Dr Rajendra Rampaul
The Breast and Oncoplastic Clinic
October is upon us, and as usual the air is abuzz with all of the initiatives and charity events that help to raise the focus on looking after breast cancer and supporting those who have been affected by it–women and, to a very small degree, men. There is so much that needs to be done to win this fight against cancer and to help a life afflicted by this devastating disease become whole again. Our women continue to be plagued by the fear that they would develop breast cancer, or worry that they would not be able to get adequate care. We live in an environment where not all centres provide the best quality of care; often, I see patients seeking second opinions for misdiagnosis or even incorrect surgery. This continues to be a worry amongst us.
More women getting it–and at a younger age
On a global scale, it is a worry that breast cancer is increasing; more and more women are being affected at younger ages. The 2012 World Breast Cancer report shows that in the Caribbean, and Trinidad in particular, breast cancer is on the rise and our women are affected with the more aggressive disease. There is no doubt that there is a familial trait, and we are now seeing more and more families telling stories about their sister, mother, cousin or aunt who has had breast cancer.The recently concluded Scotiabank 5K run was a phenomenal success. It was all female and they were all there, sisters in arms holding each other and supporting each other through their difficult battle.
Men in the shadows
As I looked on, I could see at the sidelines the "men against breast cancer" sitting in the shadows, supporting the women they love, the ones that look after the home, support the children and help make their lives and their day complete. They were either proud they could be there–or missing, wishing and crying for the ones they had lost to breast cancer.That's when I came across a very profound article championing these shadows in the mist: the men who hold the hands of their loved ones, their mothers, their sisters, their wives, and see them through the diagnosis of the treatment.
Learning to help their women
Men against breast cancer is an increasing and growing body. As men, we have to become aware of what it is to support our loved ones when they are terrified after finding a breast lump or when they are going for a screening mammogram, even if the result is not good. Going through breast cancer surgery can be devastating and humiliating; for some, it could be impossible. Women who have been told that they must have a mastectomy become worried and fearful, not only about how they will dress and face the public but about when they undress. How will they face their husband? This is worse than a scar on the face. How will I make love to him? Will he move to one side? Will he forget that I am a whole woman and treat me like a half?
And so as men, we must embrace this. Embrace that we have to support the complexities of these difficult times.Going through breast reconstruction is a difficult journey, because rebuilding something that is meant to be an embodiment of your womanhood, an embodiment of sexual attraction, can be a very difficult process. Helping men to understand reconstruction, implants, autologous flaps, a tummy tuck operation or even using fat to rebuild your breast–these are difficult things.
Emotional breakdowns
Patients come in to our practice and often have emotional breakdowns because they are unable to relate to their husband or their husband is unable to relate to them. Their sexual intimacy decreases, and their support–emotional, moral and otherwise–takes a precipitous decline. Whilst family support is there, this takes an often difficult turn.
Going through chemotherapy can be extremely difficult. When women have the side effects and other symptoms, men are being asked to nurse their wives, nurse their mothers–though they have been given no tuition or support.
Support is crucial
It is important that as a community and as a nation, as we look to support our women who have been affected by breast cancer, we must look to our men as well.As clinicians and practitioners we have to be able to understand that the male partners with the female, that the husband partners with the wife to be able to produce a breast cancer survivor that is far stronger and better than if she was alone. It would be ideal if we start to provide access to education and access to family support so that more and more patients who have to go through this dreaded disease re-emerge as a whole and the family also re-emerges as a whole. Men against breast cancer is an opportunity for us to be able to look at dealing with this in a holistic way.