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LET’S TALK About Breasts By Dionne Grant
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HE BLACK community has been reared on a culture of privacy and keeping issues – including health worries – close to our chests. For many years, the issue of cancer, be it breast or prostate, which affects one in four black men, has been taboo. But rigorous publicity awareness campaigns and fundraising drives have brought it to the fore and encouraged more and more people affected by these diseases to shun anonymity and come forward to share their stories in hope of helping others. UNCLEAR Research shows that one in eight women will develop breast cancer in their lifetime [source: Breast Cancer Care]. However, black women diagnosed with breast cancer in the UK have poorer relative survival rates than their white counterparts. “The reasons for this are unclear, but may be due to delays in diagnosis through late presentation with symptoms
or lower uptake of screening opportunities,” leading charity Breast Cancer Care noted. “The All Breast Cancer Report 2009 also showed that patients known to be black were diagnosed with breast cancers
tingham Prognosis Index (NPI) scores.” GREATER RISK In 2013, The Telegraph ran a story titled “Black women at greater breast cancer risk.”
In the research, conducted by the University of Southampton and involving 2,915 women who were aged 40 or younger when diagnosed with breast cancer, found that in general, young black women
Research shows that black women diagnosed with breast cancer in the UK have poorer relative survival rates than their white counterparts with a worse prognosis than those in other ethnic groups; their breast tumours were significantly larger, of higher grade, more likely to be node positive and had worse Not-
The warning followed a UK study that found young black women (under 41 years of age) had worse breast cancer outcomes compared with young white women.
had poorer relapse-free survival compared with young white women. Even after the researchers adjusted their findings for factors such as body mass index,
tumour size and whether the cancer had spread to the lymph nodes, black ethnicity was still associated with poorer relapsefree survival compared with white ethnicity. In other words, breast cancer was more likely to reoccur in black women. There were no significant differences in overall survival or breast cancer reoccurrence between white and Asian women. The researchers speculated that there could be both genetic and social factors involved, citing, for example, that immigrant women may be less likely to register with a GP. BARRIERS “Language barriers could prevent recent immigrants from accessing health care, [the researchers] suggested, while some research suggests black women are less likely to selfcheck for lumps than other ethnic groups,” The Telegraph reported. Conducted in 2013, the study also confirmed previous research that showed that black women tend to have more aggressive tumours. In addition to the University of Southampton, the study was carried out by researchers from University Hospital Southamp-
PAGES 27-30
PHOTO CREDIT: Estée Lauder (breast cancer awareness campaign)
MARCH 26 - APRIL 1, 2015
ton Foundation Trust, the Centre for Statistics in Medicine, and Barts and The London School of Medicine and Dentistry. AWARENESS Dr Julie Sharp, head of health information at Cancer Research UK, which funded the study, said: “It’s worrying that ethnic background may be a factor influencing a woman’s chance of surviving breast cancer. “We know that some ethnic populations carry higher genetic risks of getting certain types of breast cancer, but if this difference is down to symptom awareness or access to health care, that is particularly concerning.” Dr Ellen Copson, one of the authors of the study, said further research is needed to “pin down the exact cause or causes, so we can tackle this issue”. Ethnicity aside, female breast cancer incidence rates in Great Britain have increased by 72 per cent since the mid1970s. In the UK in 2011, around 49,900 women were diagnosed with breast cancer, which totals more than 130 women CONTINUED ON PAGE 28
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Let’s talk about breasts of the body. There are a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
CONTINUED FROM PAGE 27 every day. In the same year, 350 men in the UK were also diagnosed with breast cancer. The cancer, though much less common than breast cancer in women, with only around one new case diagnosed for every 100,000 men in the UK each year, develops in the small amount of breast tissue men have behind their nipples. The most common symptom is a hard, painless lump in one of the breasts. The following year, around 11,600 women died from breast cancer in the UK, around 32 every day. There were 75 men who also succumbed to the disease. BACKGROUND The breasts are made up of fat, connective tissue and thousands of tiny mammary glands called lobules, which produce milk. When a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts, which allow her to breastfeed. The body is made up of billions of tiny cells, which usually grow and multiply in an orderly way. New cells are only produced when and
where they’re needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably. The causes of breast cancer aren’t fully understood, making it difficult to say why one woman may develop breast cancer and another may not. However, there are risk factors that are known to affect your likelihood of developing breast cancer. Some of these you can’t do anything about, such as age, a family history of breast cancer, previous diagnosis of
breast cancer, a previous benign breast lump, breast density, exposure to the female hormone, oestrogen, obesity and alcohol, but small changes to your diet may have positive effects on your health (see page 30). There are several different types of breast cancer, which can develop in different parts of the breast. It is often divided into non-invasive and invasive types. If treated early enough, breast cancer can be prevented from spreading to other parts
Most breast lumps aren’t cancerous, but it’s always best to have them checked by your doctor. You should also see your GP if you notice any of the following: • A change in the size or shape of one or both breasts • Discharge from either of your nipples (which may be streaked with blood) • A lump or swelling in either of your armpits • Dimpling on the skin of your breasts • A rash on or around your nipple • A change in the appearance of your nipple, such as becoming sunken into your breast. Breast pain isn’t usually a symptom of breast cancer. A full list of factors can be found on the NHS website, but you can make one small change to your daily routine in the meantime. Get to know your breasts intimately, so you are better equipped to spot changes.
BREAST CANCER SUPPORT u
Breast Cancer Care T: 0207 960 3400 www. Breastcancercare.org.uk
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Macmillan Cancer Support T: 0808 808 00 00 www.macmillan.org.uk
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The Haven – Breast cancer support services T: 0207 384 0099 (London) T: 01432 361 061 (Hereford) T: 0113 284 7829 (Leeds) www.the haven.org.uk
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Cancer Centre London T: 0208 247 3351 www.cancercentrelondon.co.uk
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Breast Cancer UK T: 0808 800 6000 www.breastcanceruk.org.uk
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Look Good Feel Better (LGFB) T: 01372 747 500 www.lookgoodfeelbetter.co.uk
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The London Breast Clinic T: 0207 563 1234 www.thelondonbreastclinic.com
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Bupa Cromwell Hospital – Cancer centre T: 0207 460 5556 www.cromwellhospital.com
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HCA Cancer care T: 0800 29 444 29 www.hcacancercare.co.uk
How to check yourself The five steps of a Breast Self-Exam
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reast self-exam (BSE), or regularly examining your breasts on your own, can be an important way to find a breast cancer early, 1 when it’s more likely to be treated successfully. Not every cancer can be found this way, but it is a critical step you can and should take for yourself. About 20 per cent of the time, breast cancers are found by physical examination rather than by mammography [Breastcancer.org]
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STEP 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here’s what you should look for: • Breasts that are their usual size, shape, and colour • Breasts that are evenly shaped without visible distortion or swelling If you see any of the following changes, bring them to your doctor’s attention: • Dimpling, puckering, or bulging of the skin • A nipple that has changed
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position or an inverted nipple (pushed inward instead of sticking out) • Redness, soreness, rash, or swelling STEP 2: Now, raise your arms and look for the same changes. STEP 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). STEP 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
5 Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you’ve reached the deep tissue, you should be able to feel down to your ribcage. STEP 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.
HEALTHM TTERS
ADVERTORIAL
You are not alone Breast Cancer Care launch support service for cancer survivors
GIVING BACK: Lorraine Marke
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BREAST cancer support charity is launching an interactive new service supporting women after they have finished breast cancer treatment. Breast Cancer Care, the only specialist breast cancer support charity working throughout the UK, has found that the emotional and physical side effects of a breast cancer diagnosis can continue long after people have finished their treatment and when coupled with a lack of specialist support locally, can leave people feeling isolated and abandoned. To help patients receive the tailored support they need, the charity is launching PROWESS, an acronym for Promoting Recovery, Wellbeing, Equality and Support in Survivorship. PROWESS offers a unique series of face-to-face sessions over five weeks, which will start in March. The service will run in Deptford, south London, and will give people of all ethnic backgrounds the opportunity to have their specific questions and concerns addressed by experts and trained volunteers at informal workshops. The sessions also offer the chance to talk to someone else
MARCH 26 - APRIL 1, 2015, THE VOICE | 29
who has had a breast cancer diagnosis and understands how they may be feeling. Lorraine Marke, from Forest Hill, south London, was diagnosed with breast cancer almost five years ago and says she wishes the service was
side effects. Though the support of my family and friends was amazing I really wanted to speak to someone who had also been there.” Marke is now a proud volunteer for PROWESS and hopes she’ll be able to help others
hospital treatment and this free service will provide vital support that’s easy to access in the local community. “PROWESS will offer information and guidance on topics such as treatment side effects, healthy lifestyle and hair and skin care, all tailored to the specific requests from people in the group. “Anyone who has finished their hospital based treatment for breast cancer in the last 12 months is welcome to come along, but sign up soon as places are running out fast.” The first session will be held on Wednesday, March 11, 2015 from 10am - 2pm at Deptford Lounge and will continue weekly.
I was very upbeat and positive throughout my hospital treatment available when she was dealing with the “awful side effects” following hospital treatment. “I was very upbeat and positive throughout my hospital treatment,” the 52-year-old recalls, “but once it ended the reality of my diagnosis hit me and my mood sunk.” Marke says once she was discharged from hospital, she felt “completely lost” and found it hard adjusting to life again after visiting the hospital weekly for over a year. “I was struggling to adjust and was dealing with awful
who find themselves in the same boat as she once did. “That’s why I’m so happy to be a volunteer at the PROWESS service to help other women diagnosed with breast cancer know they aren’t alone and there is somewhere to turn and people to speak to in their community,” she said. Ben Langston, Service Development Manager, at Breast Cancer Care, added: “We are very excited to be piloting this brand new service in south London. We know that cancer doesn’t stop after you finish
To book a place or for more information contact Jennifer at Breast Cancer Care on: 020 7960 3424 or email: jennifer.finnegan-john@ breastcancercare.org.uk
Look good, feel better
How often do to you check your breasts and do you know Why this top businesswoman devotes her free what you’re looking for? time to restoring the confidence of women “I’m ashamed to admit this, but I hardly ever check my breasts. I usually do it following a visit to the doctor because they normally ask. I know what I’m supposed to be looking for (hard pea-sized lumps), but I’m worried I won’t find them.” Debbie Gibson, 31
We asked a selection of black women to share their habits think I’d suspect anything. My husband has a feel around for me every now and then, but that’s about as far as my checkup goes.” Diane Richards, 30 “I only check if they hurt, but I don’t know what I’m looking for. Also, I’ve lost some weight recently and now my breasts feel different, which makes things even less straightforward. As far as I understand, we have glands in our tissue, so how do you know if you’re feeling a gland or a lump? Honestly, I’m quite ignorant to this.” Sandra Jackson, 38
“I check mine monthly, just to feel for any changes. Mine hurt occasionally, but I think that’s just because they’re so big and heavy! Because I’m not certain of what exactly I should be checking for, I’ve convinced myself that any change/s will be important enough to get checked out.” Viola Johnson, 42
“I checked them last night actually. I normally check them once a month. I think I’m looking for an orange peel kind of texture or lumps and bumps. I’m paranoid. I always think I’m dying.” Anon, 23 “I don’t do it often, but know I’m looking out for lumps, discolouring, pigmentation, moles - any changes to the breast” Tash La Rose, 36 “I don’t check. Mines are so small that if there were abnormalities, I’d know.” Alicia Monroe, 27 “Although I’m in my early 20s, I still think it’s important to be breast aware - especially as I have a family history of breast cancer. I don’t have a particular routine when it comes to checking my breasts, but would say I check them at least two to three times a week. This could be in the shower, before I get dressed or sometimes just before I go to sleep. But what am I looking for?” Rachelle Brown, 24
who have undergone cancer treatment
FIVE YEARS ago, Joyce Connor, founder of awardwinning hair and make-up company, Brides and Beauty, made a decision to volunteer for Look Good Feel Better, an international cancer support charity, providing free and practical services for women and teenagers suffering from the visible side effects from cancer treatment. Here, she explains the reason behind her selfless decision. What inspired you to volunteer for Look Good Feel Better with all you have on your plate? I saw an article about the charity in a magazine and thought, ‘wow that’s an amazing cause’. I had raised some money for breast cancer awareness just before seeing this article and had also lost a very close friend to cancer. I contacted Look Good Feel Better and haven’t looked back since. I’ve been there for five years now. Why is it important for women to understand how to use make-up after undergoing chemotherapy? During chemotherapy, the skin changes and become very sensitised and dehydrated. This is usually temporary and
the skin will normalise again after treatment. Using makeup during treatment is slightly different to everyday uses.
and lashes and their skin is patchy and dry. All referrals to the Look Good Feel Better workshops are via Macmillan Nurses. Patients at the hospital come to the workshop and there is a waiting list, some women don’t get to come along because the treatment makes them so ill. What can women expect from a Look Good Feel Better workshop? The workshops run for two hours and there are between 8 and 12 women taking part with up to six volunteers like myself teaching them skincare and make-up.
Photo by: Carey Sheffield
“Shamefully, never. Well, certainly not intentionally. Naturally, I’ll touch my boobs when I’m in the shower, but I can’t say I ever make a concerted effort to check myself and in honesty, I’m not sure I’d know how to do it properly or what I’d be looking for. Unless, it was a very obvious lump, I don’t
EXPERT ADVICE: Joyce Connor
When women come to you, what kind of mindset are they in? Most women are not feeling their best when they come along to the workshop. They have lost their eyebrows
Black women, in particular, find that their skin may permanently darken after treatment. What would be your top make-up tip for them? The melanin in black skin increases to protect the skin during treatment and it can also make the skin more photosensitive. My top tip is to use a colour corrector on the darker skin areas and then to apply foundation of their normal skin tone over the top to even out the colour. www.bridesandbeauty.co.uk
30 | THE VOICE MARCH 26 - APRIL 1, 2015
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Food for thought
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N ANTI-cancer diet is an important strategy to help reduce your risk of the disease. Researchers have found that certain foods and drinks may be particularly useful in protecting you from cancer.
GARLIC Several large studies have found that those who eat more garlic are less likely to develop
An alternative diet may be particularly useful in the fight against cancer
various kinds of cancer, especially in digestive organs such as the esophagus, stomach, and colon. Ingredients in the pungent bulbs may keep cancer-causing substances in your body from working or from multiplying. BERRIES Berries contain particularly powerful antioxidants, mean-
help keep cancers from growing or spreading.
ing they can halt a naturally occurring process in the body that creates free radicals that can damage your cells. Compounds in berries may also
CRUCIFEROUS VEGETABLES Cruciferous vegetables, which include broccoli, cabbage, and cauliflower, may be particularly helpful in protecting you from cancer. Researchers have found that components in this group can protect you from the free radicals that can damage
your cells’ DNA. They may also slow the growth of tumors, and encourage cancer cells to die. GREEN TEA Tea contains antioxidants called catechins, which may help prevent cancer in a variety of ways, including keeping free radicals from damaging
cells. Studies have found that catechins in tea can shrink tumors and reduce tumor cell growth. Some - but not all studies in humans have also linked drinking tea to a lower risk of cancer. WHOLE GRAINS According to the American Institute for Cancer Research, whole grains contain many components that might lower
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your risk of cancer, including fiber and antioxidants. A large study of nearly half a million people found that eating more whole grains might lower the risk of colorectal cancer.
cumin (not to be confused with cumin) that may be useful in reducing cancer risk. Turmeric is easy to find in grocery stores, and you can use it in a variety of recipes LEAFY GREEN VEGETABLES Leafy green vegetables like spinach and lettuce are good sources of the antioxidants beta-carotene and lutein. You’ll also find these nutrients in vegetables that are more traditionally eaten cooked, such as kale. Research suggests that chemicals in these foods may limit the growth of some kinds of cancer cells. GRAPES The skin of red grapes is a particularly rich source of an antioxidant called resveratrol. Grape juice and red wine also contain this antioxidant. According to the National Cancer Institute, resveratrol may be useful in keeping cancer from beginning or spreading. In men, moderate amounts of
red wine have been linked to a lower risk of prostate cancer. BEANS Some beans, particularly pinto and red kidney beans, are outstanding sources of antioxidants and should be included in your anti-cancer diet. Beans also contain fibre, and eating a high-fibre diet may also help reduce your risk of cancer, according to the American Cancer Society.
TURMERIC This orange-coloured spice, a staple in Indian curries, contains an ingredient called cur-
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