 2018. We all know that women often neglect their health. Even women from the upper-class and upper-middle-class of the society, who don’t lack education or knowledge on the awareness of health issues, still tend to neglect taking care of their own health. They prioritize their family members and their needs or their busy work lives, over their health. Breast cancer doesn’t only affect women – it also affects men. According to Cancer Country Profile 2020 by WHO, 8.5% of the entire population of Bangladesh suffer from breast cancer at a 6.5% mortality rate.

Early diagnosis can help fight breast cancer effectively – in fact, if breast cancer is detected at the Stage 1 level, survival rates are only 95-99%; and the five-year survival rate for stage 2 breast cancer is 93% for women who have completed treatment. By contrast, women with stage 3 cancer have a five-year survival rate of 72%.

The most important risk factor for breast cancer is family history. There is a genetic predisposition for this cancer. If you have a family member who has been diagnosed with breast cancer, you should take special precautions to monitor for symptoms and, for women over 40, have regular mammograms.

There could be several symptoms of breast cancer like:

  • Lump in the breast or underarm
  • Swelling of part of the breast or any change in the size or the shape of the breast
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pulling in of the nipple
  • Nipple discharge other than breast milk, including blood
  • Pain in the nipple area or any area of the breast

Although it is rare, men can also get breast cancer. The most common symptoms of breast cancer in men are:

  • A lump or swelling in the breast
  • Redness or flaky skin in the breast
  • Irritation or dimpling of breast skin
  • Nipple discharge
  • Pulling in of the nipple or pain in the nipple area

Symptoms can also occur with other conditions that are not aligned with cancer. The most common cause of a lump in the breast for women is fibroadenoma or called simply a breast mouse. It is a benign tumor and rarely progresses to malignancy. Men can also get fibroadenomas but this is very rare.

To date, there is not sufficient knowledge on the causes of breast cancer, therefore, screening and early detection of the disease remains vital for breast cancer control. Simple measures such as self-breast examination is a well-accepted method where people examine their breast to detect any early lesion. There are other methods of screening for breast cancer such as an ultrasound of breasts and mammograms, which play an important role in the diagnosis of the condition. If a patient has a family history of breast cancer or their own history of benign tumors, then screening tests should be done annually. Otherwise, it is recommended for women over 40 years of age to get mammograms done every 3 years. Although ultrasound is not a routine screening test for breast cancer,  it is done in developing countries like Bangladesh.

Molecular cancer diagnostics tests can also play a vital role in cancer treatment. Those diagnosed with breast cancer at any stage should get a HER2 test done that can determine which targeted therapy or treatment protocol is best suited for a patient for early recovery. Treatment by surgery (removal of the lump) followed by chemotherapy or radiotherapy may be enough for a complete cure along with lifelong follow-up counseling which plays a crucial role. In advanced cases, the whole breast may have to be removed. A patient may also have hormone therapy after surgery, chemotherapy, and radiation are finished which can help prevent a return of the disease.

Creating continuous awareness and sharing knowledge about the cause, screening, investigation methods, and treatment for breast cancer can prevent the condition, although some cases may still progress to malignancy.

There are many success stories of women who have faced the ordeal with courage and determination and have been a source of inspiration for recovering breast cancer women. This year, let’s raise more awareness for early detection and help to curb breast cancer in our communities and in the world.

Allergy and COVID-19

Symptoms of flu, cold, and allergy are quite similar to those of COVID-19, so with every cough and sneeze, people wonder whether they have been infected with the coronavirus. Allergies normally cause symptoms such as runny nose and sinus but generally do not result in fever, as is mostly seen with COVID-19 or flu.

Bangladesh is a developing country with 150 million population. About 20% to 25% of population is suffering from different types of allergic disorder. They suffer almost all year round from different kinds of symptoms. 

Allergy vs COVID 19:

COVID-19 is a highly contagious and viral disease which can spread via air, respiratory droplets, or close personal contact. The symptom onset is around 2-14 days after exposure to the virus. Allergies on the other hand is a non-contagious hypersensitive reaction to the immune system when one is exposed to their trigger or allergen such as pollen, dust, mold, etc. Allergy symptoms are usually more localized, ranging from mild to severe, and can occur seasonally or be present year-long.

For instance, a patient with COVID-19 may have a fever, body aches, chills, a sore throat, weakness, and respiratory symptoms, while someone with allergies will be more likely to have the symptoms centered on the eyes, nose, and throat, and they usually don’t have a fever. Furthermore, in cases of allergy, symptoms improve when administering antihistamines but this does not help patients with COVID-19.

Although some coronavirus symptoms are similar to allergies, there are many variations. The image below from the CDC compares symptoms caused by allergies and COVID-19.

Some key points to differentiate allergies from COVID-19:

People often suffering from allergies have a personal history of allergy from allergens like food, pollen, dust, etc, and other atopic diseases. They may also have had previous similar allergy attacks or have a family history of atopy or allergy. COVID-19 is an extremely viral and contagious virus that can spread from person to person without any personal history. 

Allergies typically make people itchy which is not a symptom for COVID-19. People with allergies may also have asthma which can cause coughing, breathlessness, chest pain and tightness, and wheezing. Even though most are similar symptoms, COVID-19 typically does not develop wheezing.

Allergy symptoms can be treated with allergy medication like antihistamines and steroids. On the other hand, there is yet no proven medication or vaccine that can cure COVID-19.  

Some study shows the clinical course of COVID in allergic patients is associated with a worsening of allergies, for example, exacerbation of asthma. Even so, a clear understanding of COVID-19 infection in allergic patients compared to non-allergic patients is limited, and more clinical evidence is needed.

CDC recommends wearing masks as masks also offer some protection against seasonal allergies because they can prevent some larger particles from being inhaled. Discard your masks after each use, particularly if you suffer from seasonal allergies, because the covering may carry particles such as pollen.

The best way to prevent or treat allergy symptoms is to avoid the allergen. On the other hand, the best way to prevent COVID 19 infection is wearing masks, washing hands for at least 20 seconds, and maintaining social distancing. Finally, anyone who has any illness or symptoms must make sure to quarantine at home to avoid spreading the germs.

COVID-19: Message from Praava Health Chairman & Founder Sylvana Sinha

Across the world and at home in Bangladesh, as the global pandemic of the novel coronavirus continues to evolve, these are uncertain times. We at Praava Health want to share with you a personal message from our Founder & Chairman, Sylvana Q. Sinha. Ms. Sinha shares some important information on the COVID-19 pandemic, how the virus spreads and means of prevention, how Praava is caring for you and your loved ones, and above all, being good to ourselves and staying calm as we brave through this together.

To avoid coronavirus, wash your hands often with soap and warm water for at least 20 seconds, or use an alcohol-based hand sanitizer. Avoid touching your face, eyes, nose, and mouth with unwashed hands. Practice social distancing, which is deliberately increasing the physical space between you and others to avoid contracting or spreading illness. Staying at least 3 feet away from other people lessens your chances of catching COVID-19.

If you think you need to be tested, directly contact the government lab IEDCR at 01937000011, 01937110011, 01927711784, 01927711785. Government-approved hospitals for suspected coronavirus patients are Kuwait Bangladesh Friendship Government Hospital (Uttara, Dhaka), Bangladesh Railway General Hospital (Kamlapur, Dhaka), Dhaka Mahanagar General Hospital (Motijheel, Dhaka), Mirpur Maternity Hospital (Mirpur, Dhaka), Kamrangirchar 31 Bed Hospital (Lalbagh, Dhaka), Aminbazar 20-bed Hospital (Savar), Jinjira 20-bed Hospital (Keraniganj), Sajida Foundation Hospital (Jurayn, Dhaka), Dhaka Medical College and Hospital, Sheikh Rasel Gastro Liver Institute & Hospital (Mohakhali, Dhaka), and National Institute of Diseases of the Chest and Hospital (NIDCH).