Indian American Oncologists Educate Community on Breast Cancer Risks and Prevention at IACAN
By Mika Rao Kalapatapu
SUGAR LAND: On Saturday, September 29, Meena’s Udipi Café Sugar Land was filled by nearly 100 community members interested in learning more about the prevention and treatment of breast cancer. The event was hosted by the Indian American Cancer Network (IACAN) a 501(c)(3) organization in Houston and made possible through the Susan G. Komen Foundation’s support in Houston. IACAN was founded in 2009 with a mission to promote cancer awareness and to support Indian Americans affected by the disease. The featured presenters were breast oncologists Julie Nangia, MD and Polly Niravath, MD, both assistant professors with the Lester and Sue Smith Breast Center at Baylor College of Medicine in The Medical Center. The event was timed with breast cancer awareness month, typically observed in October each year.
IACAN Board member and Houston-native Dr. Nangia kicked off the presentation with a look at the statistics. “One in eight women will be diagnosed with breast cancer,” she shared. “Contrary to what many believe, those numbers are equally high among Indians in America. In other words, as we have adapted to this culture, we are seeing the same level of risk of breast cancer as the general population.” Dr. Nangia shared an estimate that, in 2012, 226,870 women in the United States will be diagnosed with breast cancer. She discussed the risk factors that may predispose some women to breast cancer. These include being identified as carrying the BRCA-1 gene – which can be carried by either a patient’s father or mother. “Often, we believe that we inherit breast cancer only from our mother, aunts, and sisters,” shared Dr. Nangia. “In fact, it is important to look at the father’s side of the family as well since men can also be silent carriers.”
Dr. Nangia was quick to point out that only five to ten percent of breast cancer cases are linked to the BRCA-1 gene. The vast majority of cases occur in women with no prior family history. “We know that both environment and genetics play a role in who develops cancer,” she said. “Lifestyle changes and avoiding carcinogens can significantly decrease a woman’s risk of breast cancer,” she shared. “We recommend exercising three to five hours per week.” She went on to explain this can be accomplished easily with just a thirty minute walk daily. “Exercise decreases breast cancer risk by decreasing estrogen levels in the body.” An audience member asked if vegetarians can expect to be at lower risk for developing breast cancer. Dr. Nangia and the other oncologists clarified that studies do show that vegetarians may be less likely to develop breast cancer but these studies include vegetarians who also tend to be more health conscious in general. However, in the Indian culture, being a vegetarian often includes a diet high in fat and calories – leading to obesity – which would not help lower the risk of developing cancer.
Other factors that influence one’s risk of developing breast cancer include early onset of menses, and the number of years a woman has taken hormone replacement therapy. Dr. Nangia pointed to studies which report that women who are off HRTs for three years or more can neutralize any additional risks associated with taking the hormone. She also pointed out that breast-feeding has been proven to have beneficial effects on reducing the risk of breast cancer. For every 12 months a mother breastfeeds a child, her risk is reduced by 4.5 percent.
Next, Dr. Niravath shared information with the audience on screening techniques and survivorship. “Many women delay or avoid mammograms because they find them scary or uncomfortable,” she stated. “However, very often we can detect cancer through mammograms so early that it does not require the patient to undergo chemotherapy or radiation.” For this reason, Dr. Niravath implored the audience to commit to regular screenings. Women should do monthly self-exams beginning at age 20 and then have yearly mammograms starting at age 40. Women without health insurance can still receive mammograms at little or no cost. In Houston, the non-profit organization, The Rose offers mammograms for $100 or free if family income is low. Clinical exams by a physician should also be done on a yearly basis. For women with two or more female relatives on the same side of the family who have developed breast or ovarian cancer, it is recommended that a risk assessment be performed by a medical oncologist. These are typically covered by insurance.
Dr. Niravath described the steps in the process of breast cancer diagnosis. After the biopsy, depending on the size of the tumor, the surgeon will perform a lumpectomy or mastectomy. Lymph nodes in the axilla (armpit area) will be evaluated to determine if the cancer has spread. Lastly, breast reconstruction is a consideration and can be done either utilizing implants or the patient’s own tissue. “Today, thanks to early detection and improved treatment options, the survival rate for breast cancer patients in the United States is 90 percent,” shared Dr. Niravath. “Studies have repeatedly shown that breast cancer survivors with a solid support system have improved outcomes compared to those without a network,” she said, “The Indian community tends to hide news of a diagnosis but it is very important for women battling breast cancer to lean on others during their treatment.” The IACAN breast cancer support group is one forum for survivors to find fellowship, information and understanding.
Following the presentation, IACAN guests were treated to a complimentary lunch and an informal opportunity to interact with the health experts in the room. “We are very pleased with the turnout today,” shared Dr. Sewa Legha, Houston oncologist and IACAN Vice President. “These two presenters represent the new generation of Indian American physicians – they are born and raised in this country. Our community is very proud of their accomplishments and IACAN is grateful for their commitment to helping and healing those with this disease,” he added.
October marks breast cancer awareness month. To learn more about the disease, visit www.komen-houston.org. For more infromation about IACAN, visit www.iacannetwork.org.