State of secrecy escalating breast cancer cases in Kashmir

The study led by a group of researchers reported that women with early menarche from the age of nine [58.41% (n= 132)] were more likely to develop breast cancer, and patients from South Kashmir [46.02% (n= 104)] were more likely to develop the disease than those from North Kashmir [31.86% (n= 72)] or Central Kashmir [22.12% (n= 50)].

Although the majority of instances in the western population are postmenopausal, the early-age cases are contributing to an alarming increase in the incidence of breast cancer in Kashmir. 

The SKIMS study has set alarm bells ringing when Kashmir’s breast cancer statistics are shrouded in secrecy due to a lack of proper research setup and spirit. 

But what’s known is that breast cancer is second among women tumour cases in the valley. 

There may be many reasons for this alarming rise in breast cancer cases among the Kashmiri women population, but the lack of research-oriented diagnosis is the major factor for such a negative outcome for this disease. 

The malaise remains hidden and people stay ignorant to self-identifying the curable initial cancer stage.

At the same time, Kashmir-based research on breast cancer is facing a big loophole, missing links or coordination between medicos and the research group.

The research indolence exists despite the Council of Scientific and Industrial Research Indian Institute of Integrative Medicine (CSIR IIIM) mining out the abundant natural resource from enriched medicinal plants in the region against various diseases.

Such institutes are known to come out with groundbreaking leads for the betterment of patients and society. Various factors that other country has documented according to their gene dynamics and environmental cues they face can be noted here and be useful to avoid the incidence of cancer to some extent.

Taking research-based essential steps which can defer cancer initiation among them or increase their life expectancy must be taken into consideration. 

The appropriate lab research, introducing standard database departments, and actively participating in patient case studies, particularly by our medicos and publishing work in the reputed journal must be the priority of the movement. 

Further, regular international/national conferences, workshops, awareness programs and international exposure to our medical team should be done as well which definitely can play a crucial role in the betterment of patients. 

But as Kashmir’s case remains a work in progress due to research rarity, breast cancer—the most common kind of harmful neoplasm arising in the breast tissue, primarily from the ductal epithelium—contributes to a main cancer-induced death in women. 

Despite the fact that it is 100 times more common in women, men are equally at risk of developing breast cancer. 

Breast cancer accounts for about 15% of all cancer-related fatalities in women. A shocking number of women are vulnerable to this type of cancer, and unfortunately, the frequency in underdeveloped countries has recently increased. 

According to Globocon 2020, there were 19, 292,789 new instances of cancer, which caused roughly 9,958,133 deaths globally. Breast cancer account for 2,261,419 cases (11.7%) and 684,996 deaths (6.9%) in this statistical report. 

According to epidemiological studies, by the year 2030, there would be over 2 million cases of BC worldwide. In comparison to rural settings, the incidence of breast cancer is almost three times greater in urban areas. 

Globocon, 2020 also highlights that breast cancer is the leading (1, 78,361; 13.5%) and death-causing (90,408; 10.6%) cancer among Indian women, accounting for one-fifth of all female cancer cases in India and roughly 7% of the global breast cancer burden.

Systemic Overflow

Risk factors

Not being physically active. Women who’re not physically active have a higher risk of getting breast cancer.

Family history of breast or ovarian cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who has had breast or ovarian cancer.

Reproductive history. Early menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.

Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.

Taking oral contraceptives (birth control pills). Taking such types of pills for a long duration has been found to raise breast cancer risk.

Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.

Genetic mutations. Inherited mutations to certain genes such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.

Radiation exposure at a young age. Exposure to ionizing radiation at a young age may increase a woman’s risk of breast cancer.

Having dense breasts. Dense breasts have more connective tissue than fatty tissue and women with dense breasts are more likely to get breast cancer.

Drinking alcohol. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.

Symptoms and Signs

• A lump in your breast or underarm. 
• Swelling in your armpit or near your collarbone. 
• Pain and tenderness in the area of the breast.
• A flat or indented area on your breast. 
• Breast size changes. 
• Changes in your nipple.
• Unusual nipple discharge.
• A marble-like area under your skin.
• Irritation or dimpling of breast skin.
• Redness or flaky skin in the nipple area or the breast.

Prevention

Keep Weight in Check

It’s easy to tune out because it’s mentioned so often, yet keeping a healthy weight is a goal that everyone should strive towards. Being overweight raises the risk of numerous diseases, including breast cancer, particularly after menopause.

Be Physically Active

Exercise is as close to a silver bullet for good health as there is, and women who are physically active for at least 30 minutes a day have a lower risk of breast cancer. Regular exercise is also one of the best ways to help keep weight in check.

Breastfeed

Breastfeeding for a total of one year or more (combined for all children) lowers the risk of breast cancer. It also has great health benefits for the child. 

Avoid Menopausal Hormone Therapy

Menopausal hormone therapy shouldn’t be taken for the long-term. It has a mixed effect on health, increasing the risk of some diseases and lowering the risk of others. And both estrogen-only hormones and estrogen-plus-progesterone hormones increase the risk of breast cancer.

Avoid eating fast foods

Eating fast food regularly has many downsides, including an increased risk of heart disease, diabetes, obesity, and also breast cancer. 

A plant-based diet can lower the chance of developing breast cancer.

Green tea

Green tea, Camellia sinensis, has shown an anticancer effect on different types of cancer and possesses many chemopreventive qualities in breast cancer. Green tea extract significantly increases the circulating of estradiol in healthy postmenopausal women. The consumption of green tea extract also reduces the circulation of cholesterol and LDL-cholesterol, and regularly consume seems to facilitate lipid metabolisms in breast cancer survivors. Drinking at least five cups of green tea per week may be associated with decreased breast cancer risk.

Black cumin

Black cumin seed from Nigella sativa, also known as cumin, is used for centuries and it has unsurpassed traditional medicinal value and versatility to treat a wide range of diseases. Cumin is the source of the monoterpene thymoquinone, a compound that can cause anticancer effects in different human cancers including breast cancer.

Black pepper

Ground black pepper (Piper nigrum) is one of the most commonly consumed spices. Black pepper has been shown to have antioxidant, anti-inflammatory, antibacterial, and anticancer properties and helps improve digestion. Black pepper has been shown to inhibit the growth and motility of breast cancer cells.

Curcumin

Curcumin has been shown to have positive health effects on many parts of the body. It has been shown that curcumin may be used to combat breast cancer in several ways, such as keeping cancer cells from growing, preventing cancer cells from spreading, stopping the cycle of reproduction in cancer cells, and causing cancer cell destruction

Turnips

The turnip plant is the source of a variety of compounds with anti-cancer activities. Various isothiocyanates derived from turnips or turnip greens have been found to have anti-cancer activity against different types of breast cancers.

Leafy green vegetables

These are a few leafy green vegetables that have anticancer properties: kale, arugula, spinach, mustard greens, and chard. Leafy green vegetables contain carotenoid antioxidants, including beta-carotene, lutein, and zeaxanthin. Higher blood levels of these antioxidants are associated with reduced breast cancer risk.

Citrus fruits

Citrus fruits include oranges, grapefruits, lemons, limes etc. These fruits and their peels are teeming with compounds that may protect against breast cancer.

Dr. Sameer Ullah Khan is a doctorate scholar and Shariqa Aisha is a DST Inspire Fellow, at Cancer Pharmacology, CSIR-IIIM Srinagar.