I would like to remind all women that breast cancer is the most common cancer in Malaysia, corresponding to as much as one-third of all cancers in women in the country. Cancer kills people but the chance of surviving breast cancer, when detected early, is excellent.
Unfortunately, along with other cancers, its care has been most affected since the beginning of the Covid-19 pandemic, which has shaken every aspect of healthcare, including cancer.
In the first three months since we began the recovery movement control order (MCO) phase, I witnessed an increased number of new breast cancer cases at hospitals. Worse, I also observed
more advanced presentations of breast tumours owing to late diagnosis or treatment delays of three to four months since the lockdown began in March.
No doubt the patients themselves were afraid to set foot in the hospital from fear of exposure to the Covid-19 but across the country, multiple changes in the provision of cancer care have also contributed to this negative impact.
Both public and private hospitals took the recommended step of suspending screening mammograms. There were disrupted diagnoses from modifications of referral schedules or even omissions for some patients, and halting biopsy procedures or elective surgery. A few clinical trials that could have allowed many of my cancer patients to receive innovative therapies either had delayed initiation or were suspended.
Health authorities had risk-classified diseases or conditions according to their urgency amidst the Covid-19 fear. Some situations are rather grey, though. Breast cancer, which commonly affects middle- aged working women in our country, sticks out within the grey zone of medical risk.
The current rapid resurgence of new Covid-19 cases is very worrying. Women who are symptomatic may not get themselves tested, leading to presenting much later, with more advanced disease, just like three to four months ago. A painless breast lump may not appear as an emergency but when left for too long, even for three months, has the potential to cause permanent disability or become life threatening.
Advanced breast cancer stages are more difficult to treat and have poorer survival outcomes. It may not be so apparent now, as the effect of delayed presentation in patients with cancer is not immediate, but premature death might occur up to five or 10 years later and will differ according to each stage of tumour subtype.
I would like to urge all Malaysian women to pay attention to your symptoms, take care of your body and not to fear coming forward to seek medical attention when necessary. Fairness is subjective but we can choose to be smart.
While it is essential to abide by public health messages about this dreadful virus, it is particularly important to weigh carefully and realistically our personal risk of suffering from a severe illness from Covid-19 versus the risks of not seeking urgent care for cancer. Neglecting your breast health could have serious consequences and can even be deadly.
DR MASTURA MD YUSOF
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