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Breast cancer is treatable, not a death sentence – specialists

Breast cancer is treatable and should not be considered a death sentence.

Medical oncologists from the Southern Philippines Medical Center (SPMC) raised the need to emphasize this to give hope to cancer patients and survivors.

“Dili pasabot nga magca-cancer ka wala nay pag-asa. (Having cancer does not mean there is no hope.) There is always hope,” said Dr. Jimmy John Ivan Singanon, SPMC Medical Oncology Senior Fellow, during the One Davao: A Virtual Presser episode of Philippine Information Agency XI on October 25.

“Cancer at an early stage, especially breast cancer, which is usa sa pinaka-treatable na mga cancers, if we detect it early on, 98% to 100% ang survival na ma-expect nato (which is one of the most treatable cancers, if we detect it early on, we can expect 98% to 100% survival rate from patients),” Dr. Singanon added.

Dr. Jimmy John Ivan Singanon, SPMC Medical Oncology Senior Fellow, emphasizes that breast cancer is treatable, especially if detected early on, and patients should not lose hope.

Meanwhile, Dr. Wenelito Clapano, SPMC Surgical Oncology Senior Consultant, emphasized the importance of early detection, regular consultation, and consistent treatment to combat breast cancer.

“Unfortunately, it is the most common cancer nga atong makita, but fortunately this is treatable, especially kung ma-note or ma-detect nato early (Unfortunately, it is the most common cancer that we see, but fortunately this is treatable, especially if we detect it early),” Dr. Clapano explained.

Dr. Singanon reported that the Philippines ranks globally in terms of the highest number of breast cancer deaths.

He added that breast cancer ranks third in the number of cancer cases in the country, where approximately one in every 13 Filipino women is likely to develop breast cancer.

In SPMC, which covers the entire Mindanao, Dr. Singanon reported that based on data from last year, around 1,000 to 2,000 breast cancer cases were recorded annually.

Moreover, Dr. Clapano disclosed that about 70% of the causes of breast cancer are still unknown; environmental exposures such as stress and diet can be associated with breast cancer but do not have direct relationships; and the remaining 20% to 30% are genetic.

The most common symptom of breast cancer is amass, which manifests either in the breast or underarm area and is usually detected physically by the patients themselves or through the use of imaging technologies such as a mammogram and ultrasound.

Dr. Singanon added that other potential symptoms of breast cancer include a change in the skin color of the breast or nipple area, pulling in or inversion of the nipple, any color or blood discharges from the nipple, and changes in the size or shape of the breast.

On the other hand, Dr. Clapano revealed that breast cancer is not only limited to women, as there are cases recorded among men diagnosed with breast cancer.

“Breast cancer in men medyo rare sya na type, but at the same time, these are the type na aggressive type of breast cancer (Breast cancer in men is a rare type, but these are the aggressive type of breast cancer),” he explained.

Dr. Wenelito Clapano, SPMC Surgical Oncology Senior Consultant, reiterates that all women and men should have regular medical consultations, especially those belonging to high-risk population or with genetic predisposition to combat breast cancer.

He added, “Ang ilahang sintomas is just the same – naay bukol, naay gasgas ang skin, naay lusay sa kilikili. At the same time, the same lang mna pod ang treatment sa woman with breast cancer (Their symptoms are just the same – breast mast, scratch on the skin,  a lump in the armpit. The treatments for breast cancer in and women are the same).”

Dr. Singanon reported that there have been two cases of men diagnosed with breast cancer in SPMC.

Early detection to prevent breast cancer progression

Dr. Clapano stressed that breast cancer cannot be prevented, especially for those who belong to high-risk populations.

“When you say prevention, we cannot prevent a tumor from occurring. Mahitabo gyud na siya nga mahitabo (that is bound to happen); the key is that we can detect it early,” he said.

In observance of Breast Cancer Awareness Month, public hospitals in Davao region, such as the Davao Regional Medical Center (DRMC) in Tagum City and SPMC, conduct medical consultations for all residents in the region concerning breast cancer. (Photo courtesy of DRMC)

Dr. Clapano explained that those who are considered ‘high risk’ are those with immediate families or near relatives diagnosed with breast cancer.

“If you have an aunt or a mother or a relative na near-relative nga naay breast cancer dakong possibilidad nga ikaw pod magkaroon (breast cancer) ang tawag nato ana high risk (If you have an aunt or your mother or a relative or near-relative who has breast cancer, there is a big possibility that you too will develop breast cancer; we call that high risk),” Dr. Clapano said.

“So if you belong to a high-risk group of people, in that case, para ma-detect nato early, we do the (screening) regardless 

kung naay complain (symptoms) o wala kailangan magpa-screen, magpa-laboratory (If a patient belongs to a high-risk group of people, so that we can detect it early, we do the screening regardless if there are symptoms or not, the patient needs to get screened and do laboratory tests),” he explained.

Dr. Clapano said that part of their advocacy is urging all women, regardless of whether they are high-risk or not, to consistently have regular medical consultations.

“Gina-encourage nato nga with symptoms or walay symptom magpaconsult ang usa ka babae, especially ang babae because as long as you are a woman, you have a breast, you always have the risk of having breast cancer (We encourage all women, with or without symptoms, to consult, especially because as long as you are a woman, you have a breast, you always have the risk of having breast cancer),” Dr. Clapano said.

“You can start sa inyong barangay healthcare unit; you can go to barangay clinics; you can go to, especially ang SPMC, where naa tay cancer center,”he added.

Breast cancer detection, diagnosis, and treatment process

Diagnosing breast cancer begins with breast mass detection. Dr. Singanon said that there are two types of examinations that a patient undergoes: physical and clinical.

Once a breast mass is detected, imaging such as a mammogram and ultrasound will be performed. This process determines whether a patient needs to undergo a biopsy or not.

A biopsy, according to Dr. Singanon, further determines the presence of cancer cells in the breast.

Aside from medical consultation, breast cancer screenings are also conducted in celebration of Breast Cancer Awareness Month. (Photo courtesy of DRMC)

He disclosed that the majority of the breast masses they detected were not malignant; only 20%, or two out of 10 breast masses, were malignant.

Dr. Clapano also added that detection nowadays is made easier through imaging technologies, which can detect a very small tumor as small as two millimeters.

Once a patient is diagnosed with breast cancer, Dr. Singanon said that the attending doctor will then stage the breast cancer to determine its subtype, whether it’s an aggressive one that can spread to other parts of the body and the possible treatment.

After identifying the nature of the cancer, treatment will follow.

Dr. Singanon said that there are only three approved treatments for breast cancer:surgery, chemotherapy, which includes targeted treatments and anti-hormonal agents, and radiation therapy.

He added that the treatment is multidisciplinary, which involves a breast multidisciplinary team.

Part of the activities in the celebration of Breast Cancer Awareness Month is a series of seminars and symposiums to debunk misconceptions about breast cancer. (Photo courtesy of DRMC)

“Kinahanglan dili lang isa ka doctor ang makakita sa iya kundi a whole team of doctors... The breast multidisciplinary team will decide kung unsay best treatment for the patient depending on the stage and the subtype. (It should not be just one doctor who oversees a patient but a whole team of doctors. The breast multidisciplinary team will decide what is the best treatment for the patient, depending on the stage and the subtype),” he explained.

Dr. Clapano added that in SPMC, they are practicing a holistic approach to treatment. Aside from the surgeons and 

medical oncologists, they have ancillary specialists like pain specialists or palliative care specialists who handle the symptoms, and nutritionists who take care of the nutrition of the patients while undergoing treatment.

Government programs and assistance for breast cancer patients

Since treatment for breast cancer is costly, Dr. Singanon said that there are programs offered in SPMC that all patients may avail of, such as the Z package under PhilHealth and the Cancer and Supportive Palliative Medications Access Program (CSPMAP) of the Department of Health.

Dr. Singanon said that the Z package is usually for patients with early-stage breast cancer andcovers free surgery, free adjuvant or additional chemotherapy, and additional hormone therapy.

While CSPMAP, which was recently launched at the SPMC-Adult Cancer Institute, offers free access to all cancer medications as long as the treatment is available in the hospital.

“Pwede kita makahatag og treatment sa atong mga pasyente with the CSMAP for as long as the medications are available. So free na siya free ang treatment for chemotherapy, antihormonal treatment, targeted treatment... pag enrolled sila sa program (We can provide treatment to our patients with the CSMAP for as long as the medications are available. So the treatments for chemotherapy, anti-hormonal treatment, targeted treatment... are free only if the patients are enrolled in the program),” Dr. Singanon explained.

He said that for cancer patients to avail of the program, they have to have medical consultations atSMPC or any CSPMAP treatment sites. In the Davao region, only the SPMC and the Davao Regional Medical Center in Tagum City are currently accredited as CSPMAP treatment sites.

Dr. Clapano said that with the Adult Cancer Institute in SPMC, all cancer treatments are available in the hospital.

Also, he said that cancer patients can access other assistance and programs from the Davao City Mayor’s office, Malasakit Center, Department of Social Welfare and Development (DSWD), and Philippine Charity Sweepstakes Office (PSCO), among others. (ASO/PIA Davao/Thumbnail photo from DOH)

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Antonino Oblianda

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