Asked who was most prone to develop breast cancer, Dr Asante VanWest-Charles-LeBlanc, chair of the Cancer Society (TTCS), responded: “Everybody!”
In a candid interview with Newsday last week, LeBlanc said there are genetic risk factors that include, from a medical standpoint, whether a woman has children, if she breastfed late, if she had a late first period.
Coupled with that, Le Blanc said, comes lifestyle. “What did you eat? Where do you work? How do you sleep? Do you exercise? How is your life situation’s stress-coping mechanism?”
She added that cancer are badly behaved cells, or cells that are indisciplined.
She explained: "They don’t respond as they should and grow out of control.
"All cells have a integral programmed cell death and cell function: it is in the DNA of each cell. The RNA is what makes the proteins in the cells. The genetic material is DNA and RNA but when there are intrinsic or extrinsic factors that affect the genetic machinery...sometimes it can affect the process."
A gene may be turned on or off. "Then the program is changed and the cell death cycle (apoptosis) can be affected and the cells don’t die, but continue to multiply and function."
This is uncontrolled, cancerous growth.
LeBlanc said breast cancer is non-discriminatory, "so it is difficult to say, 'This particular group of women or ethnicity of women are affected most.'
"What can be said is that the genetic factor plays a major role.
"But also our lifestyle is another big influencer in terms of our risk of developing breast cancer, including our jobs, our diets, our medication (hormone replacement), certain procedures, not breastfeeding.
"So we urge women, and men, to truly make those small yet impactful changes in their lifestyles, such as no smoking, no vaping; limit or moderate alcohol intake; eating a healthy, balanced diet, exercising; sleeping well – that is getting good sleep hours in with effective sleep; stress-coping mechanisms including meditation, breathing, yoga, tai chi, qi gong, to mention a few.
"Cancer affects us all," she added, "so along with this we urge everyone to get screened."
For early detection, LeBlanc said everyone must take stock of their lives and health, as they are the protagonists of their health.
LeBlanc also said it’s important that women also remember sisterhood: “Speaking to one another and letting that communication happen, because different things come from different sources."
Most important, she said, "You have to get screened...Because we’re seeing younger women being affected by cancer. So this is where we’re trying to educate even the younger women – under 40 – to know their breasts and not be afraid of their breasts.
"Look at your breasts, do your self-examinations, go and have your clinical breast examination with your physician every year, and then, based on your genetics and lifestyles and what might be found in one of those two, we determine if you need an ultrasound and if you need a mammogram if you are under 40."
Once a woman turns 40, she said, "We start with the mammograms and ultrasounds if necessary.”
LeBlanc said it’s important to continuously educate and break down the myth that mammograms cause cancer. She described them as the gold standard for screening for breast cancer.
“So you have to do your annual screening, because if you pick it up in one year, it’s going to be early detection.”
But how do women truly get around the stressful environment in which they work and go about everyday tasks?
“You can’t get around the stress, but you can get around how you let it affect you. Yes, it’s easier said than done, but it takes work, and it has to be something that you’re actively and consciously doing.”
Different practices such as breathing techniques, meditation techniques and yoga are all good, she said, but don't happen overnight.
The TTCS provides screening, and if a woman tests positive for breast cancer it offers options in terms of public and private-sector treatment. Le Blanc said the TTCS does its best to support a patient along whichever route they choose, as well as offering counselling to all patients and their families. The first session is free and the follow-ups are all subsidised.
The TTCS also provides a survivor network to walk the patient through the process. And as they go through treatment, being part of that survivor network, they will be called to find out if they need anything.
“We also have two buses, thanks to Republic Bank and Hannah Janoura and friends, that are going to transport patients to their sessions at the National Radiotherapy Centre,” added LeBlanc.
She also stressed: “I want not to forget the men, 'cause men have breasts too, and there is male breast cancer. It’s not a big number, but I want men not to forget to feel their breasts every once in a while and if they feel a lump, go to their physician.”
From a 2008 report based on the PAHO (Pan American Health Organisation) country profile, LeBlanc said breast cancer is one of the leading causes of cancer deaths in TT. Some 23 per cent of cancer deaths are from breast cancer.
Are more women being screened for breast cancer?
“Yes. More and more, because of our education initiatives, initiatives from corporate TT, including Scotiabank and Republic Bank, and even our sponsors for our new mammogram unit.
"We’ve been able at TTCS to boost and to spread that word constantly, and to keep that message alive. So we are seeing an increase in numbers in women getting screened at our clinic. We’re hoping it’s the same in other institutions,” LeBlanc said.
So are fewer women affected?
“That’s an interesting question, because screening is looking for disease in a normal population.
“I would have loved to say yes, but I can’t honestly say yes. When you get hit with that diagnosis, we do hear the survivors saying, ‘I did this different, and I really paid attention,’ and you see more attention being paid.
"But when you speak to survivors, what most of them might have in common, as women: we don’t take care of ourselves. And when I say that, I don’t mean we let our bodies go, you know, I mean I was stress-coping. Our altruistic nature, we’re the caregivers of the world, without us nobody gets care. So we go and go, and we always push through on empty cylinders.
"But cancer sort of said, 'Wake up! Take stock and watch yourself!'”
She added that listening to the survivors or the women who are affected by breast cancer and going through treatment,
makes it clear they are not all women who have had poor lifestyles, but also some who have been taking care of themselves, eating healthily, exercising and sleeping well.
“So you have things to look at: your inherited genetic factor to look at, and then you have the extrinsic factors, which include lifestyle.”
LeBlanc issued a reminder that the TTCS is there for TT and welcomes callers for any help needed, any education initiative, to talk or offer guidance. Anyone can reach out to the TTCS where cancer is concerned.
Finally, she stressed: “We are begging you all not to smoke, we are begging for healthier lifestyles, to exercise, use alcohol in moderation.
"And note that because we are so passionate about what we are doing, our services and prices will never be raised above market value. They will always be the lowest in the market, because we don’t want a barrier to access this type of healthcare.
“We welcome volunteers, survivors, donations – but most importantly, we are here to serve the public when it comes to cancer.”
The TTCS is celebrating its 50th anniversary this year.