What is the lymphatic system?

lt is a network of lymph nodes and lymph vessels that collect and carry watery, clear lymph fluid throughout the body including the heart, much like the veins.

What is Lymphoedema of the arm?

Lymphoedema is the build-up of lymph fluid in a part of your body.

During surgery or radiotherapy for breast cancer, lymph nodes and lymph vessels are removed or damaged.

This affects the flow of lymph fluid from that side of the body, causing that part of the body to swell.

What should I look for?

·               Swelling in breast, arm or hand which initially reduces by resting or braising arm.

·               Part of your body feels full or heavy.

·               Skin colour changes.

·               Skin feels tight or hard.

·               New aching, tingling or discomfort in the area.

·               Less movement or flexibility in joints.

·               Trouble fitting into blouse arms or buttoning blouse or chudidhar.

·               Bra does not fit the same.

·               Ring, watch or bangle does not fit well.

Air Travel

If you are planning travel by air, make sure to:

–              Move around.

–              Exercise at-risk body part.

–              Maintain good hydration.

–              Wear prophylactic compression stockings

When do I call a doctor?

·               New rashes or skin breaks that don’t heal.

·               Feeling of tightness in arm.

·               Rings or shoes are tighter.

·               Weakness of arm.

·               Pain in arm.

·               Sudden increase in size of arm with pain.

Treatment

·               Manual lymphatic drainage.

·               Compression bandaging/stockings.

·               Arm exercise.

·               Maintain healthy body weight.

·               Total body care.

Bandaging

·               How long is it to be applied?

12—hours in a day. Can be taken off prior to sleeping.

·               Can I do regular work?

                Yes, while making sure all precautions mentioned are taken.

·               Who should do the dressing every day?

                The same caregiver every day.

Next Article:- Breast cancer awareness in October

The month of October has marked the world over as Breast Cancer Awareness month, to raise awareness about breast cancer early detection and treatment.

Breast cancer is the most prevalent cancer in Indian women.  1 in every 21 women in India will develop breast cancer in their lifetime. The rate of breast cancer in India is still lower than in the west where the risk is 1 in 8 women. 

Globally, the mortality due to breast cancer has reduced. However in India, it still remains high.

It is said that for every 2 women diagnosed with breast cancer in India, one woman succumbs to it. This is predominantly because breast cancer is diagnosed late, in the advanced stages.

Any woman may get breast cancer. The risk increases if your periods have started early or stopped very late.

Women who smoke, eat high fat diet, drink alcohol are more at risk. Overweight women are at a higher risk of developing breast cancer and many other cancers. Having had no children and late pregnancy also increase risk for breast cancer

Breast cancers detected early have very high cure rates of greater than 95%. However in India, only 60 of 100 women with breast cancer will survive beyond 5 years.

This is largely due delay in diagnosis. The key tool in early detection is self-breast awareness. Most women usually have noticed a change in the breast, however put it off due the challenges of work, office, and children.

It is not a disease of the old, the disturbing trend is, about 48% of breast cancer occurs in women younger than 50 years old in India.

The next recurring misconception is that “nobody has cancer in my family, so how I can a have cancer”.

How can I detect cancer early?

Most often breast cancer presents as a painless lump/mass or thickening in the breast.

Look out for

• A new lump or thickening in your breast or armpit

• A change in the size, shape or feel of your breast

• Skin changes in the breast such as puckering, dimpling, a rash or redness of the skin

• Fluid leaking from the nipple in a woman who is not pregnant or breast feeding

• Changes in the position of the nipple

Self Breast awareness/Self Breast examination is an important tool for early detection. You should know what your breast looks and feels like.

Every month, usually after your period or if periods have stopped, on a fixed day look and feel for any of the above changes in your breast.

Any change in the breast has be evaluated by a clinical examination, mammogram, and biopsy to rule out cancer.

After 40years of age it is recommended to get an annual mammogram or at least once in 2 years. Mammograms may detect cancers very early, even before you can feel a lump.

The things you can do to help lower your breast cancer risk include:

• Keep a healthy weight and exercise regularly.
• Incorporate loads of fresh and colourful vegetables and fruit in your diet.
• Do not drink alcohol, or limit the amount of alcohol you drink.
• If you are taking hormone replacement therapy or birth control pills, ask your doctor about the risks.
• Breastfeed your children, if possible, for more than 2 years cumulatively.

The easiest, least expensive way to reduce your risk for cancer is just by eating a healthy diet.

Be aware, bring on your brave face every day! Act now.

For More:- Breast Feeding and Cancer

Breast feeding enriches the bond between mother and child. Though breast feeding is a personal choice it gives a healthy start to the baby.

Exclusive breast feeding for the first 6 months of life provides all the nutrition required for the healthy development of the baby.

Beyond 6 months breast milk should be supplemented with solids for adequate nutrition, however breast feeding should continue.

Research shows that breast feeding decreases the risk for both pre and post-menopausal breast cancer. Breast feeding delays menstruation and hence exposure to estrogen which is responsible for breast cancer.

Shedding of breast cells during pregnancy and lactation removes cell with DNA damage, decreasing the risk of cancer.

Lactation also may alter the genes in breast cells making them more resistant to cancerous change. Breast feeding for 6 months decreases the risk of breast cancer by 2%. Lactation beyond 6 months provides additional protection.

For every cumulative period of 12 months of breast feeding (one or multiple children) the risk of breast cancer reduces by 4.3%.

Breast feeding also deceases the risk for ovarian cancer by preventing ovulation and also reduces type 2 diabetes mellitus.

Children breast fed for 6 months or longer have a lower risk for leukaemia, infection, dental problems, and obesity in later life.

Breast feeding strengthens the baby’s immune system as antibodies pass from mother to child decreasing respiratory, gastrointestinal and ear infections. It also reduces allergies in children.

For More:-

Cultural barriers in Cancer

In many patients with breast cancer, the breast can be preserved.

Only in advanced cases, complete removal of the breast may be necessary.

However these patients may chose to undergo an immediate/delayed reconstruction of the breast.

Cancer effects everyone differently.

I have seen patients,some so positive yet others so negative.

In a country where we still have care givers who do not want the patient to know the diagnosis and hide the truth from them, I wonder how do these patients cope.

Who do they turn to?

Who is protecting whom?

Everyone person is entailed to the truth. I try to be truthful (as I am allowed to be) with my patients.

A young educated cancer patient working with a MNC was in tears post surgery.

On further inquiry I realized she was scared to go back to work.

She was actually worried if her colleagues/friends would treat her right, would they shun her.

If we have barriers like such in the shining India, how do patients in rural areas manage?

We have to remove the stigma associated with cancer.

For more topic:- Lingering questions and thoughts on the mind of a Breast Cancer Survivour

Screening mammogram: is it necessary

A lot of questions and thought remain on the mind, long after the last chemo/radiation.

Life should have gone back to normal, no more fatigue/nausea, a head full of hair.

But the truth is survivors still face a host of problems.

To name a few:

• How to prevent Breast Cancer recurrence
• Management of  relationship with spouse/family/friends
• Whats the ideal diet… what can i eat
• Can I exercise… when and how much
• Why do i feel so fatigued…
• Regular sex life… is that ok? Vaginal dryness and a lowered sex drive are common side effects
• “Chemobrain” – mental changes like inability to focus and memory deficits
• To deal with accumulated effects of other treatments; neuropathy

It is important to  “maintain a healthy weight, not smoke, eat a balanced diet, limit alcohol, and have the recommended cancer screening tests”.

DIET

• Many vegetables, fruits, nuts, and other foods contain antioxidants. Foods with antioxidants include broccoli, liver, and mangoes. Antioxidants protect your cells from damage.
• Beta-carotene gives carrots, apricots, yams, and other vegetables and fruits their orange color. Some studies that suggest that a diet high in beta-carotene-rich foods may lower the risk of dying from breast cancer.
• Eat low-fat protein, such as roasted chicken and baked fish.
• Avoid steak, duck, sausages, or other high-fat meats and processed meats linked to cancer which include bacon, bologna, hot dogs, ham, and smoked meats.
• Eat five servings of a variety of vegetables and fruits each day
• Eat whole-grain foods like whole-grain bread and brown rice, rather than white bread and white rice.
• Cut back on alcohol. Limit yourself to one to two drinks a day.
• Consider loosing weight by increasing activity and cutting calories, if you are overweight being overweight after completing treatment was associated with shorter survival times and higher risk of cancer recurrence..

             EXERCISE

• It is not known if physical activity can prevent cancer recurrence or slow the progression of disease. But studies have shown that regular physical activity can reduce anxiety and depression, improve mood, boost self-esteem, and reduce symptoms of fatigue, nausea, pain, and diarrhea.

Next:- Lemonaid Signs of Breast Cancer

• Not every lump in the breast is cancer.

Fact: Only a small percentage of breast lumps are diagnosed to be cancer.

• Only if you have a family history will you develop breast cancer.

Fact: Genetic factors are estimated to cause only 5% to 10% of breast cancer cases.

• Men do not get breast cancer.

Fact: 1% of breast cancer occurs in men.

• Breast cancer is contagious.

Fact: No its definitely not.

• Mammogram can prevent cancer.

Fact: Mammogram will help in early detection of cancer.

• Wearing a bra (tight/underwired) increases the risk of cancer.

Fact: Wearing a bra and type of bra does not effect cancer rate.

• Removing the entire breast (mastectomy) is better than just removing the cancer (lumpectomy) and having radiation treatment, in terms of survival.

Fact: Discuss with your doctor the various options available to you.

• Presence BRCA1and BRCA2 gene mutation does not mean you have to develop cancer.

Fact: The chances of developing cancer is much higher in the presence of this mutation but not 100%. Talk to your doctor about risk reducing measures.

• Antiperspirants and deodorants cause breast cancer.

Fact: Researchers do not have any conclusive evidence for this.

• Having an breast implant increases the risk of cancer. 

Fact: Implants do not increase the risk of cancer, however more mammogram views may be required to examine the breast.

Next Article:- Time to lose weight: Obesity a modifiable risk factor in Breast Cancer