 Breast cancer is now the, I think it's one of the most rampant cancer in what's it called, in, especially in the world, not just unique to Nigeria, because they say that 2.26 million cases were diagnosed rather in 2020. It is also the most common cancer amongst women in both developed and developing countries. Given it a major public health concern, now breast cancer was rare in Nigeria in the past, but it is now increasing due to urbanization and lifestyle change, and is now the leading cause of cancer, especially cancer related deaths in Nigeria, accounting for about 23% of all cancer cases and 18% of cancer death. Now in most cases breast cancer is often diagnosed at the late stage in Nigerian women, which reduces their chances for survival. Nigerian women are also more likely to be diagnosed with triple negative breast cancer that can, than women of European ancestry, and they tend to be diagnosed at much younger age. Because of the late diagnosis, the only treatment option available are expensive procedures which many Nigerian women cannot afford. So today we're asking how can, or how do we do better with breast cancer awareness in Nigeria, and what is the importance of early detection. Now let's hear what you have to say. Remember you can join the conversation, send us an SMS or WhatsApp to the rate 1-803-4663. All right, so quickly, when last did you check for, like, screen your breast? I'm by hospital. When last I know you? I think the last time I checked myself for any signs or any giveaways, that was last week. You callin' girl. It was breast cancer awareness and I'd seen one video and I was really scared. Are you serious? Let me take, let me confess, let me confess. Because the blessing don't reach, like, last year or two years ago. But somehow, right in the bathroom, I tried to do those quick, you know, check with your forefingers, kind of, round the breast, round the nipple, press the nipple. But that was what I did last week. Aunty. It wasn't the hospital. I'm talking about hospital screenings. See me giving you free accolades. Let me bring in our guest. Dr. Odinuala is a medical doctor and social entrepreneur with cogent experiences in advocacy, teamwork, and strategic planning. She's a TEDx speaker with years of experience in advocacy and health, media, and communication. She is a team lead of the Health City, a social enterprise that provides young people with preventive health information and services via their website, the healthcityonline.com. And several other projects, both online and physical. She also founded Panacea First Aid Services, a social enterprise that provides first aid medical services and training. And she is with us in studio looking all fly with her lovely smile. Hi, doc. Hi. We love it when we have doctors here because trust me, it's not easy to find people. People are always busy, busy, busy. Well, thank you so much for making our time to discuss breast cancer with us. Thank you so much for having me. It's a pleasure to be here. Okay. So, first of all, the question I asked Jennifer, how was the frequency that women should, like when it comes to checking or just trying to check your breast and all that, how often should you check, you know, for breast cancer? So, I will first start with, in the past, we used to talk about self-breast exam, right? I know that you guys were talking about earlier, it's crazy. But now, we've moved past that to self-breast awareness, right? So, it's not just routine checking, like maybe every other week or every other two weeks, but now it has moved on to awareness, right? So, most women would not even know that, in most women, that one breast is bigger than the other. So, it's maybe when they are pregnant and their breasts are really heavy and there's a chain and they're like, what's happening here? So, some women, they don't, if you take a picture of their breasts and really they don't know, and then you send it to them and they're like, no, this isn't right. This isn't my breast. Right? So, we moved from that exam to self-awareness. You know what your breasts look like. So, that when does it change? You are able to, you know, not just, you know, the breast size and consistency changes throughout the sac, the menstrual cycle, right? And some women have fuller breasts when they're on their period, with a PMS, like painful breast swelling. So, if you are aware of what your breast looks like, feels like normally, if there's any little change, you are able to, you know, pick it up, like, there's a change in the skin colors, getting your nipple as being infected. Some of, some signs of breast cancer, you're able to pick it up. Not all changes are cancerous, of course, right? Some women have lumps in their 20s. And it's not manigula, because my sister actually had a lump. But by the time we were panicked and everything, they took it out and they did the test. It was not cancerous. So, let's talk this issue about heaviness of the breast, right? As a woman gets older, so there are so many things I never used to feel when I was, like, when my monthly cycle comes. But this, for the past, I think, three, four years now, whenever my period is coming, it's from my breast. Like, it is extremely painful and heavy, you know, it's very hurting. Like, it's so sensitive that you can't touch it. So, are these, like, normal? Or is something that I need to be concerned about that I need to be checking? Because it's something that never happened to me. When people are talking about menstrual, this thing, it just comes and it goes. I don't feel nothing, no waist pain, no nothing. So, for the past, I think three years now, you know, whenever, like, literally, I feel like you can boil egg with this, you can eat that comes out of my breast. Like, it's hot. I don't know whether you're feeling the same thing, but it's very hot. You feel the temperature that it's different from my body temperature. Extremely hot, extremely heavy. So, is this something that I should be concerned about to check it or it's just okay that my hormones have changed? Well, I would say this that PMS comes in waves. It comes in, it comes in several waves. So, there was a trend that I showed on Twitter just related to common people's breasts and stuff. Some women were talking about how, when they were in their 20s, they never had menstrual pain, you know, do you have any pain at all? And then, sometimes they eat 25 or 26. They started having it all of a sudden. And some women would talk about having anal pain. Rectal pain, yes. PMS also can cause rectal pain. Some people start talking about bloating. So, PMS comes in waves. As long as you're a woman, you're menstruating. The symptoms you've never had before, you might grow older and then have them. Some women that have dysmenorrhea, that's really painful. Abdominal pain during periods. Sometimes when they have children, they realize that it stops. So, it comes in waves. Your body is not static, it's dynamic. And for the heaviness of breasts, a lot of women feel really heavy. Where it's painful. And it has to do with the hormonal changes that are going through the body. What is going through. But even, and it has been happy for three years, as he said. I think the part where it becomes a concern is if it's impairing your quality of life in that period. Because we expect that by the time your period is over, it happens in a couple of days to your period. It's like two weeks before the period. So even before the period comes, the pain stops. And everything goes back. It relieves, yeah. Yeah, baby. Are you with me or are we not? I mean concerning heaviness, it was when I was younger. I think breast heaviness for me became minimal. That was two, three years ago. But then recently, I don't experience. I don't experience that. I know it gets heavy, but then it's not as heavy as it used to be. And it's not as painful as it used to be. And even my cramps, the pain has also reduced. That sometimes I don't even know. I mean, I can check my calendar and know that, oh, I'm supposed to experience, I'm supposed to have my period in the next few days. Or it's supposed to start today. So I don't even know until it has started. Then the pain starts. But then sometimes the pain is non-existent. It's not as painful. But what I want to ask is, so bringing it back to breast cancer. I know there's so many signs that doctors have put out there. It's all over the internet. But if you can shed more light into some of these things that we need to take note of. So in case you notice something, I mean, sometimes people might not necessarily be so aware to do the checks. So let's say I didn't do the check. And I just woke up one day. The problem I'm about to show, I look in the mirror. What are those easy telltale signs, right? That should get me a bit worried or I need to go to the hospital and get proper screening done. Okay. So I would first like to start with that. Most breast cancers are asymptomatic. You don't have to feel alone for there to be breast cancer. Some women, the lump isn't there. But maybe they go for mammography. You know, mammographies will get them. Mammograms are for women over 14. Maybe they go for mammograms. There's no lump. You can't feel anything. But the mammogram picks it up that there's a cancer there. So you don't have to feel alone for there to be cancer. Just to start with. And most women feel like if the lump is hard and painful, that's when it is cancerous. Pain and only like 5% of people with breast cancer presents with a painful lump, like very minute numbers. So it's not like you have like a hard painful lump. Do you have breast cancer? So, well, if there is a lump, obviously, go get it checked out, right? And not just lump in the breast. Lump in the axilla of the armpits and lump in the area above the chest. So if you feel lumps in those places, please go and see your doctor. And also for the skin on the breast itself, it could be, you can, if you notice any redness and there's no normal skin change, sometimes if the skin, the skin around the breast is like, your normal skin can be red, if you have like a skin reaction or something. But if the redness is persisting or the skin is becoming ticker, it's becoming harder, those are some of the signs that you can look out for. Also the nipple, if the nipple goes inside, like the nipple is supposed to be outside and that's not the way your breast is. The nipple is inverted, if you are coming back or you have bloody discharge from the nipple, please, those are some of the signs that you can see. And there's something they call pure dirange, like orange peel appearance of the skin. So it's like the skin of an orange. There's dimpling all over the skin of the breast too. Those are some of the signs that... I feel like I'm cleaning my chest to look a little better. Those are some of the signs that women can look out for. So I mean, it's quite interesting or you know what, let's take a very short break when we come back from the break, we'll continue this conversation. Stay with us. Alright, thanks for staying with us. Now if you're just tuned in, this is truly for the ladies. And men too, because men is important that you pay attention to your partner's breast. Breast cancer awareness and importance of early detection is what we're discussing and we have with us Dr. Odunola. Now please, let's hear what you have to say. Remember you can join the conversation, 1-800-384-663. Now the reason I said men is because men, some men cannot see breast and close their eyes. So whilst you are in that your comfort zone doing the do in the other room, it would be nice that you also pay attention to your partner's breast and all of that. Also it's important to mention at this point that men can also have breast cancer. I was going to ask that. I've actually heard that. How common is breast cancer for men? Should I say rare? It's becoming commoner but it's still rare compared to women. So if 100% of people with breast cancer year, 95% of them would obviously be women. But 5% of them would be men. So there is a chance. Does this have anything to do with the men that are big? Because those are people that have tissues in the breast. Men that have a big breast is called gynecomastia. But it's not necessarily a precursor to breast cancer. Obesity is a risk factor for breast cancer in women but not necessarily a risk factor in them. But if men that have breast but they have gynecomastia is in a medical condition they should just go and remove it. What do they need this for? No, it's true now. Going back to breast cancer because we're talking about early detection because you see some of the signs that you mentioned from the little knowledge I understand is that those are like advanced stages. When you start having the discharge from your nipple and the blood and all of those things is that not too late? Is there any kind of like hope for someone when you are at that stage? Well, I don't believe it's too late. The best kind of cancer is the one that is discovered when there is a breast and there is just a pain and it has not moved anywhere. By the time women are seeing those changes in their breast it might be a sign that cancer has advanced. You can't make a clinical diagnosis of that until they actually go to the hospital the lump is checked if it has spread it's checked and they actually take the cancer out and test it and that's when they can make a diagnosis of what stage the cancer is in but those things can say that or maybe it's past stage 0 or stage 1 you can just deal subjectively. I would let Jennifer come in. Two things what factor does family history what factor does it play when it comes to breast cancer and from the introduction that I made it said that 35 people now in their 20s people now in their early 30s are also presenting breast cancer so when you talked about the earlier musical method of protecting it shouldn't we shift that age also to a more younger age since younger people are presenting now so two things family heritage and you know why do we have young people presenting. Family history definitely has a huge role to play in breast cancer so if someone has a sister or a mother that has breast cancer the risk that they have breast cancer so if they have two or more relatives that have had breast cancer the risk increases five times and then if someone in the family has ovarian cancer not even personal if mother or sister has ovarian cancer it's also a risk for breast cancer so family history and then there is the issue of the BRCA1 and BRCA2 gene these are genes that is like of course we all inherit genes from our parents so if that gene runs in family and then passing in heritages it puts them at a risk for breast cancer and I'm sure the story of Angelina Deleys over 4 years at this point and her mother had the gene and for those that have that gene they present with breast cancer at a much younger age so also someone in family presenting breast cancer at a much younger age is also a huge risk factor that if someone's mother presents with cancer it's maybe like 30 it's also a risk that you the child might have breast cancer like a huge risk factor so genetics definitely as a huge role to play and yes I like what you are saying about the fact that we are seeing younger people with breast cancer 30 25 epidemiologically speaking they are not in the majority and this is technology that they used to determine with statistics is what they used to determine at what age and what changes should we make so they analyze the year in review like 2022 if you say that this test they are not free they are still expensive and they will still consider the pocket of the average member of the population so several factors come into play so if they say that the number of people that are presenting with breast cancer less than 40 are still 5% that doesn't necessarily mean that it would reduce the age but if the number is getting more current statistics still says that women should start doing like by yearly depending on risk if you are at low risk nobody in your family has had breast cancer before if you do it a year you can do it by two yearly but if you are at risk someone in the family has had breast cancer before or there is a solid family they would recommend annual mammogram so I think it all depends on your clinicians because someone that knows your medical history will have a full decision about your health other than what statistics is so you already answered the question I was going to ask because I wanted to ask what the frequency of checks should be so since you have answered that my next question would be if I notice those signs what should be my next steps next steps there is this thing that I really much like to discourage that we do we are very religious people and of course I personally have a question and I believe so much but go to the hospital take medical advice I know it's not easy it's easier said than done because by the time you start people like sharing experiences from a fourth newborn like how many of us have had breast cancer and you are telling someone that they might have had a breast it's not good news but it's better to be alive and well most people are scared to go to the hospital because maybe they might have to remove their breast or they might have to go to chemo or radio and those things can be expensive and they can be draining emotionally and financially but regardless of all things the first step is to go to the hospital what about lump your scene even if it's a lump it might not be cancerous you are an exceptional biopsy to take it out and then go and test it in the lab so the best thing to do you notice any changes in your nipple your nipple is discharging the skin and your breast is changed as long as it's not normal go to the hospital, get tested that's when you know the next steps to take so talking about taking out the breast obviously it means that it has gotten to a stage where that needs to happen there's no remedy to save that breast so it needs to be cut off so obviously people are definitely going to be worried or women will be worried about functionality still feeling like a human and probably other things that can function in their body just can you shed more light into the positive outcome of the breast being taken out right you will be alive I don't understand the positive so you can still function as a human so if one breast is taken out because I've heard these questions if one breast is taken out can you still breastfeed with the other breast breastfeeding in women with cancer it's advisable I would not say it's not advisable I'm not a gynecologist or obstetrician I think if that happens the best thing to do will also be discussed with your clinician as regards the breastfeed I don't think breast removal defines people as women your breast is not definitely an immigrant woman and there are options for reconstructive surgery after like a silicone-based implant and all of those things she took out the tissues and just put implants there because it's the tissues that actually develop into cancer the options are really good they might just be expensive to be honest if the other option is the cancer spreading taking out your other organs it's not it's not a good quality of life in the long term so if taking out the breast would save your life in the long term so I was going to say that for breast cancer early detection how long does it stay stagnant before it gets dusted because there can be cancer there it might just be dormant I don't know if you understand what I'm saying so how long does breast cancer because again when we are talking to people and we are saying go get checked some people really have time some people may be 10 years and all of that before it then starts to probably react or whatever to the body how long is that time in your experience like different women well there's no specific time time frame so some people it's months you see a lump there and in the next couple of months the person doesn't do anything about it different cancer adds different growth rates so breast cancer has various subtypes right and you will talk about Doctor Casinoa invasive Lobula Casinoa it has different subtypes and those different subtypes have different specificities to them so it's not something to joke with it's not how you see it so you could say it will be years there's no time and that's a message that we have to eat home on that you could say it could be years then it's just a couple of months and everything has gone sideways so the best thing to do is that you're seeing it you're dealing with it you attack it so if something is going to impair your function it's better to to eat it I've had friends siblings that I've had like lumps or things like that you discover you'll get it checked out the best kind of class they would say is Casinoa in situ in that time you might not even feel the lump maybe they pick it up on mammogram it has not left the cancer is just there now Casinoa in situ can this is what they have let's take care of it maybe I'll come back nobody can really tell how bad it's going to get or how fast and does your lifestyle affect these things because I'm trying to understand it because I mean some people have lumps and I've heard stories of how they stayed nothing happened and they took it out you hear what I'm saying does your lifestyle affect the rate at which the cancer spreads or the cancer grows in your system I can't say technically I can't say for sure if lifestyle would affect cancer but one thing I can say is that lifestyle is a risk factor for development of the cancer itself alcohol, intake, smoking, obesity sedentary lifestyle and healthy diets that can trigger cancer but for the great rate I can't I can't say that this would make it go faster ok so sorry Jennifer so if somebody finds out now right you talked about affordability I wanted to touch a bit on that because I know that a lot of organizations are actually doing free things I need to touch more on what you do so for people that you just want to get checked I've seen a lot of free campaigns free days, free dates they do that so when you find that out what's the best thing do you, some people start to say ok I need to fly outside of the country are there places you can go to in Algeria here I can help you I've had success stories and all of that just maybe walk us through that ok so like I said any hospital really but government hospitals are where you find more consultants, more specialists more hands that are more experienced with what you do some people would not prefer that because of these hospitals because of the way time is where a lot of people go and you know there's also the question of affordability treatment is not cheap I can't put a fee go to it but it's a long term at least for a bit to make from what I said is surgery then radiation therapy or hormonal therapy chemotherapy depending on what you find in this surgery so radiation therapy could go from anywhere like five weeks and above and that's what you have to do consistently so achieve the desired result so for people who can afford it they can try private hospitals for the average Nigerian government hospitals really and for people that can afford it of course like you said they are NGOs that are working on supporting people with breast cancer they are also NGOs and some of the programs of these NGOs are also elderly early detection too because they understand the expense when it gets to that stage where prevention is always better than cure those are NGOs I will also do like as this month is breast cancer awareness month they will do like 3 mammograms for women up to 40 wow those kind of things I feel like if anyone needs help you just go online and search there are a couple of them that do provide support so you didn't touch on your organization oh yeah what my organization does is actually social enterprise we provide health information for elderly sensor and young people my work is focused more on yes information about breast cancer will also be a part of it but I love preventive medicine and that's what I'm doing so our website you find information on sexual health mental health, fitness and diet just the way of you know educating young people so they can start making healthier choices now that your future self can so my work is really preventive that's beautiful so I have a comment here that says the advice I would love to give women most especially the market women stop putting money into your breast because breast is made up of tissue so putting money exposure of breast to sunlight can kill it and cause free access to air diseases and women should be careful of their body when having sex with your partner okay can you explain me that money against I breast I don't understand it thankfully I think there was a major campaign that went from because now you see all those market men they have their pouches that they put the money because that money I breast for me was the handling you don't know who has touched just come and put it you know so for me I didn't understand that thing when they were using your bra sorry at least eating your body nobody would take it so what about the sex part I don't understand I don't understand it but I feel like men have a big role to play men that have partners you actually can actually because I've heard cases of it was in the process of romance and foreplay and all of that that the man felt the breast of the wife and something is different you know and that means the man was also paying attention because me I believe that I mean it's it's a two way thing if the woman is not able to notice it the man should be able to say oh there's something different about your body but talking about sizes I know that they say that every woman has one bigger breast than the other some of us we don't really have it like obvious right so the people that have like does breast size have anything to do with you know like predisposition to cancer because you know sometimes when the breast is big you might just feel oh this is the normal thing because like my breast is quite sizable you know so it's something that in two seconds I'm done with what it is I wanted but you know some people are really big right is it possible that some of these lumps are able to hide in those kinds of sizes of breasts or breast size don't have anything to do with it size doesn't matter to be honest like if men who really have rudimentary like who in the can have breast cancer then you realize that size doesn't matter the lobals and like the breast has lobals, has docs, has everything that makes up the breast whether it's small or it's large anyone can have breast cancer but I do agree with your story about maybe because of how massive the some people's breast can be maybe they might not be able to tell right but still that's why I would say that breast awareness not just no matter how massive your breast is you will stand in front of a mirror for certain examine and you know if you're younger you might not take notes but if something happens to you before you may not stand in front of a mirror and examine and you will check everything and be sure that so if you feel like there's a place that is becoming other or there's a skin over you would be able to tell but do you advise that outside of self examination that maybe she should just go to because if the breast is big or more assume breast as a so if it's not better to just go and give the professional a hand in hand the breast over to the professional it's true not to help you like because they would do the real examination or just go for because maybe you're not there age for Manga Mugama if you go for Manga Mugama it's not as if they would turn you down it's just so if it's a matter of concern so I was reading the recent study on this self breast and it says that if a woman is of low risk there's no family there's no breast cancer okay alright thank you so much we had so much fun discussing breast before we go because all our social media handles listen to our podcast on Spotify at WeShow Africa now like share invite your families and friends to watch ample the conversation this particular share the link to many women that you know and men too because we hear that some of men have it so if you missed our quote for today here it is again it says I am a 36 year old person with breast cancer and not many people know that that happens to women my age or women in their 20s this is my opportunity now to go out and fight as hard as I can for early detection this source from Christina Applegate we'll see you guys tomorrow at 8pm so bring another great conversation to your screen ciao