“Cancer took so much away from me but in return has given me so much. I have a better perspective on life, what matters and who counts. I live my life like its golden. I don’t take anything for granted” Twena Harvey-Ewusi

Twena is a Ghanaian fashion designer and a breast cancer survivor. She fought and survived breast cancer, the most common cancer that affects women in Ghana and the leading cause of cancer deaths among Ghanaian women.

The mention of any kind cancer sends shivers down the spine of many; for a lot of women, cervical and breast cancers are a death sentence. Does it have to be tough? Definitely not! Undeniably, breast cancer does claim lives. Such was the case of the late Mrs. Beatrice Mensah Osae, the beloved mother of AhmazingGrace Baaba Danso. “She was diagnosed in 2011 when she discovered a tumor in her left breast which grew bigger to the point it became inoperable. It burst and became an open sore on her chest and ate away at her breast even claiming her nipple. She had three chemo treatments which weakened her greatly till she switched to homeopathic treatment. This helped her regain her strength a bit but ultimately she succumbed to the disease and passed in September 2016” recalls AhmazingGrace. Madam Beatrice was one of the 1% of breast cancer patients who are likely not to survive breast cancer.

Okay! Let’s pause briefly and talk about what breast cancer really is. Dr Grace Gyimah-Boateng, a general medical practitioner at Sonotech Medical and Diagnostic Center describes breast cancer as growth of abnormal cells in the breast. Ideally, the body has a way of working to control how the cells in the body divides but cells become cancerous when they grow abnormally and at a rate that the body can no longer control.

Breast cancer comes in two main classifications: primary and secondary. Primary breast cancer cells originate or start from the breast, whereas secondary breast cancer occurs when cancerous cells in any other parts of your body spread to the breast. According to Dr Gyimah-Boateng, primary breast cancer makes up about 90% of diagnosed cancers in our part of the world. She further elaborated that the breast has 3 main parts, the lobule, duct and connective tissues. Breast cancer most commonly found is the Invasive Ductal Carcinoma (phew! this one is kind of heavy) which in simple terms means invasive cancer (abnormal growth) in the breast duct.

For Twena, finding out she had breast cancer “...was very devastating. My heart was broken, I was scared, didn’t know where to go and what to do. I was very scared because where I come from, the word cancer is a death sentence“. Was Twena’s fear unfounded? Of course not! Imagine processing a medical diagnosis as a death sentence. Nobody really wants to die. This fear of breast cancer lingers even in women who have never had a breast screening.

Karen Aziza Yassine is a Malian-Ivorian entrepreneur, a translator and a breast cancer survior. When I asked Karen what her diagnosis experience was, she said: “The day of my “official” announcement, the day I heard the doctor tell me that I had stage 3 out of 4 breast cancer, 4 meaning that you have a 99.9% of change of dying, the conversation went like this:

The doctor: I’m sorry to inform you that you have stage 3 breast cancer, and the younger you are the faster cancer spreads”

Me: ok! So what do I do now?

The doctor: (repeated) you have breast cancer ma’am!

Me: I heard you the first time around, I already cried yesterday… what do I do now?”

Karen was 27 years and had a 2 month old baby when she herself discovered a lump in her breast. Doctors told her it may just be a clogged milk duct as she was breastfeeding. It wasn’t until she went back a few months to get it checked again after having watched the cancer story of Angelina Jolie, that she was officially diagnosed. In a few months, the small lump had progressed to a stage 3 cancer. This news would scare anyone, I know I would have been scared, but her response! She had 99.9% surety that she was going to die but she said “…I already cried yesterday, what do I do now” She wanted to do something about her situation so she decided to make use of the 1% survival chance she had.

In her interview, Karen said her reaction surprised the doctor. She didn’t consider dying an option, saying: “…I was not going to waste another second being sad, I saw my grandmother dying of breast cancer and I was not going to let it win this time. I thought about my kids, my mother, my family and I knew that 70% of your recovery is in your attitude and my plan was to be as POSITIVE as possible and take the bull by the horns!” And she did take the bull by the horn. She survived it!

What caused Karen, Twena, Madam Beatrice or any other woman to develop breast cancer? Well, doctors don’t know that, yet! Scientists don’t know the exact cause of breast cancer. Dr Grace Gyimah-Boateng explained that there are risk factors; things that could make one prone to developing breast cancer. These are categorised as modifiable and non-modifiable factors. Non modifiables are factors women have no control over, they include genetic mutations, family history, radiation treatment to the chest, dense duct, prolonged exposure of endogenous estrogen (eg: early menstruation, late menopause and late age of beginning child birth) increasing age and being female, as 99% of cancer is found in women. One other minor non modifiable risk factor which Dr Grace mentioned is still being researched is height. Tall people have been found to be more susceptible to breast cancer. Modifiable risks which are factors women have control over are obesity, alcohol intake, and physical inactivity. These risk factors however do not always have a bearing on a woman’s diagnosis, as especially more now than before, women below age 45 are increasingly being diagnosed with breast cancer.

Breast cancer can be scary, we’re not here to tell you it isn’t. What it also is, besides being scary, is that it is curable. Twena did “6months of chemotherapy, surgery (lumpectomy) and 30 rounds of radiation. I was put on medication for 7yrs“. Karen on the other hand did “10 rounds of chemotherapy, and IV (Intravenous therapy)…a double mastectomy – took out both of my breasts and 3 months of radiotherapy” Not everyone diagnosed with breast cancer goes through these same treatments. Treatment is tailored to the type and level of cancer one has.

Depending on the stage and type, breast cancer treatment may include surgery to remove the cancer tissues, radiation to kill or shrink the cancer cells and medication which includes chemotherapy.

So you see, unlike dysmenorrhea- I know this a terrible comparison but I couldn’t help it, forgive me, breast cancer has a definite cure and you can get rid of it before it becomes life threatening. How do you do that? Early detection!!! My mind’s voice actually screamed that. Twena emphasised that “early detection is the reason I’m still here. Cancer if detected early can be cured. Girls/boys should be educated from the age of 12 on how to do the monthly self-exam. We should all mark it on our calendar to do it monthly” For AmazingGrace, her mum’s death has made her “hypersensitive and aware and desperate to ensure that women detect it early so they have better chances of survival…” She has since become a staunch breast cancer awareness advocate who dedicates time to encourage women to overcome their fears and get screened. This October, AmazingGrace says she’ll continue sharing her mother’s story to encourage women to get regular breast screening, although she wishes she had money to do more.

As we mark Breast Cancer Awareness Month this October, I’d like to tell you that You Don’t Have to Die. Breast cancer is curable, it’s okay to be afraid to get screened but don’t let fear cause you to lose your life. Breast cancer doesn’t have to be a death sentence. Read on breast cancer, go and get screened by a medical professional at least once a year, learn to examine your breast by yourself and do it regularly.

To examine your breasts:

1. Lie on your back and put one arm behind your head. With your three middle fingers placed flat on your breast, move your hand gently in circular motions checking for lumps, knots or thickening. Do this over the entire breast area including the area from your collarbone right down to the ribs below your breast. Apply pressure moderately as your fingers move. Put the other hand behind your head and do same for the other breast.
2. Stand up straight, raise your left arm and use the right hand to check your arm for lumps. Squeeze your nipple between your thumb and index fingers and look out for any fluid or discharge. Do same for the other breast.
3. Stand in front of a mirror with your hands on your waist and observe your breast. Look out for any changes in size, shape, any swelling or dimpling of the skin.

These are best done within the first week after menstruating. Report any unusual observation to a medical practitioner. Remember this does not replace getting screened by a professional.

Let these words of Karen Aziza Yassine who survived a stage 3 breast cancer resound in your ears this month and every other day – “I’d like to remind people that 1 in 8 women will be diagnosed with breast cancer during their lifetime. Men can also develop it…So Inform yourself, touch your breast in the shower or when you’re putting cream on, don’t be scared, fear will not help you. No matter what happens, remember that you are stronger than you think you are, we all have it in us!”

And remember, it’s not a death sentence. Get screened.

By Sarah Benewaa Fosu, Knowledge Management Assistant, AWDF

01/10/2019