Changing the Face of Breast Cancer
By KRISTINE C. MOSQUEDA-KELLY

Women are no longer helpless victims of breast cancer. Through early detection, they are getting a step ahead in the battle against the disease. However, doctors are concerned about a new study indicating that many women who undergo a mammogram at the recommended age of 40 fail to return promptly for equally important follow up exams.

Performing regular breast self-examinations (BSE) is one way to determine if something is wrong with your breasts. Women are advised to do monthly BSE beginning at age 20. The best time to do it is two days after your period. Using this diagram as a guide, check both breasts for changes such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk.

Women are making strides against breast cancer. Experts say there have been significant gains in breast cancer survival in the last ten years, and they credit this achievement to an increased awareness among women of the importance of early diagnosis through regular screening and tests.

The American Cancer Society (ACS) California cancer facts and figures indicate that deaths from breast cancer has gone down by 24 percent in the last decade, even as the incidence rate has not increased since 1988.

Despite the progress, however, doctors are worried about the emerging trend of women delaying or skipping lifesaving subsequent screenings that are just as crucial as the first mammogram.

“Most women now follow the recommendation to receive their first screening mammogram at age 40, but there is widespread failure to return promptly for subsequent exams, which raises a woman’s chances of dying from breast cancer,” says researchers from Massachusetts General Hospital (MGH) and Harvard Medical School.

The experts say focus should now turn to encouraging women to return promptly once they have begun screening.
Nobody knows the importance of regular breast examinations and screenings more than Peachy Gamez, a breast cancer survivor.
Like many Filipinos, Peachy Gamez, who was diagnosed with breast cancer at age 29, never checked her body for abnormalities. Neither did she bother to go to the doctor for preventive screenings or tests.
It was only when her live-in boyfriend noticed a lump in her right breast that she realized something could be wrong.
“I never did breast self-examination. I didn’t bother because I didn’t feel sick. There were no signs, but because my boyfriend was very concerned I decided to have it checked,” said the former chain smoker who has a history of cancer in her family.

Peachy had a biopsy following a series of tests.
After a few days, a phone call from her doctor. The lump was malignant and she was given two options: get rid of the cancerous portion and undergo chemotherapy or have a mastectomy to remove her entire right breast.
Although the cancer was in its early stage, her doctor recommended mastectomy to prevent the cancer from recurring. With this procedure, she could skip chemotherapy.

“I was crying. I didn’t know what to do. I felt like it was the end of the world. I even asked my boyfriend to just leave me because I felt that he won’t love me anymore when my breast is gone. It was a very emotional time for me,” she recalled.

Peachy chose mastectomy. Constant monitoring followed the surgery. The doctor performed mammogram tests on her other breast every three months during the first year, every six months on the second year, and once a year afterwards.
It has been 16 years since her bout with cancer, but the experience still brings tears to her eyes. Those were the darkest days of her life, but from the darkness emerged a winner, a true survivor.

“It was hard, but when I look back I feel stupid for feeling so depressed because I am blessed that I survived to share my story with other people.”
Today, Peachy grabs every opportunity to talk to her family, friends, and strangers about what she has learned from her experience. When the right time comes, Peachy plans to discuss it with her eight-year old son who is already learning from his mother the meaning of living a healthy lifestyle.
Peachy’s personal campaign to spread the word about cancer has stretched to the community. The former ACS volunteer-turned-staff member devotes her time and effort to educating people about the value of preventive care and providing support to other cancer patients.

“Filipinos…usually go to the doctor only when there’s something wrong. We are not conscious of our food intake. Many do not meet the required five servings a day of fruits and vegetables. I used to be careless. I hated vegetables. I started smoking in high school,” she noted.

Needless to say, the Filipino survivor has quit smoking, improved her lifestyle, built her knowledge about the disease, and has since been cancer-free.
Not many people are as lucky as Peachy, who caught the cancer early enough to address it. Some learn about their condition too late, when the cancer cells have metastasized or spread to other parts of the body.
The problem is that the preventive care practices of many Asian Americans are poor, especially among recent immigrants. ACS statistics show that only 33.7 percent of female immigrants over 40 who are relatively new in the U.S. had a mammogram in the last year.

A recent study by Dr. James Michaelson of MGH shows that “specific sub-populations delayed mammography.” Non-English speaking women did not begin screening until a median age of 49. Those without a private health insurance delayed screening until an average age of 46. Uninsured women who do not speak English begin screening at much later age of 55.
Breast cancer does not usually show symptoms until the latter stages, and the only way to detect it soon enough is through screening. The survival rate is higher when breast cancer is spotted early.

“We do have a challenge with immigrant populations as far as getting them to screen for early detection. Finding a doctor that they are comfortable with is a factor. Language barrier is another issue with first generation immigrants,” observed Herman Kattlove, M.D., M.P.H., Medical Editor of the American Cancer Society.

The discomfort that comes with many of the tests also discourages people from getting checked. “All these tests can be uncomfortable and invasive. No one wants to do it, but this is the only way to protect your health,” the oncologist said.

Breast cancer is the most common cancer in women, including Filipino-Americans. More than 2,400 new cases have been detected in Filipinos from 1996-2000.
In California, where there is a big concentration of Filipino-Americans, the ACS projects new cancer cases to reach 68,555, and cancer deaths to hit 26,610.
The prevalence of cancer is low among Asian Americans, but research indicates that cancer rates in populations immigrating to the United States tend to increase over time as they adopt to more Westernized lifestyles.
Besides keeping a good diet and fostering regular physical activity, being your own advocate and arming yourself with knowledge is the best defense against cancer. The Internet holds a treasure trove of information about cancer and other diseases, as well as help and services available.

Peachy says that one can never be too careful when it comes to his or her health. “Now I regularly perform breast self-examination and undergo Pap smear and mammogram. I go to the doctor whenever I feel something because you never know.”

The Filipino cancer survivor advises women and men to make time for regular health checks.

For those who do not have health insurance or those who are bound by financial constraints, there are clinics in your community that provide free services.
If you need help and/or information, call the American Cancer Society 24-hour information 1-800-ACS-2345 or visit www.cancer.org. For Filipinos who need a kababayan to talk to, contact Peachy Gamez at 213-386-7660 x261.

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