Prescription to fight breast cancer: Be aware

Women remain central to Dr Farah Arshad’s life. An expert in breast diseases, she is committed to raising awareness about breast cancer, writes Alka Pande.

At the age of six, Farah first accompanied her gynaecologist mother to the hospital where she was working. The little one sat patiently through the day, as woman after woman walked through the doors of the clinic and shared her joys or agonies with her mother.

What Farah observed that day was her mother’s indefatigable effort to reach out to her patients — whether it was reducing their suffering through medicines or by simply giving them a chance to talk about their lives. Farah came back to her mother’s clinic often after that day. She was inspired to do similar work.

Over two decades later, women remain central to Farah’s life. An expert in breast diseases, Dr Farah Arshad is committed to raising awareness about breast cancer. Says the young doctor, “During my internship as an endocrine surgeon I observed that there was a dearth of women breast diseases specialists. Women patients wanted women doctors to examine them.

Eight out of ten women patients came to me. Although it was a nightmare because I was over-loaded with work, the experience helped me choose my field. Most women doctors become gynaecologists or paediatricians; not many opt for specialising in breast diseases and I decided to take it up as my area of expertise.”

In 1999, when Farah did her Masters in Endocrine Surgery from Jawahar Lal Nehru Medical College in Aligarh, Uttar Pradesh (UP), there was no dedicated branch for breast diseases. Four years later, she got married to Dr Afzal Arshad and shifted base to Lucknow, the capital of Uttar Pradesh (UP), since her husband had been posted at the Sanjay Gandhi Post Graduate Institute of Medical Sciences in the city. It was here that she got the opportunity to specialise in breast surgeries.

According to the latest statistics of Indian Council of Medical Research (ICMR), 100,000 breast cancer cases are detected every year in India. More than 70 per cent of these cases are diagnosed at an advance stage. Alarmingly, it is projected that this number could double by 2020.

As a state that has nearly 10 million women (Census 2011), the situation in UP is particularly critical. The ICMR numbers reveal that in 2010, 8,882 women succumbed to breast cancer here, making it the State with the second highest number of deaths caused by breast cancer in the country.

Reveals Farah, “During my training years, the women who came to me with breast cancer were in their forties. Today, I see that the disease is catching women at an early age — between 25-30 years — especially in urban areas. This is distressing as India has a large population of youngsters.”

The factors fuelling the disease among young urban women include the stresses of a fast-paced life, late marriage, the prolonged use of oral contraceptives and reduced breast feeding. Most of these causes play havoc with women’s hormones and increase their vulnerability to breast cancer. Increasing alcoholism among urban women is an added problem.

The International Agency for Research on Cancer (IARC), a part of the World Health Organization (WHO), has pointed to the fact that cervical, stomach and breast cancers account for 41 per cent of cancer deaths in women in rural and urban areas. 

Unfortunately, while the disease is fast turning into an epidemic, especially in the urban centres, there is increasing concern over the lack of well-established breast cancer screening programmes nationwide. Serious alarm was raised by experts at the first-ever International Congress of the Association of Breast Surgeons of India (ABSICON) held in May, 2012 in Hyderabad.

Low awareness

Dr Farah Arshad has been doing extensive work towards raising awareness about the disease ever since her first posting at a private medical college in UP, where she had launched her first initiative. She elaborates, “What motivated me was the lack of awareness about this disease in the majority of women.

Most of them consulted homoeopaths for lumps in their breast. There were two reasons for this — first, in a patriarchal society women feel guilty about spending money on themselves and homoeopathy is inexpensive; second, it does not involve any physical examination. Women avoid going to male doctors for such diseases,” says Dr Farah.

Incidentally, UP, the most populous State in the country has just two women breast diseases specialists, and Dr Farah Arshad is one of them. To overcome the hurdles in tackling this killer disease, Farah decided to focus on education. Breast cancer, she says, is completely curable if diagnosed at the first stage.

She started Project Lakshya, with support from the Cancer Aid Society in October 2011. True to its name, the project targeted college-going girls. The specialist talked to the students about breast cancer, self examination and treatment. In a year, Farah has reached out to more than 2,000 girls in their teens.

Her success with the young motivated her to take her awareness programme to the next level. From March this year Project Lakshya covered women in the rural areas. Camps were set up, under the community management programme, with an aim to educate rural women about breast diseases.

Women were taught self breast examination as well as motivated to go to the nearest health centres for regular check ups. Free check-up facilities, including complimentary ultrasound, were offered and during investigations if a woman showed symptoms of breast disease, she was referred to the medical college for further diagnosis and treatment. Over 50 villages in and around Lucknow were covered under this drive.

“These two initiatives — one in the urban scenario and the other in a rural setting — made it clear that awareness was  low in both places. Women in general were shy of talking about their problems and they did not want to go to male doctors for checkups.

Besides, for women their own health is their last priority,” reveals the medical practitioner.
A dedicated surgeon, Dr Farah Arshad does not want to restrict her awareness work to screening and treatment. Research has been a major area of interest for her. In fact, she hopes that her research papers would spur the State government into formulating precautionary measures.

For instance, her paper ‘Adolescent Girls’ Breast Screening In Rural Areas’ was aimed at motivating the government to start programmes in rural areas, while the purpose of ‘Malignant Breast Cancer in Adolescent Girls’ was to compel the State to include breast diseases in the school curriculum. 

She has also persuaded private hospitals in Lucknow, where she is working, to include mammograms in their health package. The reason for such an emphasis on breast cancer, explains Farah, is the fact that after being the world’s capital of diabetes, India is now dangerously poised to lead in breast cancer cases as well.

Thankfully, spreading awareness on the issue has become a priority — initiatives like the Breast Cancer Awareness Month, marked worldwide in October — are making a marked difference.

Says Dr Farah Arshad, “Three years back, hardly a couple of patients came to me in a month. Nowadays, the number has jumped to more 150. Most of the cases are treated only with medicines because they are diagnosed early. This has happened only because of rising awareness.”