Breast cancer is the most common among women worldwide, accounting for 16% of all female cancers. The figures surrounding this terrible disease are appalling.
In medical terms this is breast cancer: a clonal disease where a single cell product of a series of somatic or germline mutations acquires the ability to divide without control or order. This causes it to reproduce and form a tumor.
There are two main types of breast cancer. Infiltrating ductal carcinoma, which begins in the ducts that carry milk from the breast to the nipple, is by far the most frequent (approximately 80% of cases). The second place is occupied by infiltrating lobular carcinoma (10 to 12% of cases), which begins in parts of the breast called lobules, which produce breast milk.
It must be made clear that although the disease is related to women, men can also suffer from it: for every 100 cases in women there are 1 in men.
Any woman can be a victim of this disease. In the Americas, cancer is the second cause of death, and it is estimated that each year 2.9 million people are diagnosed and 1.3 million die from this disease. Approximately 52% of new cancer cases and 35% of cancer deaths occur prematurely in people 65 years of age or younger. If no additional measures are taken, it is expected that, by the year 2025, the burden of cancer will rise to more than 4 million new cases and 1.9 million deaths.
The incidence varies widely throughout the world, with rates normalized by age of up to 99.4 per 100 000 in North America. Eastern Europe, South America, Southern Africa and Western Asia present moderate, but increasing incidences.
The lowest incidence occurs in most African countries, but there is also an increase in the incidence of breast cancer.
Likewise, breast cancer survival rates vary widely throughout the world. In North America, Sweden and Japan is eighty percent. In middle-income countries it is sixty percent and low-income countries survival rates are forty percent.
Survival rates are in many cases related to early detection programs. So, the lack of adequate diagnostic and treatment services poses a real issue.
The signs and symptoms of breast cancer are:
● Presence of masses or lumps in the breasts or armpits
● Hardening or swelling of a part of the breasts
● Redness or peeling in the nipple or breasts
● Sinking of the nipple or changes in position
● Nipple discharge, at periods other than breastfeeding
● Any change in the size or shape of the breasts
● Pain in any part of the breasts or armpits
● Swelling under the armpit or around the clavicle
Family history of breast cancer multiplies the risk by two or three. Some mutations, especially in the BRCA1, BRCA2 and p53 genes, are associated with a very high risk of this type of cancer. However, these mutations are rare and explain only a small part of the total breast cancer burden.
For this reason, the POR MI, POR TI, POR TODAS Foundation (for me, for you and for all) was created. A foundation whose only goal is to help, provide a helping hand, a space in which all fears can be thrown away, where there will always be someone to talk to.
I spoke with Diana Appleton Lewis, founder of POR MI, POR TI, POR TODAS and I felt small because of her immense work.
A few years ago Diana Appleton Lewis got sick. She was diagnosed with breast cancer. She was specifically diagnosed with bilateral breast cancer (cancer in both breasts at the same time).
At that moment they gave her a three months life expectancy. And, after much pain, agony, suffering, she made a decision. She was going to survive this disease. She was going to enjoy her life and she was also going to help other women in this terrible situation.
It all started as a support group. And, with his experience she established different benefit programs. The programs were designed taking into account the experience Appleton Lewis had. These are:
Sanarte: healing through art. It consists of an acting workshop.
Famisana: provides support for caregivers and psychological support for family members.
Look Good – Feel Good: makeup and skin care workshops.
Well-being: it is an exercise program for patients undergoing treatments.
Your challenge: labor reinsertion.
Your closet: clothing donation.
Happy heart: mobile room for chemotherapy patients and relatives of the departmental hospital (hospital departamental del Valle) who come from other municipalities and do not have money to buy food.
So far, the program that has received the most reception is Look Good – Feel Good.
This program helps people to accept the reality in which they find themselves, in addition to motivational talks. There are also exercises to develop.
Carrying these programs has not been easy. For now it has the support of eight volunteers and sixty-nine patients. As Diana told me, everything has been done from scratch. The support of patients and their families has been key. And, fortunately, people have donated clothing, food, time and money.
In any case, living from donations is not simple or ideal. The foundation is maintained on a daily basis with the sale of desserts, shirts, hats and keychains.
They have recently released the first TOPBRA RENACER collection. It is a bra that Diana designed for mastectomized women. They are made by two of the women who are part of the foundation.
Perhaps the most difficult part has been the economic part so far. The truth is that there is a lot to do, a lot of women, men and families to help and not enough money to do so.
Treatments and problems
Even though the WHO estimated that by 2030 the number of cancer patients will augment in 47%, mortality because of this desease should diminish. Thoretically this should happen due to mediacal advances and early detection.
As we know, an international day to remind us about this disease is not necessary, but it exists. Cancer has an ominous power to change the lives of millions of families in the world.
In 2017, 32,818 new diagnoses were carried out and 18,071 deaths, especially due to breast cancer and prostate cancer. As is known, early detection can save lives. And, there are many people who are saved thanks to it. Having access to the right treatments in the time frame due is critical. But, more is missing in this aspect.
The areas of greater risk in Colombia are concentrated in the Coffee Region, Antioquia, Valle del Cauca, Santander and Norte de Santander, Bogotá and Meta.
The chances of healing depend mostly on early detection. However, an adequate diagnosis and treatment are needed to act immediately and effectively.
In terms of treatment in Colombia there is a 45 day waiting period for breast, cervical, colon, stomach and prostate cancer, that is two weeks longer than expected.
According to calculations by experts from the Colombian League Against Cancer, approximately 10 percent of mastectomized women MAY NOT have the option of breast reconstruction.
However, many women are advised not to perform reconstruction but there are also women who simply decide that they do not want to go through another intervention.
It is worth noting that although Colombia is one of the few countries in the region where care is comprehensively covered there are innumerable administrative barriers that hinder the lives of patients.
Another problem that a patient can face is that of oncology services. In Colombia, oncology services are concentrated in capital cities, which exposes gaps of effective access to enormous specialists in the regions.
To sum up
Cancer is a terrible disease. It is terrible for patients but also for families.
There is a sense of fatalism when it comes to cancer. It is thought that it is simply too difficult to deal with such a complex disease. This fatalism permeates governments, and even patients and their families.
All countries, without exception, need to be better prepared to fight cancer better. As a result, mortality rates will be reduced and this challenge for health systems will become a surmountable reality.
Breast cancer can occur at any time and anyone can be your victim. For this reason, Diana Appleton Lewis’ work is impressive. It may have been born from a personal experience, but her work transcends his illness, is directed to give him a new opportunity, a respite to all those who need it. It is for and for everyone!