Breast cancer continues to account for the highest figures in terms of incidence and mortality in T&T.
Dr Steven Allen, consulting radiologist with the Pink Hibiscus Breast Health Specialist, and chairman of the Breast Multidisciplinary team at the Royal Marsden Hospital in England said breast cancer cases are increasing in first world countries in stark contrast to the disease being almost non-existent in third-world countries.
Speaking to Guardian Media before he gave his keynote address at Pink Hibiscus's third breast cancer symposium at the Guardian Group Corporate Centre, Westmoorings, recently, Allen said,
"Unfortunately breast cancer is increasing and we're detecting more of it. It's increasing as an entity itself because of our western lifestyle, women having children later in life, fewer children when out at work, less time to breastfeed, perhaps a bit more overweight as a population, drinking more alcohol.
"All these factors are small, but over a population, it means breast cancer is ticking up gradually each year. The total opposite is happening in poorer African countries where breast cancer is almost non-existent."
He said the reason for that was the women in those countries started bearing children at a very early age, breastfed throughout the fertile period of their lives, were not overweight, did not drink alcohol, engaged in more physical activity, walked more and provided for their family.
Allen said over 50,000 women a year were diagnosed with breast cancer in the UK, out of a population of 33.46 million women, one in eight had a lifetime risk, it increased with age, as women got older they were more likely to get breast cancer.
Allen said women under 40 were not so much of a problem but the risk did start to go up from that age.
He said between the ages of 40 to 50 was a bit of a danger area because the risk increased quite quickly and cancer, unfortunately, was quite aggressive and a slightly different screening programme was needed for those women.
Allen, speaking about advancements in the field of medicine such as the treatment of HIV, said "HIV thankfully has been the success story in medicine in the last couple of decades. The modern medications allow just a single tablet that could control the disease for many decades. So much so that conditions such as diabetes are more dangerous than HIV if you're treated in a poorer part of the world with a not so efficient health care system."
Regarding increased detection rates and the advancement in technology and medicine for treating breast cancer, Allen said they were evolving.
He said the modern mammogram machines were limited a bit but were much better than the old-fashioned mammograms which printed up films.
Allen said further advancements were coming in the area of imaging, such as giving injection-based mammograms. He said in certain cases they can inject dye into a mammogram. There are also computer-assisted detection (CAD), MRIs (magnetic resonance imaging) and Thermography.
He cautioned that the breast cannot take too many mammograms when women are 40 or older, however, it was a very safe thing to do for the majority to save lives.
Allen said T&T had the best equipment available for breast cancer diagnosis, what was needed was people to be more aware of when to come for screening, there were a few downsides but more upsides that can save a life.
Dr Rajendra Rampaul, oncoplastic surgeon and medical director of Pink Hibiscus said breast cancer was overwhelmingly the most common cancer in T&T, far ahead than cervical cancer.
He said the flip side of this was there were medications and treatment for the disease which enabled women to live longer lives.
Rampaul said the number of women who reached Stage 4 of the disease was about two to three per cent in the UK, while in T&T it was about 12-15 per cent.
He said this was a combination of not having an aggressive screening culture, no national funding, and cultural barriers in T&T.
Rampaul said the perception of one in four or five women was that she will feel a suspicious lump, hope it will go away and waver between she heard really bad stories versus she was too young for this to occur.