With a small population of about 450,000 in Brunei Darussalam, The Brunei Cancer Centre (TBCC) receives over 800 to 900 cancer cases every year that have been referred and diagnosed, where out of that number about 130 make up breast cancer cases from the pathology registry.
Most breast cancer cases are from the Brunei-Muara District (70.6 per cent), followed by 16.4 per cent in Belait, 11.6 per cent in Tutong and 1.4 per cent Temburong.
These statistics were revealed by Medical Director of Pantai Jerudong Specialist Centre (PJSC) cum Director of The Brunei Cancer Centre (TBCC) Dato Seri Laila Jasa Dr Babu Sukumaran during his presentation on ‘Epidemiology of Breast Cancer in Brunei Darussalam’ at the Lecture Theatre of PJSC yesterday.
Globally, among the cancers in women, one in four of those cancers is breast cancer, where the World Health Organization (WHO) estimates that there are about 18.1 million new cancer cases in 2018 of which 11.6 per cent are breast cancers, with 9.6 million cancer deaths that year of which 6.6 per cent was from breast cancer.
The medical director said that as of Mid-October this year, TBCC has received about 90 cases and is expected to reach about 100 cases by the end of the year.
The medical director explained that in western countries, traditionally, the peak at which most of these breast cancer patients are in aged above 50, while countries within the Southeast Asian region for this year alone have seen cases that are in the earlier age group with a substantial growth of patients aged between 40 to 49 at 24 per cent.
“This means quite a lot for the society and the families, as some have very young children, some are active working members. It hits the family quite hard, because they are young active members of the society,” said Dato Seri Laila Jasa Dr Babu, adding that fortunately for patients in Brunei, even though it is difficult for a young woman who developed a stage in breast cancer, there is good family support. More people are aware now that cancer can be developed at a young age.
Dato Seri Laila Jasa Dr Babu also explained that breast cancer incidences vary in different countries.
Countries like Japan has the lowest incidences which may be factored by different things, such as lower breast cancer incidences in the country, as well as the possibility of a higher pick-up rate where patients go for a check-up and more cases are detected early, he said.
However, Brunei still sees a large percentage of patients diagnosed at Stage 3 and Stage 4 of the cancer, which TBCC hopes to be able to detect the cancer at Stage 0 or Stage 1 as these stages have nearly a 100 per cent survival rate.
The causes of cancer, said Dato Seri Laila Jasa Dr Babu, 90 to 95 per cent are from environmental factors which include 30 to 35 per cent due to diet which forms a very important aspect, tobacco at 25 to 30 per cent, infections at 15 to 20 per cent, obesity at 10 to 20 per cent, other factors at 10 to 15 per cent, and alcohol at four to six per cent, while genetics factor in five to 10 per cent.
“Prognosis and survival rate depend on the stage a patient is in, where a patient in Stage 0 will have a 100 per cent survival rate, while Stage 1 will have a 98 per cent survival rate, whereas Stage 2 to Stage 3 will have a big drop in survival rate percentage, and in Stage 4 a patient only has a 16 per cent survival rate,” said the Medical Director. “However, Stage 4 is a mixed group depending on the ER, PR, or HER 2 stages. But an important take-home message is that we are trying to get more people at Stage 0 or Stage 1. That’s the whole process of getting early detection.”
Dato Seri Laila Jasa Dr Babu also said that breast cancer patients are now living longer with some of his own patients who are at Stage 4 going on eight to 10 years, which would not have happened many years ago, and these patients are getting treatment and going home.