#SunMedHerStories Women & Cancer - What You Should Know
07 March 2022
How it affects women and what you can do about it
In this modern-day and age, women are facing more societal pressure than ever to live a complete and full life. Making up 55.8% of the Malaysian workforce in 2019, women are contributing equally to the economy and individual household incomes, yet still remain as the backbone to most family dynamics; from the primary carers of the young, elderly, and the infirm.
Suffice to say, we have our plates full managing a work-life-family balance, sometimes to the detriment of our own health. We might convince ourselves that we are healthy by going to the gym regularly or cautious of our food intake, but this does not mean we are safe from the dreaded C-word. Cancer.
Dr Jennifer Leong
What is cancer?
To put it simply, cancer is labelled or named after where the tumour arises from, and according to the National Cancer Society Malaysia, the top four most common cancers found in Malaysian women are breast cancer, followed by colorectal, cervical, lung and ovarian cancer.
Some cancers, like ovarian cancer, have been called the silent killer as its presenting symptoms can be vague and often be mistaken for other benign conditions, while others such as breast cancer can be genetically passed on.
“This is why early screening is very important, regardless of age or ethnicity, as one in four people will get cancer at some point in their life,” says Dr Jennifer Leong, clinical oncologist at Sunway Medical Centre. However, this should not be viewed as a death sentence as cancers can be cured and even preventable with early detection.
While the symptoms may vary according to the type of cancer, in general, unexplained and unplanned weight loss or appetite should alert one to a potential warning sign. Prolonged diarrhoea and constipation that is persistent after several weeks is also cause for concern.
Other symptoms to look out for include unusual bumps and lumps and changes in the breast, belly, pelvic or back pain, fatigue, night sweats or fever, changes in your pee, coughs that do not go away or changes in your skin.
In general, any pain that persists or doesn’t go away is a reason for concern, and it is important to see a doctor as soon as possible before it reaches a later stage.
Why is screening important?
The first step is to get yourself screened as a precautionary step to ensure the cancer, if any, can be caught before it starts to spread. Spending just half a day on an annual check-up could save years of quality life in return, and depending on the area of concern more specific screening processes could take place from mammograms, to pap tests and HPV testing, to colonoscopy among other things.
If these screening processes sound daunting, do not fear as there are often less invasive screening processes available. “Always have a discussion with your doctor first,” says Dr Jennifer, and recommends that an average population screening should start at 50 years old, at every two years. However, if there is a family history of cancer, it is best to start at 40 years old.
While the temptation to avoid a diagnosis could be strong, as a woman, it is important to remember that an early diagnosis early can help save their life which will have a tremendous impact on their family members. “Think of it as not only doing it for themselves and their own peace of mind but for their family,” adds Dr Jennifer. “When women think of it that way, they are more motivated to get themselves checked.”
How important is it to get a second diagnosis?
If you or someone you love is diagnosed with cancer, it is very likely to come as a shock—especially when there are no prior symptoms. This is normal and a common part of accepting the diagnosis, which will then typically involve patients wanting a second opinion for validation.
“Sometimes as a doctor, we too may find that the interpretation of the biopsy report is not too clear, and may ask for a second opinion ourselves,” says Dr Jennifer, adding that it is the doctor’s priority to hit the right diagnosis and the right treatment, as the prescribed treatment plan can affect the patient’s survival outcome.
“Patients might also want a second opinion on their treatment plan,” she adds. “Being an oncologist isn’t just about being clinical; It’s a lot about listening to a patient’s perspective.”
Regaining control over your body
Once a diagnosis is made, it can be frustrating or depressing to feel like you have lost control of your body and its functions ... but do not feel defeated. There are coping mechanisms for patients to have control over their bodies.
First of all, you should be proud to have taken the first step to taking control of your health. It takes a lot of courage and now that you know what you are dealing with, we can now chart a plan on your discussed path to recovery with your doctor that you are comfortable with whether it’s chemotherapy, radiation therapy, surgery, depending on the type of cancer.
While chemotherapy might sound daunting and is still the backbone to a lot of treatments, the key is to select the right patient, to inform them what to anticipate, and to give them the right medication. “The radiotherapy machine has also improved leaps and bounds,” says Dr Jennifer. “These days, the treatments are less detrimental compared to 20-50 years ago.”
Besides the clinical treatment, nutrition also plays such an important role. “This is something patients have control over,” says Dr Jennifer, adding that the right diet is crucial to one’s recovery. “A lot of times, patients diagnosed with cancer will limit their food and become very thin and malnourished, and that is not helping with their immunity.”
She recommends eating a well-balanced diet, getting enough rest, minimising stress as much as possible, and going for your follow-ups.
While the challenges faced by a new cancer patient may seem overwhelming, sometimes all that is needed is a bit of guidance to help with the transition. Luckily, Malaysia’s healthcare system is able to provide nurses through various services to support patients especially once they leave the hospital whether it’s to help change a colostomy bag or a feeding tube, so you don’t have to go through it alone.
It is a tough journey for any cancer patient, but it’s crucial to have support especially once they leave the hospital.
Family members are encouraged to come with the patient for their follow-ups with the doctor, so they understand the rationale of the treatment that is being given. Dr Jennifer adds that, “A lot of times, patients are afraid of chemotherapy and such, so with the family coming and listening to the doctor’s discussion ... they then make more sense of the treatment and can offer better emotional and physical support to the patient.”
Physical support can be shown in the small things, like preparing meals that will help the patient to focus on recovery and the treatment.
However, equally as important is not to make cancer the focus of every interaction with the patient. While family members may have the best intentions at heart, eliminate the need to flood the patient with all kinds of myths and unstudied news regarding cancer as this could only cause more stress and depression within patients.
Instead, focus on taking their mind off the cancer and making life as stress-free as possible during these moments, which doesn’t have to be treated as a death sentence. Always remember that, “If you get diagnosed at an early stage, the survival outcome for any cancer improves tremendously,” says Dr Jennifer. “You can go on to live a beautiful long life.”
The Right Support
When it comes to fighting cancer, think of it as a 2-part journey; the first being clinical from diagnosis to treatment, and secondly, the psychosocial element which focuses on emotional wellbeing. “A lot of patients feel like they are a burden, but truthfully family members just do not know how to broach the subject,” explains Dr Jennifer. “Ask for help, and get someone you can trust to be a listening ear.”
If that is not an option, Dr Jennifer also suggests patients to join survival networks as it helps talking to other survivors who can relate to what they are going through and provide them with the moral support they need, especially when they feel like giving up. However, if additional support is needed, Dr Jennifer recommends getting a referral to a psychologist.
“As women, we always put ourselves as the least of the priority; we care about our children, family and work; but it’s important to schedule a pap-smear screening, mammogram, ultrasounds, and a yearly check up in your calendar, and show up when the time comes.” says Dr. Jennifer.