MRCCC Siloam Hospitals Semanggi is Indonesia’s first and largest private comprehensive cancer centre. Since opening its doors in 2011, it has grown to become one of Indonesia’s leading hospitals providing high quality healthcare for all patients. NOW! Jakarta met one of its most prominent oncologist surgeons, dr. Alban Dien,SpB (K) Onk to gain a deeper understanding of the disease.
According to dr. Alban, before 2010, cervical cancer used to be the leading cause of cancer death for women. However, since the introduction of the cervical cancer vaccine, death rates have declined, with breast cancer taking the number one spot of the list. Nearly 1.7 million new cases of breast cancer were diagnosed in 2012. This number is expected to grow even larger due to unhealthy diets, drinking and smoking habits, lack of exercise, pollution and a high level of stress. Several other factors can also contribute to breast cancer. Those with a weak immune system are more likely to develop cancer. Once they have the disease, their immune system will weaken even more as the healthy cells, which are supposed to fight the bad cancer cells, attack the other good cells instead.
Research has also shown that women with a high level of estrogen and a lack of progesterone are more likely develop breast cancer. “Even though breast cancer mainly occurs in women, men can develop it as well, although the chance is by far not as high. But breast cancer in men is more dangerous given their smaller chest, which is only two to three centimetres thick. This allows the cancer to spread more rapidly to other organs. It is quite rare for men to have breast cancer - they only make up about three percent in the statistics while the remaining 97 percent are still women,” dr. Alban explained.
THE SOONER, THE BETTER
The oncologist surgeon suggests that women should have a regular check up using Breast Ultrasonography (USG) as soon as they turn 18. There is no need for mammography until the age of 35 since the breasts are still solid and contain much dense and fatty tissue, leading to unclear mammography results. Breast USG—which applies high-frequency sound waves to produce images of the internal breast structure—serves as an additional examination besides mammography to conduct early detection of abnormalities and to determine whether a breast lump is cystic (fluid-filled) or solid. Ultrasounds are considered safe during pregnancy, for breast-feeding mothers and women with breast implants. By the time women are 35 years of age, they should undergo mammography check ups every one to 1.5 years, especially when they already have children and are breastfeeding as the liquid inside breasts is reduced compared to women at a younger age. More frequent check ups are not recommended because a high exposure to X-rays can come with harmful side effects. Mammography is a specific technique of imaging, using a low dose of X-ray to examine breasts—it helps to show early signs and symptoms of breast cancer, including lumps, knots, thickenings or indentations in the breast, a change of breast shape, size, colour or texture and abnormal nipple discharge.
MRCCC Siloam Hospitals Semanggi also provides a Positron Emission Tomography–Computed Tomography (PET/CT) Scan which, according to www.radiologyinfo.org, uses small amounts of radioactive materials called radiotracers, a special camera and a computer to help evaluate your organ and tissue functions. By identifying body changes at the cellular level, PET/CT Scan may detect cancer cells, determine the deployment and stage of the cancer cells, assess the effectiveness of the treatment plan or chemotherapy and radiotherapy. Indeed detects new tumor growth. “Self-check ups, like examining your own breasts for any indications of a lump, are not always effective because the lump might be located deep inside and you cannot feel it. But if you suddenly feel a lump growing out of the blue, you should immediately see a doctor for further examinations,” dr. Alban said.
WHAT TO DO IF IT BECOMES SERIOUS
“Please bear in mind that having been diagnosed with breast cancer is not the end of the road as long as it is still stage I or II. Stage I has a 90 percent survival rate, while stage II is at 85 percent. Unfortunately, the percentage goes significantly lower for cancer stages III and IV. If patients are cooperative and have check ups and treatments on a routine basis, they can be cured,” dr. Alban explained.
Chemotherapy is recommended to patients with indication of breast cancer or at high risk of relapse. During chemotherapy, the drugs will eradicate the cancer cells or shrink the size of the cancer itself. Similar to chemotherapy but with fewer side effects, targeted therapy relies on drugs or other substances that interfere with specific molecules of the cancer.
Radiotherapy means applying beams of X-rays, gamma rays and charged particles on the patient’s breast to get rid of the cancer. It must be paired with Breast-Conserving Surgery or BCS (removing part of the breast that contains the cancer) in order to improve the patient’s chance of survival. Patients can also undergo hormonal therapy that consists of anti-estrogen drugs to cut down the hormones responsible for breast cancer. As long as the cancer does not concentrate on or around the nipple, mastectomy (surgically removing one or both breasts to prevent cancer from spreading to and affecting other organs) is not required.
MRCCC Siloam Hospitals Semanggi