From Preparedness to Reality: A Survivor’s Perspective on Breast Cancer

There are two types of people: (a) those who meticulously plan every detail of their lives, and (b) those who plan only what is necessary and handle the rest as it comes.As someone who understands the importance of breast health, Carmen Loh conscientiously practices breast self-examination (BSE) and maintains her yearly scans. The nature of her job also meant she was financially prepared for any future eventualities.However, nothing could prepare her for the moment she received her breast cancer diagnosis. In this issue of Best Advice from women, for women, Carmen shares with us the importance of planning for contingencies, especially when you are healthy and symptom-free.What kind of breast health issue did you face? I was diagnosed with Stage 3 Inflammatory Breast Cancer in October 2022.How did you discover it? I started noticing some rashes on my left breast in September 2022, which I initially thought would disappear with some rash cream. However, the rash persisted and within the next 2-3 weeks, my left breast began to harden, reminding me of the time when I last breastfed my two daughters. Feeling uneasiness about these symptoms, I decided to schedule an appointment with a breast surgeon to clarify my doubts.What was your biggest revelation after you were diagnosed? The biggest revelation was realising that, despite yearly checks, having no family history of cancer, breastfeeding my two daughters and maintaining a healthy lifestyle with BMI 18, I actually knew nothing about breast cancer. Breast cancer was the last thing I ever thought would happen to me.What is one thing you wish you knew before you started treatment? I wished that I had been exposed to more real-life stories and journeys of cancer survivors, similar to mine, as it would have equipped me with more mental preparedness. Nevertheless, I’m grateful for the unwavering support from my doctors and team, who demonstrated remarkable patience, expertise and kindness throughout my journey.What has the journey of dealing with or managing this issue been like for you? Prior to receiving the results on 14 October 2022, I thought I was mentally prepared. However, when my doctor announced the results straight to my face, I was totally taken aback and overwhelmed with mixed emotions. The first thought that crossed my mind was “am I going to die soon, or how much more time do I have?” as my two girls were then 3 and 5 years old. I was absolutely clueless on what was coming next due to the fear of uncertainties that lay ahead of me. The journey has been a roller coaster due to the side effects of chemotherapy. However, I am managing well mentally and emotionally with the support from my loved ones, family and friends.Before this happened, what was your attitude toward breast health? I understood the importance of not taking breast health or overall health for granted.Did this journey change that attitude? No, it did not. This journey has reaffirmed what is still important e.g. to have regular breast checks, and also to have both medical and critical illness insurances so you can be well covered for medical bills in times of need. My financial burden was eased because I had such plans.What do you think women in general feel about breast health? I think there are a lot of myths and perceptions about breast health that women in general have. They do not really know enough to have themselves well-equipped with the knowledge of pre- and post-cancer situations e.g. family history risks, eating too much red meat, alcohol & smoking etc.What are your thoughts when it comes to general awareness/education in this area? I think we can do a lot more to educate and to help support more women so that they are more empowered if cancer happens to them, or to someone close to them. A lot more should be done in helping women emotionally and financially before cancer strikes, as there is very little that can be done after.What advice would you give women about breast health? All women should go for yearly checks, especially mammogram (choose 3D as less painful vs 2D) and constantly monitor themselves. Do not delay treatment if you have any symptoms and be mentally prepared, in case cancer happens, whether at an early or late stage. Always ensure you and your loved ones are well-covered financially by planning with a trusted financial consultant while you are still healthy and without any pre-existing conditions.Coincidentally, I am both an insurance agent and a breast cancer survivor. When diagnosed, reality can hit so badly that you wished you could live differently if given a second chance in life. People often say YOLO, You Only Live Once, but the truth is YODO, You Only Die Once, and you live every day! This applies to cancer as well; since it is a critical illness, you can only claim from insurance once upon diagnosis. As I am no longer eligible to buy such plans, I am on a mission to share my journey and help others while they still have the chance.Life is full of surprises and while there are many things beyond our control, we can still take the effort to equip ourselves with the knowledge and understanding of our own body and its changes. Consult a breast surgeon if you are unsure about any breast lumps, bumps or pain, or feel anything abnormal.
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Early Breast Cancer Detection: What Keeps Women from Getting Mammograms?

Nobody wants to deal with breast cancer, but detecting it early can make a big difference. Regular mammograms can help spot potential problems before they become serious. Yet, many women skip this very important screening. Why?1) Overwhelming Fear and StigmaIt is common to think a cancer diagnosis means a death sentence. Fears surrounding a diagnosis or treatment, combined with the stigma attached to cancer, often overshadow the importance of regular mammograms[1][2]  .Many also worry about potential treatment costs, social exclusion and the internalised shame associated with having breast cancer[1][3].There is also the misconception that recovery is impossible[3].It is important to remember that these feelings and fears are natural, and that everyone’s experience with cancer is different.2) Perceived Health and Breast Cancer MisconceptionsIn the 2022 National Population Health Survey, the leading reason women in Singapore aged 50 to 69 delayed getting mammograms was their belief that being healthy meant there was no need for screening[4]. The challenge however, is that some women diagnosed with breast cancer may not have any symptoms[5].The misconception that breast cancer only affects older women can cause younger women to neglect their breast health[6].While breast cancer risk does increase with age, it can still occur in younger women. It’s important for women of all ages to be aware of what’s normal for their breasts and to monitor for any changes. 27-year-old Tay Lautner, wife of actor Taylor Lautner, discovered a hard breast lump while showering[7].She took action by seeing a doctor and getting screened for cancer. No matter your age, keeping up with breast health is essential, as breast cancer can affect anyone.3) Balancing Health and Daily DemandsAnother common reason women skip screenings is because they are too busy[1].With work, family and everyday responsibilities, it can be tough to find the time. Even caring for children takes priority over scheduling mammograms.With these many reasons, some women delay getting their breast lumps checked even after feeling them in their breast. While some breast lumps are not cancerous and may even go away on their own, others worsen over time[8].You never know for sure until you see a doctor.Benefits of Being Breast AwareBreast cancer is the most common cancer among Singaporean women, with cases rising more than threefold to 74 cases per 100,000 population[9].Understanding what is normal for your breasts can help you notice changes earlier, allowing you to address issues before they get worse.Scheduling screenings such as mammograms is key because catching the cancer early—when it is still small and has not spread—can improve treatment outcomes[5].Early screenings can also improve your chances of survival. Studies show that annual mammogram screenings can reduce breast cancer mortality by approximately 41%[10].While self-examinations can help you spot changes in your breast or nipples, mammograms should not be overlooked. Mammography can help detect cancer before any symptoms show up, when the cancer is too small to even see or feel[5][11].How to Make the Most of Your AppointmentNaturally, going to the doctor can be overwhelming and anxiety-inducing, especially if you are there for cancer screening.Here are some simple steps to help make the experience less daunting and ensure you get the support you need[12].If you have symptoms, jot them down before your appointment. Note when they started, when they happen and how often they occur. Let your doctor know if you are worried about cancer or if you have a family history of it. Do not hesitate to ask your doctor for clarification on anything you find confusing. Having a friend or family member with you can provide much-needed comfort.  They can help you take notes or ask questions too. Empower Yourself and Embrace Breast HealthBreaking down breast cancer myths and encouraging open conversations can help women feel less hesitant about getting a mammogram. Highlighting the potential for better outcomes with early treatment can shift perceptions and boost breast health awareness.The Ministry of Health Singapore reports that breast screening rates are around 50% for women with higher education and 28% for women with primary education[13].Regular breast self-examinations and screenings are crucial for staying on top of breast cancer. It is not just about being aware—it is about taking proactive steps to monitor your breast health effectively.Show your breast friends you care—book a mammogram appointment and encourage others to do the same. Remember, early detection saves lives.References[1] A review of barriers and facilitators to mammography in Asian women[2] Barriers to early presentation of self-discovered breast cancer in Singapore and Malaysia: a qualitative multicentre study[3] Determination of the Association between Perceived Stigma and Delay in Help-Seeking Behavior of Women with Breast Cancer[4] Ministry of Health Singapore, National Population Health Survey 2022[5] Cancer Research UK, Symptoms of Breast Cancer[6] National Breast Cancer Foundation Inc., Myth: Breast cancer only affects middle-aged or older women[7] E News, Taylor Lautner’s Wife Tay Lautner Shares Breast Cancer Scare[8] National Breast Cancer Foundation Inc., Myth: Finding a lump in your breast means you have breast cancer[9] Health Promotion Board, Singapore Cancer Registry Annual Report 2021[10] Outcomes of Breast Cancer Screening Strategies Based on Cancer Intervention Surveillance Modeling Network Estimates[11] American Cancer Society, Breast Cancer Signs and Symptoms [12] Cancer Research UK, Seeing your GP when you have symptoms of breast cancer[13] Ministry of Health Singapore, Screening Rate for Breast Cancer
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