Dubai: Greater awareness about breast cancer has inspired several women - and men - to gather courage for self-examination and go in for regular screenings. According to the statistics, breast cancer continues to be among the top three female cancers in the UAE. Oncologists have constantly maintained that early detection is the key to managing breast cancer. As the breast cancer month makes brisk progress, many brave women have come forward to share their stories so that other women too can do the needful and not delay their screenings.
‘God is our healer’
Michelle A, a 45-year old legal and compliance executive in Dubai, had felt a lump in her left breast in the midst of the pandemic.
“I was aware of the possibility of breast cancer as my younger sister had died of it three years ago. In the beginning, I was scared and in denial,” said Michelle, who remembers the fear that paralysed her in getting her breast lump checked, causing the tumour to progress.
Michelle added: “A couple of months were lost in this until I felt God told me to take responsibility and have courage over the matter. I was diagnosed with Grade 2 locally advanced breast cancer in June. My tumour had grown to approximately 10cm. I am thankful to Dr Medhat Faris, medical oncologist at the International Modern Hospital, for inspiring confidence and providing me emotional support to go ahead with the treatment.”
Dr Faris told Gulf News: “The main aspect in the treatment of breast cancer treatment is winning the trust and extending emotional support to the patient and I patiently did that.”
His protocol for the patient included six cycles of chemotherapy that shrunk her tumour to 3cm and after her PET scan results future course of action will be taken.
Take away: Michelle’s message to other women is: “Give up on fear, denial and take responsibility for yourself. After facing a relapse, I came to terms with my condition as nothing worse could have happened.”
Relapse after five years
Dimple Shamim, a 39-year old Indian expat in the UAE and mother of a teenage daughter, thought she had won the battle over breast cancer, as she was close to completing five years of being cancer-free — when she had a relapse.
Recalling her ordeal, Shamim said: “I was first diagnosed with breast cancer at the age of 34. I took the decision to go in for an early screening when I felt a lump and was diagnosed in stage one. Although I was devastated because my daughter was a toddler, I feel I was blessed as I was lucky to be diagnosed at an early stage.”
Shamim underwent the usual treatment of chemotherapy, lumpectomy and radiation.
For nearly four and half years with regular screenings Shamim enjoyed a cancer-free status but her worst fears were confirmed when she went in to get a painful lump checked again in August 2020.
“Owing to the pandemic, I was tardy in visiting the hospital. However, there was swelling, reddishness and infection at the site. This time, owing to the delay it had reached the skin surface,” said Shamim, who was now mentally stronger to face her ordeal.
A BRCA test eliminated the possibility of her having an inherited cancer gene; that was a small consolation.
Dr Nida Shapoo, medical oncologist at Zulekha Hospital, who is treating Shamim, said: “Patients who already suffered breast cancer once are at the highest risk of breast cancer. Although Shamim was BRCA negative, her tumour was diagnosed as Triple X, which is very aggressive in its growth.”
Dr Shapoo added: “Fortunately for her, the relapse was localised. We did not take a chance and she underwent a mastectomy followed by special treatment protocol tailored to her needs, which also included immunotherapy.”
Take Away: Shamim’s message to other women: “Be vigilant and strong. Breast cancer can be beaten by your courage and positive attitude.”
‘Don’t take your health for granted’
Mona Mohammad Ahmed Abdel-Aty, a 46 year old Sudanese expat in Abu Dhabi was surprised with her diagnosis when she felt a small lump in her breast in August 2019.
“I have no history of cancer in my family. I lead a healthy life; I do not drink or smoke so I did not think the lump was cancerous. That was my first mistake,” said Abdel-Aty, who delayed going in for screening until the end of January 2020.
“The diagnosis came in by February 2020 and by then it was Stage 2 breast cancer. Had I gone in earlier, we could have caught the cancer earlier,” said Abdel-Aty who started her chemotherapy cycles in March 2020 and later underwent mastectomy and radiation.
Dr Toufic Ata, Consultant Laparoscopic, bariatric and general surgeon at Burjeel Hospital, Abu Dhabi, carried out the surgery in consultation with a multidisciplinary team that consisted of plastic surgeons and oncologists.
Dr Ata said: “The patient was diagnosed with Stage 2 multifocal breast cancer of the right breast in July 2019 and underwent chemotherapy, radiotherapy as well as a surgery to remove a benign tumour from near her liver, and removal of uterus, ovaries and Fallopian tubes as part of the treatment.”
He added: “In March 2020, she underwent radical mastectomy in March 2020 after her treatment cycles were completed. According to the American Cancer Society, the five-year relative survival rate for a patient like Mona is close to 90 per cent and 10-year survival rate is 84 per cent.”
Take away: Abde-Aty said: “I want to advise all women never to delay their medical check-up, be regular in your periodic screenings.”
‘My denial cost me my health’
Joan Bautiste, 43, a Filipina expat and mother-of-two first felt a lump in November 2019, which was diagnosed as benign.
“My oncologist advised me to go in for a more thorough screening, however, there were some issues with my health insurance and I put off the detailed examination. Later, in January 2020, when the lump got bigger, I finally went in for detailed biopsy and my cancer had progressed to Stage 2 by then. I was stunned.”
She added: “The only person in my family who died of colon cancer was my grandfather when I was a child. For generations there was no cancer in my family and then to get such a diagnosis was shocking. I had two little kids and I could not stop crying.”
In the months following her diagnosis, Bautiste was brave enough to face her fears and undergo the whole treatment protocol. She has emerged stronger.
A team of oncologists at Burjeel Hospital, Sharjah, comprising of Dr Humaid Al Shamsi, consultant medical oncologist; Dr Mehdi Afrit, oncologist and surgeon; and Dr Sadiq AlRawi, treated Bautiste by tailoring her treatment protocols to her needs that included chemotherapy, lumpectomy, immunotherapy and radiotherapy.
Take away: Bautiste said: “Prioritise on your health, especially in these times. Remember that one can die not just of COVID-19 but other reasons too; and adjust to the new normal.”
A victory for telemedicine
Okebugwa Osinachi, a young 26-year-old pharmacist, working in a local hospital in Nigeria, availed of telemedicine facilities in UAE to connece when she was diagnosed with breast cancer, after self-examination raised her suspicion in 2020.
Osinachi took to online search and found Dr Ahmed Awad Salim El Hakim, consultant, General Surgery, NMC Royal Hospital, Sharjah.
“I am only 26, had no history of cancer in my family, have always very health conscious and being a pharmacist, was aware and educated about breast cancer,” said Osinachi, whose worst fears were confirmed.
Dr El Hakim collaborated online with the doctors and caregivers in Nigeria to reach a conclusive diagnosis and plan her treatment protocol. Osinachi completed her initial treatment in Nigeria and came to the UAE for her radical mastectomy at NMC Royal Hospital, Sharjah in January.
She returned to Nigeria in April. She has been undergoing radiotherapy sessions and plans to return to the UAE for breast reconstruction later.
Dr El-Hakeem said: “The patient’s left breast had a lump of a little over 6cm and she also had axillary lymph nodes, fixed and hard. The investigations done in Nigeria, under my guidance, included breast ultrasound scan and histopathology, which revealed the cancer while the CT chest showed significant spread into her left axillary -armpit. We took our decisions in the best possible manner to allow for treatment to start immediately in Nigeria before the patient came here.”
Take away: Osinachi said: “Age is no bar for breast cancer to strike. Every woman must do self- examination every month and seek medical advice on the slightest suspicion.”
Male breast cancer
In exceptional circumstances, men can also suffer from breast cancer. Indian expat Mohammad Aslam Khan, 60, was diagnosed with breast cancer in September 2020. The diagnosis came as a shock to Khan, a senior manager in an organisation, whose elder sister had succumbed to breast cancer 19 years ago.
“I was driving to office and I felt a pain and pinning on the upper part of my right breast. I felt a lump and decided to get this checked. I went in for the check-up, underwent ultrasound and later needle biopsy that confirmed my worst fears,” he said.
“I had no manifestation of any illness or any weakness and was shocked as I thought breast cancer happened to women only,” added Khan who was diagnosed with Stage 2 breast cancer, and underwent radical mastectomy and chemotherapy.
Dr Sivaprakash Rathanaswamy, Oncology (Consultant), Aster Hospital, Qusais, who treated Khan, said: “Male breast cancer is a rare disease but still it affects men of elderly age group usually. For every 100 female breast cancer diagnosis, one male breast cancer is diagnosed.”
Dr Rathnaswamy added: “Most of the male breast cancer patients get diagnosed at locally advanced stages because of lack of awareness and self-negligence. Usually male breast cancers are hormone receptor positive types, have good prognosis and better cure rates when diagnosed earlier.
“Treatment is usually same as female breast cancers except the need for radical surgery, in view of early involvement of skin and muscles because of the lack of adequate breast glandular tissues. Khan is doing well and has high chance of complete turnaround will be able to have good quality of life.”
Takeaway: Khan said: “I am a living example of the fact that breast cancer is not gender specific. Our lifestyles these days, is triggering cancers. Take charge of your health and do not delay screening.”
In the UAE, pharmacological firm AstraZeneca spearheaded a ‘New Normal, Same Cancer’ campaign in partnership with Emirates Oncology Society and Friends of Cancer Patients, and supported by Aster and Medcare Hospitals and Clinics, to encourage people to get screened, contact their doctors, and not wait for the pandemic to end.