Lifestyle changes alter breast cancer patient profile

Breast cancer, the urban malaise, is spreading not just in terms of numbers, but is percolating to the poorer sections even as it breaks the age barrier to affect more young Indian women. If 3,800 women walk into hospitals with breast cancer now as against 1,500 women annually five years back,doctors say the main reason is lifestyle.“In the last 20 years,women have their first child later, don’t breast-feed children for long and are overweight compared to their mothers.The results are showing,’’ said Tata Memorial Centre’s director Dr Rajan Badwe. Breast cancer, which has a genetic component as well, is now mainly a lifestyle disease, said experts. Besides, a study published in Lancet last month showed younger women were dying in larger numbers in developing countries. India was no exception, said the study of 187 nations by the Washington University’s Institute of Health Metrics And Evaluation. Dr Sanjay Sharma from the Breast Cancer Foundation of India said while the age profile of a breast cancer patient from the West would be 55 to 70 years, the Indian patient could be in the 40-55 age group. However, Dr Badwe says this is because India has more young than old people. Another study, published in August in the British Journal of Cancer by the Indian Cancer Society, showed college-educated Mumbai women had a 90% increased risk for being overweight, compared to illiterate women. It showed in 30 years, rates of breast cancer among women aged 30-64 rose significantly. A recent Breast Cancer Foundation sample survey of 1,000 Mumbai women found a worrisome socio-economic trend. “Nannies appointed by urban working women are mimicking employers. They leave their children in slums on packaged milk, forgetting breast-feeding,’’ Dr Sharma said, adding patients from the lower socio-economic strata were hence increasing. The transition of the disease from urban rich to the urban poor is not just in Mumbai but other metros of Delhi, Kolkata, Bangalore and Chennai too, said doctors. Dr Vinod Raina, head of the department, medical oncology at AIIMS, said, “Late marriages, delayed child-bearing and fewer children, leading to reduced breastfeeding, are behind the increased risk of breast cancer.” Dr Shyam Aggarwal, chief of medical oncology at Delhi’s Sir Gangaram Hospital, said, “Sedentary lifestyle, increased consumption of fat and less of fruits and vegetables is one of the main reasons for the increased rates of breast cancer among women in urban India.” India’s worst statistic, Dr Badwe said, was that though the country’s cancer incidence was one-third of the US, death rate due to the disease was almost same. “This is because women, whether old or young, come to us at a very late stage,” he said. The origins Breast cancer arises from cells lining the milk ducts and slowly grows into a lump. A tumour is believed to take about 10 years to become 1 cm in size, starting from a single cell. A malignant tumour has the ability to spread beyond the breast to other parts of the body via the lymphatics or the blood stream. The factors     Lifestyle choices or biological characteristics contribute to developing breast cancer.     Biological characteristics encoded in DNA are factors that cannot be controlled.     Other factors, however, can be controlled to prevent an increased risk for breast cancer. Preventable factors Body weight: Obese or overweight women are at increased risk of developing breast cancer. A woman who exercises four hours per week reduces her risk of breast cancer. Exercise pumps up the immune system and cuts estrogen levels. Smoking: Smoking not only increases risk of lung cancer, but breast cancer as well. A recent study indicated there may be a link between breast cancer and cigarette smoking and second-hand cigarette smoke, though the relationship is still under investigation. However, smoking decreases survival rate once you have been diagnosed with breast cancer. Drinking alcohol: The more alcohol you drink, beyond a drink a day, the higher your risk. Studies show that breast cells are exposed to higher levels of estrogen when consuming alcohol, which may trigger them to become cancerous. Diet: Eat a low-fat, nutritious diet. Fat triggers the hormone estrogen, that fuels tumour growth. Fill your diet with plenty of fruits and vegetables. Non-preventable factors Family pre-disposition: If a person has developed breast cancer in the past, or currently has breast cancer, women in the immediate family are at greater risk for breast cancer than those without family history. If you have a grandmother, mother, sister, or daughter who has been diagnosed with breast cancer, this puts you in a higher risk group. See your doctor at any sign of unusual symptoms. Age: The risk increases with age. Most cases are found in women over 40, though the number of younger women developing breast cancer is currently on the rise. Race: Breast cancer is diagnosed more often in white women than Asian or African women. Reason for this is yet to be defined, but women of all races should still be concerned. Reproductive and menstrual history: Women who experienced their first menstrual cycle before age 12, had menopause after age 55, and/or never had children are at increased risk.