Is smoking an important cause of breast cancer in urban India?

The last two decades has seen a dramatic shift in the smoking rates amongst Indian men & women. Smoking rates have fallen among Indian men but they have risen among women.

In a recent study published earlier this year in the British Medical Journal and which was earlier carried by the The Journal of the American Medical Association (JAMA), they examined the prevalence of smoking in 187 countries between 1980 and 2012 and found that while cigarette smoking among Indian men has fallen from 33.8 per cent in 1980 to 23 per cent in 2012, it has risen from three per cent to 3.2 per cent among Indian women within the same time frame. 

Smoking has been associated with various cancers but there was some discrepancy regarding it’s association with breast cancer. But in a recent study, researchers at the American Cancer Society have found an increased breast cancer risk among women who smoke, especially those who start before they have their first child.

In a new study, published online February 28, 2013 in the Journal of the National Cancer Institute, researchers analyzed data from 73,388 women in the American Cancer Society’s Cancer Prevention Study II (CPS-II). During more than 13 years of follow-up, researchers counted 3,721 cases of invasive breast cancer. The rate of new cases was 24% higher in smokers than in nonsmokers and 13% higher in former smokers than in nonsmokers.

The risk of invasive breast cancer was highest in women who began smoking at an earlier age. When compared to women who never smoked, those who started smoking before their first menstrual cycle had a 61% higher risk of breast cancer.

These studies highlight two important points:
1. A clear association between smoking and breast cancer
2. Increasing incidence of smoking among Indian women.

This increasing incidence could certainly be one of the contributing factors leading to a high incidence of breast cancer among urban Indian women. Another factor which has to be considered is ‘passive smoking’ which has not be studied in any trials.

During this Breast Cancer Awareness month, in addition to spreading awareness about breast cancer, we should also educate Indian women regarding the ill effects of smoking and it’s association with Breast cancer.

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Our Breast Cancer Counsellor – The Pink Crusader

Our Pink Crusader

Our Pink Crusader

Her true name is Mrs. Meera Raj, an English professor (ma’am – please forgive me for any grammatical errors 😉 ), breast cancer survivor and more importantly, a Breast Cancer Counsellor.

Her battle with cancer started 3 years back, when she was detected with breast cancer. She noticed a lump in her breast and got it evaluated from a surgeon, who confirmed her worst fears after conducting a biopsy. All of a sudden, her perfect life was jolted by this diagnosis and she was clueless about what the future had in store for her. After the initial shock, she came to terms with her diagnosis and outlined a plan for the future.

During her treatment, she felt the need for a person whom she could share her fears and apprehensions with but at that time she had no one to counsel her except her oncologist. Following her treatment, she took it as a challenge to help others suffering from Breast Cancer. She quit her job and did a course in Cancer Counselling in an effort to make a difference in the lives of others. Ever since that, she has not looked back. She joined the Department of Breast Oncology at Mazumdar Shaw Cancer Center as a Breast Counsellor and has been helping out patients suffering from this dreaded disease.

Her routine starts with interacting with the OPD and in-patients and telling them more about the disease and what to expect in the future. She shares her experience with them and that gives the patients strength to prepare for the battle ahead. She routinely visits the chemotherapy ward to give pep talk to the patients undergoing chemotherapy and also runs a Breast Cancer support group, which is growing day by day.

At Work

At Workin

We had carried out a study at Safdarjang Hospital on “The correlation of anxiety and depression levels with response to neoadjuvant chemotherapy in patients with breast cancer”, which was published in a reputed scientific journal and we had concluded that counselling and family support plays an important role in alleviating the anxiety & depression associated with cancer diagnosis in these patients. After joining the Breast Cancer Unit at Mazumdar Shaw Cancer Center and observing Meera ma’am dealing with the patients, I have come to the conclusion that it makes a huge difference in the patients attitude towards the disease if proper counselling is carried out. Breast counsellors (or Navigators) are a routine part of a Breast Unit in USA and UK but this is relatively new trend in India and only a couple of Breast Units in India currently have dedicated Breast Cancer Counsellors.

Mrs. Meera is an inspiration not only for the patients but also for all the doctors in the Breast Unit. Her enthusiasm towards the patients and her job pushes us further each day to help patients suffering from breast cancer. She is truly a “Pink Crusader.”