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00:00Breast cancer is one of the most talked about diseases in the world, but for many women,
00:04it is a conversation filled with fear, confusion, or even silence.
00:07Today, we're joined by someone who has dedicated her career to changing that.
00:11Dr. Aida Al-Awadi is a medical consultant oncologist,
00:15scientific committee chairperson at Amherst Oncology Society,
00:19specializing in breast cancer and sarcoma.
00:21And she joins us today to talk about awareness, early detection, treatment,
00:25and why conversations like this matter more than ever.
00:29Dr. Aida Al-Awadi, thank you so much for being with us here today.
00:31Thank you so much for having me.
00:33Thank you so much for allowing me to be in this platform.
00:36I think talking about breast cancer is very important.
00:39The prevalence worldwide is increasing,
00:40and I think we have to talk about it beyond the month of October,
00:44raise awareness, early detection, and save lives.
00:47Like you were saying, breast cancer has grown a lot over the years.
00:50But from your perspective, what are people still getting wrong about this disease?
00:55Yeah, so there's a lot of different misconceptions that we hear from the community.
00:59For example, breast cancer would only affect older women
01:04or those with a family history of breast cancer.
01:07But in fact, it can affect women at any age.
01:12We see it more in older patients,
01:14but we've seen cases in their 20s, 30s, 40s.
01:19So I think it can happen at any age.
01:21The prevalence is higher when it's beyond 40 years of age,
01:25but we still see cases in their 30s and 20s.
01:27So women have to be vigilant about any changes in their breast
01:31and seek medical attention as soon as possible.
01:33Also, a lot of patients that are diagnosed with breast cancer,
01:37a lot of women diagnosed with breast cancer,
01:39do not have family history of breast cancer.
01:42So this is one misconception.
01:44The other one is that breast cancer is a single disease,
01:46but it's a different disease that behaves differently,
01:50different risk factors, different treatment paradigm.
01:53Some cancers are more aggressive and rapidly evolving,
01:57and other cancers are more treatable with higher cure rates.
02:00Another misconception is that breast cancer is associated with fear,
02:03hopelessness, death sentence.
02:06But that's not true because with advances in screening options,
02:12technologies, medications, including targeted therapy,
02:15immunotherapy, even personalized cancer treatment,
02:19the cure rate has improved significantly,
02:21and the outcome has changed to be more positive.
02:27And a lot of patients are cured, treated,
02:30and being an effective part of the community.
02:34Well, you were saying that breast cancer, you know, happens to all ages.
02:39We always had, you know, maybe this misconception that it only happens to older people,
02:45or, I mean, people at a later stage in life, you know, so, I mean, women.
02:50Could you tell us more about this?
02:51Like, have you seen any cases that are, you know, people, younger women?
02:55So, it's very important to note that breast cancer,
03:01a diagnosis in women at younger age in our region,
03:06actually the median age of diagnosis is 10 years younger than that we see in the Western population.
03:12Wow.
03:12So, it's very important to understand this.
03:15And we, in fact, see patients, I mean, it's not the common scenario,
03:19but we've still seen patients in their 20s and their 30s.
03:23We don't know the exact reason, but it could be hereditary,
03:26like a BRCA1 or 2 mutation that can happen in 10 to 15% of all cancer cases.
03:31It could be multifactorial, like different factors,
03:35but it's very interesting to see that younger patients are being diagnosed with breast cancer
03:40and something that we need to know more about and to be prepared for.
03:45And why do you think that is, like, why is it 10 years younger than, you know, the Western?
03:51Is there any specific reason?
03:53I don't know the exact or the direct reason,
03:55but I'm sure that genetics, environmental factors may play a big role in this.
04:03Again, as I mentioned, that about 10 to 15% of all cancer cases are hereditary.
04:08They carry these genetic mutations, most commonly BRCA1 and BRCA2.
04:13But then again, there are younger patients with no genetics mutations,
04:18and there could be other reasons, including other risk factors.
04:24Have you personally noticed any changes in screening habits or awareness in women in recent years?
04:30Absolutely.
04:31So compared to 10 years ago, I see, like, more women are being screened and more early detection.
04:36That's very important because we get also a lot of women to our clinic asking us the questions,
04:43requesting to be screened.
04:45So that's something very good, and we are anticipating to see more of those.
04:50And I think that is basically due to awareness campaigns, social media, you know,
04:56and the survivors' stories.
04:57And that's very important, you know, to get it out there
05:01because it will basically help normalizing the conversation.
05:05But still, there's a lot of work to be done because there are still women who fear screening.
05:11They don't want to be screened because they fear the bad news.
05:15But I tell them, and I all the time tell them that delaying screening does not prevent cancer,
05:24but rather delay the diagnosis, which can lead to poor outcomes.
05:28We hear the phrase, early detection saves lives.
05:31But medically, how much of a difference does early detection actually make?
05:35So it makes a tremendous difference, and it indeed saves lives.
05:40Early detection, meaning that I'm catching the cancer before any signs or symptoms,
05:47before actually the woman can feel it.
05:49So that's very important because we caught in that stage.
05:52Treatments are usually very simple.
05:54Multiple surgeries are less likely that we're going to remove the full breast,
05:58but rather just that part where the abnormality is,
06:02and less chances for intense chemotherapy or chemotherapy at all,
06:07and higher chances for cure.
06:10So that's very important because awareness of early detection,
06:14doing the proper screening is very important because it can save life.
06:19What are the current screening recommendations women in the UAE should know about?
06:23So the screening recommendation in the UAE is for average-risk women to start a mammogram
06:29at the age of 40 and every two years.
06:31But those obviously with higher risk, like for example,
06:35if they have hereditary genetic mutations in BRCA1 or BRCA2,
06:38they have higher chances of getting breast cancer.
06:41So we may recommend to start a screening earlier,
06:45and maybe not only with mammogram, but to add different modalities as well.
06:49We also recommend a female to be aware of their bodies to do their regular checkups,
06:55and if they felt any changes, to immediately seek medical attention.
07:00Now, most of the changes are benign,
07:02but I would still recommend seeking medical attention for unusual changes that happens to the breast.
07:10Do you think there are any symptoms or warning signs that women usually tend to ignore?
07:15Yes, there are many of them, and we have to be aware of these changes in the breast
07:20that may indicate breast cancer.
07:22It could be a lump in the breast.
07:23It could be changes in the skin, color or texture,
07:28sometimes petting on the skin that is new,
07:31changes in the nipple that can be pulled inward,
07:34or bloody or unusual discharge from the nipple.
07:37So these are the usual signs of breast cancer.
07:45A lot of time, some benign condition can overlap with these symptoms,
07:51and that's why it's very important to seek proper medical attention,
07:54to be checked, to be diagnosed properly.
07:59A lot of patients also sometimes delay seeking medical attention
08:03because they assume that this is because of hormonal changes.
08:07But that can be true, but still, I would encourage them to seek medical attention
08:13because if there is one percent chance that it could be cancer,
08:16then you want to diagnose it properly and treat it properly as well.
08:20Our body always gives us signs.
08:22I mean, if you have a headache or if you have continuous headaches,
08:25if you have something hurting you,
08:28I feel like this is your body's chance of giving you a sign.
08:31So there are two important things that I need to mention.
08:34Sometimes breast cancer can appear as a redness in the skin,
08:37inflammation in the skin, without underlying lump or mass.
08:40So that's very important because if that was the case,
08:45it could be inflammatory breast cancer,
08:47which is a rare and aggressive type of breast cancer that needs prompt treatment.
08:51So that's very important to be aware of.
08:54Second of all, although it's rare,
08:56we get sometimes breast cancer in pregnant patients.
08:59It's very rare, but we've seen it.
09:02Unfortunately, a lot of time it's a delayed diagnosis
09:05because they assume these changes are related to hormonal changes related to pregnancy.
09:10So for all pregnant women,
09:12if you've noticed any persistent changes in your breasts
09:16and it's not getting better,
09:19definitely seek medical attention and you don't want to ignore that.
09:23We see in many communities that breast cancer
09:25is a difficult topic to openly discuss.
09:28Why do you think the stigma still exists?
09:31Unfortunately, breast cancer is still associated with fear.
09:36The women feel that if she is being judged because of this
09:41or a burden on her family,
09:43sometimes they are concerned that they will be looked at differently
09:47by family members, by friends.
09:50Sometimes it's associated with loss of femininity
09:54or even some hopelessness.
09:58On rare occasion, we've seen some patients saying that it may be contagious,
10:01but that's not true at all.
10:02It's not contagious.
10:03It does not spread.
10:06But silence is dangerous.
10:07We need to talk more about it.
10:09We need to normalize the conversation,
10:13to empower more women to seek medical attention as soon as possible.
10:17So for me, awareness is not just by detection, early screening,
10:23but also to break the cultural factors that may prevent the patient
10:30to go and seek medical attention or do the early screenings.
10:35How important would you say are family support
10:37and open conversations when it comes to a patient's journey?
10:40Family being part of the journey is very important
10:44because the journey is not only physical, it's emotional, it's psychological, it's social.
10:49So it's very important to see a family member or members being part of that journey
10:55to provide support, reassurance.
10:57And we know that when a family member is there to support the patient,
11:01that treatment usually goes very easy
11:04and they cope better with it, both emotionally and practically as well.
11:09And sometimes, you know, the support that the patient needs
11:14is not advice and recommendation, eat this, stop doing this or that,
11:19but rather reassurance, emotional support, listening, acknowledging her fears
11:24and even be there to listen to her when she has concerns.
11:30So that, I think, is very important.
11:32And most importantly is not to judge.
11:36Like, you got breast cancer because of this, because you did not do this, you did not do that.
11:40That's a very dangerous thing to do.
11:42And I think just be there, listen, reassure and support emotionally.
11:48That means a lot.
11:50Sometimes it's not about, like, recommendation, eat this, do this or that,
11:53but just simply as, it's okay, I'm here for you.
11:57You can, you know, count on me whenever you want.
12:00Some patients, they have the stigma of not telling their family
12:03and they just want to go through it alone, but it's a very difficult journey.
12:07I mean, they need that support to relieve some of the stress going on during the treatment.
12:15One thing mentioned often is people always say,
12:19fear the disease, not the treatment.
12:21What does that really mean?
12:22To me, it means that delaying treatment out of fear
12:26is more dangerous than the treatment itself.
12:29So many patients or women, you know, imagine that the treatment and the side effects
12:35as many, many decades ago.
12:37Things has changed since things has improved.
12:40No low breast cancer patient would need chemotherapy.
12:43Not all of them will lose their hair.
12:46And a lot of time we can count on, like, targeted therapies, you know, and hormonal therapies.
12:52And I think even chemotherapy, if they needed chemotherapy,
12:56the side effect is much better manageable with supportive medications.
13:01And even with the hair loss thing, now we provide cooling caps to the patient to prevent
13:08hearing loss.
13:09And that's very important because it maintains the patient's satisfaction and even a comfort
13:16level and psychological, you know, tolerance to the treatment.
13:19So for us, it's not about just treating the patient, but also preserving their quality of life.
13:24Treatment today has evolved so much.
13:27What advances in breast cancer gives you the most hope right now?
13:30Yes, so there's been a tremendous advances in the treatment of breast cancer.
13:34We talk all about personalization and not one size fits all.
13:38So that's very important because we need to understand the biology of the disease
13:42and then tailor the treatment towards that biology.
13:45There has been an improvement in terms of the modalities of treatment.
13:51Now we use more immunotherapies, targeted medications for certain types of breast cancer,
13:56and even hormonal therapies.
13:57Now we have a much more targeted option that would make it more effective in terms of outcomes
14:08and treatment outcome.
14:10So that's very important to know.
14:14And I think we attend conferences, you know, on like on a yearly basis, many different conferences.
14:21And we see the huge advancement.
14:23And I think it does not end there.
14:25There are more and more things that are coming in the future that can increase hope and increase
14:32the cure rate as well.
14:33Even in those patients with a stage 4 disease, when the cancer has spread already to different
14:38parts of the body, usually we say that the treatment is for lifelong and with palliative
14:43intent.
14:44But in fact, with the advancement of treatment, a lot of patients living on this treatment for
14:49a long, long time with also good quality of life.
14:53So that's very important to highlight.
14:54So for someone who has been avoiding a difficult conversation or a screening about their health,
15:01what would you tell them today?
15:03I would say it gently, but honestly, the sooner you face it, the more options and hope you have.
15:08And we have a lot of patients when they do their screening, they come back to us afterwards
15:13and they say, we wish we had done it earlier.
15:15So I think you should take this step.
15:18It's very important.
15:20It's for you, for your loved ones, for your family.
15:23Finally, if there's one message you wish every woman listening to this conversation, remember,
15:29what would it be?
15:30Yeah, absolutely.
15:31So do not let fear delay you.
15:34Your life matters.
15:36Your health matters.
15:37Early detection saves lives.
15:40And seeking help early is actually an act of strength and not fear.
15:44Dr. Aida, thank you so much for being here with us today and informing us and telling us,
15:50educating us more about this very important disease and very important to know more about
15:56the treatments, about, you know, early detections, how important it is.
16:00And, you know, it's, it was great to have you here.
16:03Likewise.
16:04Thank you so much.
16:04I enjoyed the conversation and I hope that it spreads out there and we continue to save lives.
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