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NEED MORE DATA ON OUR OWN COHORT OF PATIENTS

Interview Cancer Care For you Doctors February 2018 Health and Wellness Onco Corner Patient Care Report

NEED MORE DATA ON OUR OWN COHORT OF PATIENTS

BY ARUN FRANCIS

NEED MORE DATA ON OUR OWN COHORT OF PATIENTS 1

Dr. Jayanti S Thumsi is not just an experienced breast surgeon, but the proud author of a book on breast cancer. She comes with over 18 years in breast care practice from some of the most distinguished institutions in the country. Her specialization lies in breast cancer surgeries, post-op treatments, and breast reconstruction surgery. She currently serves as a senior consultant and in-charge of the breast oncology department at the Global Cancer Institute of Gleneagles Global Hospital, Bengaluru. Snippets from our conversation with Dr. Thumsi:

Being a specialized breast surgeon, you must have treated patients at all stages of breast cancer. At a time when awareness and workshops on cancer are increasing, what are some factors that still hold our women back from coming in for early screening?

Over 60 percent of women reach out to a doctor when the disease is already in its advanced stage. Lack of awareness, shyness, and complacency are some factors that hold them back from seeking help early.

Is the treatment approaches the same for women under and over 40 years of age?

Breast cancer treatment in women less than 40 years of age tends to be more aggressive since they are fitter and tolerability to treatment looks better. These women often prefer breast conservation and reconstruction. Also, many of them might be keen on getting pregnant after the treatment. For such patients, we offer fertility preservation techniques like embryo or oocyte or ovarian cryopreservation.

There are women who are diagnosed with cancer during pregnancy. This can be scary. Is it also harmful to the fetus? How is the diagnosis in pregnant women different from the rest and what are the treatment methods used?

Breast cancer during pregnancy has added anxiety in women and doctors. The goal is to clear cancer from the woman’s body and also safeguard the baby. If the patient chooses, she can continue the pregnancy after assessing the survival rates according to the stage of the disease. The diagnosis itself is difficult during pregnancy as the breast goes through a lot of changes, and feeling a lump might be difficult. Very few radiological options are available during pregnancy, to spare the baby from radiation. Chemotherapy is avoided in the first trimester of pregnancy but certain drugs can be used from the second trimester.

Do you think breast cancer is preventable to an extent? If yes, what are some conscious efforts we can make to help reduce the chances of contracting it?

Some cancers are preventable, like cervical, head, neck, and many more. As far as breast cancer is concerned, the risk can certainly be reduced. Breastfeeding for at least a year, maintaining ideal body weight, cutting down on alcohol consumption, quitting smoking, having the first child before 30 years of age, avoiding indiscreet usage of oral contraceptives and HRT can cut down the risk.

How effective is targeted therapy in the treatment of breast cancer?

Targeted therapies are very effective. They have reduced the risk of death in breast cancer patients by 53 percent. Hormone therapy for hormone-positive breast cancer and anti-HER2 therapy for HER2 positive breast cancer are very effective and routinely used.

What are the chances of cancer spreading from one breast to another, and what are its probable causes?

Cancer can spread to the other breast through crossover lymphatics or as a metastasis from one side. It can even be a new disease with new biology of breast cancer.

What are some necessary investigations for the staging of cancer?

Mammogram, USG of both breasts, liver function test, USG of abdomen and pelvis, chest X-ray, CT scan of chest and abdomen, PET scan, CT Scan, MRI are investigations to stage cancer.

You are part of several professional medical associations, have organized various national and international talks, and have been involved in many clinical trials as well. According to you, how far have we come in terms of research and development in the field of cancer care? What are the improvements you wish to see in the near future?

In India, many labs have come up with facilities to carry out genetic testing and molecular biology studies. But research in our country is in its infantile stage as the limited resources available are being directed towards treating patients than towards research. However, we are progressing well. Breast cancer in our country behaves differently as compared to that in the west. But our treatments are based on research carried out in the west. Hence, there is a need for our own data and research on our cohort of patients.

You have authored a book on breast cancer, titled Lump to Laughter. What inspired you into penning it? Do you have more projects lined up in the future?

I have been actively involved in raising awareness among women in our society about breast cancer. So far, 256 awareness programmes have been held and over 1,56,000 women have been reached out to. I found the idea of raising awareness for a noble cause through a book interesting. The book shares real stories of women who have battled breast cancer, their emotional journey, success stories, some not-so-successful stories with medically validated information, and the like. The book has been well received and is already in its third edition. Talking about future plans, we have quite a few breast cancer awareness programmes planned for this year. I guess it is the need of the hour to educate our women further about this disease

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