A serious sign of danger

“My wife’s breasts are having monthly periods and I hate it!” It was John, one of my old time sex coaching clients calling.

“Strange! How does that happen?” I asked, trying to fathom what this was all about.

 “I am not sure; I cannot tell if I bit her nipples subconsciously!” He exclaimed laughing loudly, “You know there are things that happen in the heat of the moment that you cannot remember.”

I requested the couple to come to the clinic. John was an interesting chap. As soon as they entered the consultation room, he asked his wife, Jane, to expose her breasts.

“Well, we can first talk then I will examine her,” I requested.

“No, let me show you what happens,” he replied helping his wife out of her blouse and bra. He then went into detail of what he does during foreplay, caressing and fondling Jane’s breasts. As I watched in amazement, blood started dripping from the nipples.

“Now that puts me off!” John exclaimed loudly, an expression of disgust on his face.

“Okay, okay, sir,” I reacted, signaling him to stop and sit down.

I asked if Jane had been undergoing routine breast examinations. She was 41 years old, and had one child who was two years old. She had stopped breastfeeding four months after delivery when she had to go back to work.

COMMON CANCER

I took the opportunity to talk to the couple about breast cancer which is the commonest cancer among women in Kenya, and whose consequences can be pre-empted if only women knew what to do about it.

Routine breast examination detects the cancer early, at a stage when treatment is easy. Women should examine their breasts every time they dress in front of a mirror. Master the shape of your breasts so that any change in shape is easily detected.

Further, note the size and shape of your nipples. Many cancers cause a change in the nipple and that may be the first sign of danger. Additionally, note the normal colour of the skin of your breasts.

After that, gently but firmly massage all sections of the breast. Any stone-like isolated feeling should alert you of an abnormality.

Do not forget to check the part of the breast that extends to the armpit.

Finally press the breast for any discharge. Abnormal discharge, especially if blood-stained should not be taken lightly.

In addition to self-examination at home, women who are younger than 40 years should have their breasts examined in the hospital at least once in three years. Those above the age of 40 should undergo the examination at least once a year.

At the hospital the health worker will physically examine the breast and also order for mammography, a special X-ray for examining the breast.

Research has shown that where routine examinations of the breasts are done, deaths from breast cancer reduce by up to 30 per cent.

About 460,000 women die from breast cancer in the world each year; most of the victims do not follow the simple recommendations for breast examination.

Africa is unfortunately famous for high death rates from breast cancer. Out of all women diagnosed with breast cancer in Africa, about 55 per cent die of the disease, as compared to 30 per cent of the women in developed countries.

DEPRESSING SITUATION

The difference in Africa is that most women only go to hospital once breast cancer symptoms appear, while in developed countries, early growths are detected during routine breast examinations in hospitals.

It is easier to treat the early cases than the advanced ones that are already exhibiting symptoms.

“Please, doctor, what exactly are you saying?” John asked frowning, “That my wife has cancer that is advanced?”

“Not exactly,” I replied, “we will need to examine her and do mammography to find out what the problem is.”

Examination showed a stony mass around Jane’s right nipple. There were other stony masses in her right armpit. Mammography showed a growth consistent with cancer in the right breast.

Under the circumstances, it was necessary to do further tests. Tissue removed from her breasts confirmed that the growth was cancerous, while a chest X-ray showed that the cancer had spread to her lungs.

“All these are like a dream to me,” said Jane as the results were being read to her, “for sure I have never imagined that I am unwell and if John had not cheekily complained of the blood, I would not have taken any action.”

Jane’s was a depressing situation medically. Treating a cancer that had spread was going to be challenging.

It has been three and a half years today and we have lost the battle. John called me this morning to deliver the bad news: Jane died in her sleep at night.

The surgery to remove her breasts and subsequent chemotherapy did not stop the disease. May her soul rest in peace and may all women go for routine breast examination to avoid a similar tragedy.