17 October 2006

Breast Cancer in the Philippines

Many of you might already know that cancer ranks third among the leading causes of mortality and morbidity in the Philippines. Infectious and cardiovascular diseases are the top two. Cancer prevention attitude here sucks, and a researcher has lamented that if this continues, "it is estimated that for every 1,800 Filipinos, one will develop cancer annually."

Seventy-five percent (75%) of all cancers here occur after age 50 years, and only about three percent (3%) occur at age 14 years and below. Most Filipino cancer patients wait until the last hour before consulting (see Filipino Patient Type #1) and at this point, the cancer is most often at an advanced stage.

From the Japanese Journal of Clinical Oncology, Vol.32, Sup.1, 2002

The grim fact is this: "for every two new cancer cases diagnosed annually, one will die within the year."

For this post, I will limit the discussion on breast cancer in the Philippine setting, risk factors involved, and conclusions reached in some studies.
  • In Asia, the Philippines has the highest reported incidence rate of breast cancer. From 43.2 in 1993-1995, the age-standardized incidence rate (ASR) is now 47.7 per 100,000 females, and this figure exceeds the rate reported for several Western countries, including Spain, Italy, and most Eastern European countries.

  • Liede and colleagues have estimated that at least five percent (5%) of breast cancers in the Philippines may be attributed to mutations in the breast cancer susceptibility genes BRCA1 and BRCA2.

  • Many breast cancers are diagnosed among 35 to 50-year-old Filipino women.

  • In terms of breast cancer detection, a local study revealed that the use of breast self-examination (BSE) and aspiration biopsy/open biopsy are the most cost-effective strategies in the Philippine setting, incurring savings for the government by almost 3 million Philippine Pesos or US $60,000 (1989 value) per year per 100,000 women. Mammography is not readily available nor affordable especially in the rural areas.

  • How many Filipinas do a regular breast self-examination (BSE)? Another local study reveals that only 54 percent had ever done a BSE, of whom only 27 percent are still practicing it at an average of 9.2 times a year. Reasons given for not doing the BSE included no symptoms, busy, don’t know how, don’t like, don’t think important, always forget, afraid and not aware.

  • Why do Filipinas with breast problems always consult when it is too late? A 1993 local study on the determinants of late-stage diagnosis of breast cancer among Filipino patients indicated that economic factors, non-awareness of the gravity of breast cancer and fear of being diagnosed with cancer may be reasons for late diagnosis.

  • Unreasonably stubborn breast cancer patients - a 1997 DOH-WHO breast cancer screening field survey in Metro Manila revealed that there was a large non-compliance rate (79.1 percent!) among women found to have breast masses (2.8 percent positivity rate) in terms of consulting hospitals and specialized clinics for re-evaluation and possible treatment. Now, you know why many breast cancer patients die here.

  • Women who are currently on combined oral contraceptives or who have used them in the last 10 years are at a slightly increased risk of having breast cancer diagnosed. There is no evidence of an increased risk 10 or more years after stopping use.

  • Post-menopausal women are at an increased risk of having breast cancer diagnosed while on hormone replacement therapy (HRT). There is no evidence of an increased risk of breast cancer 5 or more years after stopping HRT.

  • Significant risk factors identified for breast cancer in the Philippines from a local study include: longest residence in rural areas, lower than high school education, history of benign breast disease, infertility, and greater than 35 years age at first pregnancy.

  • Protective factors identified: severe dysmenorrhea (don't hate those cramps anymore!), number of livebirths (the more children, the better!), and breastfeeding (best for baby, best for mommy!).

  • Cooking methods like boiling food in coconut milk have recently been associated with a significantly increased risk of breast cancer here in the Philippines.

  • Another study suggests that high intake of deep-fried, well-done red meat may be associated with an increased risk of breast cancer, and the positive association may be modified by body weight. The same study also said that nonhydrogenated soybean oil, if not used in high-temperature cooking, may be associated with a reduced risk of breast cancer.

Breast cancer is easy to beat if you catch it early. Ladies, please learn how to do a breast self-examination, and do not fear going to your doctor for a consultation.

Here's an excellent website on How To Do Breast Self-Exams (be sure to turn on your speakers; it will teach you step-by-step procedures).

20 reactions:

Anonymous said...

This is one of the reasons why my hubby told me to go under a general check up ASAP.

di kasi ako umaatend sa mga yearly check ups,pero now i realized that I really need to. :)

bugsybee said...

Thanks Doc Emer! This was very helpful. I only wish seomthing could be done to make the women in the rural areas more aware about BSE.

Sassafras said...

thanks for this post. di ko alam iyong tungkol sa coconut milk, and that bit about deep fried red meat reminded me how much meat we've been eating compared to veggies.

Anonymous said...

breast cancer also happens to guys. if i am not mistaken, slightly less than 1 % of breast cancer patients in malaysia are guys. i cannot confirm the figure though, will need to check.

ipanema said...

This is a troubling fact. That the Philippines tops breast cancer incidence in Asia, even surpassing some European nations.

What I didn't know until now are recent findings about food-related incidence (boiling food in coconut milk)though. This is interesting.

I've never subject myself to a breast exam in a hospital because I'm afraid. Yes, I'm that kind of patient.

Anonymous said...

It's a very helpful post, specially the link on how to do the breast self-examination.

Grace.life said...

Your blog is very interesting and helpful. Thanks for posting.

Anonymous said...

hi..your information are very useful..may i know what is your source about the coconut milk? because we are having a study about breast cancer and your information is very interesting. thank you. bluefire338@yahoo.com <--- you can e-mail me at this address. hope you will reply :)thank you and God bless :)

Anonymous said...

as a radiologic technology student, i give this article a thumbs up... =)

Anonymous said...

Fortunately we have tests that are predictive such as BRCA gene testing. It's available here in our country already with Ambica biotechnologies. For more info pls call 8286617-18.

dj said...

Yes all these are helpful for the early detection of breast cancer. Another important test which is predictive and worth your buck is the BRCA gene testing now already available in our country. Pls. contact 8286617-18.

Anonymous said...

my mother has a breast cancer and i dont know what to do to help her she always feel numbness to her left chest even though she was operated is that normal?? do you really feel numb when you when to an breast operation??
and our problem is her diet she only eats fish!!! cause she has a high blood pressure can you suggest anything for her!! please email me when you read this we really need help!! i love her and i dont want her to die!! here is my email address knightfox1984@yahoo.com

Anonymous said...

how can i contact you !!!! my mother needs help and advise!! pls help us!!! email me !!! knightfox1984@yahoo.com

Dr. Emer said...


Exclamation point-riddled comment, you must really be in distress. This blog is only meant to supplement health and medical knowledge. It does not aim to treat or diagnose ailments.

You need to see the doctor who operated on your mother for the numbness you said she's feeling now. It is possible that a nerve or a bundle of nerves have been affected by the operation.

For the high blood pressure, she needs to see an internist or a cardiologist.

God bless you, and thanks for reading this post.

aning_jo said...

hi...reading this blog was worthwhile..anyway do you know how much breast biopsy usually cost?

florida said...

To knightfox1984@yahoo.com/Dr. Emer
I familiar with the numbness you are mentioning because I am also a breast cancer patient,eventually that numbness will subside but first she needs to exercise or use her arms as if nothing happen.Her strong will can help her overcome the numbness.There's alot to tell if you can just contact me on my email :florida_dlcrz@yahoo.com or cel#0921-7750741.

Anonymous said...

Another good reason is all in the book called "Dressed To Kill" it talks about Bra's and Brest Cancer. Most Fillipina wear there bra 20 to 24 Hours aday and the breast can not move freely as they are ment to be. So think twice in wearing a bra for more then you have too. Read the book as I did and learn things most doctors will not tell you about the causes of a bra!

jcli said...

Thank you, it helped me in my epidemiology assignment. Very informative! Merci! :)

Anonymous said...

I hadn't noticed emeritus.blogspot.com before in my searches!
My cousin recommended this blog and she was totally right keep up the fantastic work!

Breast Cancer Patient said...

Wearing Bras does not cause Breast Cancer!

The book Dressed to Kill has unsubstantiated allegations.

Please lang, this is the number 1 myth sa breast cancer.

If you read on any reputable research about breast cancer, walang bra bra na yan.

Please don't spread false information kasi kawawa yung naniniwala.