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It’s Important To Be Selfish When It Comes To Your Health & Cancer Prevention: Dr Aditi Godbole’s Advice To Women
Women, often expected to prioritize others before themselves, embody sacrifice and compromise. However, these sacrifices can come at a significant cost, especially when facing challenges such as breast, cervical, and ovarian cancers. Amidst these health concerns, there remains a cloud of misunderstanding and misconception surrounding these diseases.
CancerMitr recently had the privilege of conversing with Dr. Aditi Godbole, a seasoned consultant obstetrician and gynaecologist with over 17 years of experience. Her insights shed light on the broader landscape of women’s health and the specific risks they encounter.
1. Tell us a bit about yourself. How did you start your career as a gynaecologist? What drew you to the profession?
As an obstetrician and gynaecologist based in Thane, my journey into the world of medicine was deeply influenced by my father’s unfulfilled dream of becoming a doctor. His family faced financial hardships, so he had to give up his dream. But, he instilled in me a passion for the profession. During my initial year of medical school, like many students, I was confused about choosing a speciality.
It was during my first clinical posting, where I assisted in childbirth, that I found my true calling. Witnessing the miracle of life and the profound impact healthcare professionals can make on individuals and families ignited a fire within me. From that moment on, I knew I wanted to become an obstetrician.
Beyond providing medical care to my patients, I am driven by a desire to advocate for the importance of consultations. In an age where information is readily available online, it’s crucial to recognize the limitations of self-diagnosis. While the internet offers a wealth of knowledge, it cannot replace the expertise and personalized approach of a healthcare professional.
Every individual is unique, with their own set of needs and circumstances. As a result, diagnosis and treatment must be tailored to suit each person’s specific situation. Through my practice, I strive to emphasize the significance of seeking professional medical advice and guidance, ensuring that every patient receives the personalized care they deserve.
2. In your career, how often have you come across breast cancer patients, and in what age group were they?
In my experience, I’ve encountered numerous breast cancer patients, many of whom initially seek guidance from gynaecologists rather than oncologists. This trend is particularly common among elderly women, although there’s been a concerning rise in cases among those in their 30s.
One poignant example is a young patient I know who discovered a 3cm lump in her breast, initially suspected to be a benign fibroadenoma. However, confirmation could only come from an oncology consultation and biopsy. Unfortunately, personal challenges delayed her visit to the oncologist, resulting in the cancerous growth escalating from 3 cm to 8 cm.
Similarly, a staff nurse I’m acquainted with detected a lump but delayed seeking professional help. After a cancer diagnosis, she underwent neoadjuvant chemotherapy (NACT), total mastectomy, and adjuvant chemotherapy, ultimately achieving a positive outcome.
When patients come to us with concerns, we strive to alleviate their fears by presenting the best-case scenarios. However, definitive diagnosis and treatment planning requires further investigation. The crucial message here is the importance of prompt action—hesitation can have severe consequences.
By sharing these stories, my hope is to emphasize the significance of early detection and proactive healthcare-seeking behaviours. Don’t delay—swift action can save lives.
3. Breast cancer is the most reported cancer amongst women in India. What are the reasons behind such high numbers?
There are numerous factors contributing to breast cancer risk, which I’ve categorized into two sections: avoidable and unavoidable. While genetic predisposition falls into the latter category, routine screening is essential for early detection.
Among the preventable risk factors, smoking, alcohol consumption, and excessive junk food intake are well-recognized culprits. Additionally, breast cancer risk is linked to estrogen and progesterone hormones, particularly in ER-PR-positive breast cancers. Prolonged exposure to these hormones due to early menarche, late menopause, and delayed childbirth significantly increases risk.
Unfortunately, societal factors also play a role. Many Indian corporations fail to support working married women, often terminating or pressuring them upon pregnancy. This lack of support extends to judgmental questions during screenings and a general disregard for women’s ambitions and aspirations, leading to heightened stress levels.
In contrast, overseas workplaces often provide facilities like breastfeeding areas and daycare, a practice I wish to see more of in India. Additionally, reliance on outside food due to time constraints and a lack of domestic support further exacerbates health issues.
Ultimately, the overconsumption of outside food poses significant health risks, as it often contains the same oils and artificial additives. It’s unfortunate that these societal and lifestyle factors contribute to the burden of breast cancer among women.
4. What's the prevalence of triple-negative breast cancer (TNBC) when compared to ER-PR-positive breast cancer?
Genetics plays a significant role in triple-negative breast cancer (TNBC), accounting for about 10-15% of all breast cancer cases, although this figure can vary by region. TNBC is particularly associated with the BRCA-1 gene, which is reportedly less prevalent among Asian populations.
5. Triple-negative breast cancer (TNBC) is considered more dangerous than ER-PR-positive cancer. What's your professional opinion on that?
Indeed, triple-negative breast cancer (TNBC) poses greater risks. It exhibits faster growth compared to ER-PR-positive breast cancer, with a heightened risk of recurrence even after total mastectomy. Moreover, treatment options are limited due to the ineffectiveness of hormone therapy. Consequently, TNBC carries a lower 5-year survival rate compared to other breast cancers. These factors collectively underscore its dangerous nature.
However, proactive measures such as routine screening, early detection, and timely intervention play pivotal roles in mitigating the impact of this condition. By emphasizing the importance of these preventive measures, we can significantly improve outcomes for individuals at risk of TNBC.
6. A patient recently spoke to us about how she was very careful in terms of diet, lifestyle, and age of childbirth. Still, she had breast cancer due to a family history. Is family history a massive risk factor?
Absolutely.
Family history carries significant weight as a risk factor for breast cancer. I recall the experience of a relative whose sister battled early breast cancer and triumphed over the disease. This relative led to a healthy lifestyle, practicing habits like early rising, gardening, and regular exercise. However, during a momentous occasion – her daughter’s wedding – she discovered a mass in her breast while showering, later diagnosed as ER-PR positive breast cancer.
Following surgery and chemotherapy, both she and her family rejoiced in the positive outcomes. Yet, subsequent screenings uncovered cholangiocarcinoma, a devastating revelation indicating widespread cancer spread. Despite courageous battles against complications like ascites and anorexia, she ultimately lost her life to the disease. Her daughters were advised to undergo regular breast cancer screenings due to their family history.
Recognizing the paramount importance of family history as a risk indicator, I strongly advocate for women with first-degree relatives affected by breast cancer to undergo genetic testing. Additionally, routine yearly screenings are imperative for early detection, a crucial strategy in defeating cancer.
Regrettably, fear of a positive diagnosis often deters many women from genetic testing and routine screenings. This reluctance can lead to delayed diagnoses, significantly diminishing their chances of overcoming the disease. Let us encourage openness to screening, as it holds the key to early intervention and improved outcomes in the fight against breast cancer.
7. Other than the most discussed factors, what else is linked to breast cancer risk? Is wearing the wrong bra size linked to breast cancer?
No. There is not much evidence to support the same.
8. Does undergoing frequent mammography increase cancer risk?
Of course not. As I mentioned earlier, there is not much evidence to suggest that exposure to mammography increases cancer risk. There are plenty of debates about this because radiation is involved. I understand if there are concerns which is why they need to consult a doctor to get answers and to prevent overdiagnosis.
9. Regarding cervical cancer, recently, the Indian government announced free HPV vaccines for young girls. Will HPV help prevent cervical cancer completely?
You know, the HPV vaccine is quite remarkable. It’s been proven to slash cervical cancer risk by a staggering 99%. I mean, that’s pretty impressive, right? Sure, there’s that tiny 1% left, mostly due to stuff like smoking, heavy drinking, and risky sexual behaviour. But let’s not downplay the impact of this vaccine—it’s a game-changer in the fight against cervical cancer.
Now, as a gynaecologist, I see firsthand the challenges that sexually active young adults face, especially those in their late teens. It’s tough out there. There’s this worrying lack of awareness about safe sex practices. Too many young girls are putting all their trust in their partners, even when they’re being pressured into unprotected sex.
But here’s the thing—it’s risky business. Engaging in unprotected intercourse opens up a Pandora’s box of health risks. And what’s worse, fear of judgment stops these girls from seeking the help they need. It breaks my heart to see them hesitate because all I care about is their well-being, not passing judgment on their choices.
I firmly believe in offering non-judgmental care to everyone who walks through my door. My job is to give them the best treatment possible, no questions asked.
At the end of the day, it’s all about taking charge of your health, regardless of what society says. Remember, no one else is going to deal with your health issues for you—we’re responsible for our own well-being. Let’s encourage open conversations and proactive healthcare-seeking behaviours. It’s time to empower individuals to own their health without fear of judgment holding them back.
10. Angelina Jolie underwent a double mastectomy after undergoing a BRCA test. What about someone with a family history of ovarian cancer? Should she consider a double oophorectomy?
Deciding whether to undergo procedures like double oophorectomy involves careful consideration of several factors, including age, childbirth status, and family history of ovarian cancer.
For women with a family history of ovarian cancer, the option of double oophorectomy may come into play. However, it’s essential to acknowledge the potential challenges that accompany this procedure, such as hot flashes, osteoporosis, and pain due to induced menopausal symptoms from the loss of estrogen production. Moreover, if genetic testing reveals no cancer-causing gene, the procedure may be unnecessary.
On the other hand, if genetic testing indicates a heightened cancer risk and a woman has completed her family planning or chooses not to have children, double oophorectomy might be a viable consideration.
Lynch syndrome, which is linked to colorectal and uterine cancer risks, introduces another layer of complexity. While hysterectomy is an option, living without a colon presents significant challenges, as observed in the struggles of colorectal cancer patients.
Given these complexities, prioritizing routine screenings for early detection emerges as a preferable alternative. However, for women with hormone-dependent conditions, double oophorectomy remains a potential option. Ultimately, the decision-making process should involve thorough discussions with healthcare professionals, taking into account individual circumstances and preferences. Let’s empower women to make informed choices about their health, supported by comprehensive knowledge and guidance.
11. What are the important steps women can take to prevent breast, cervical, and other cancers?
You know, when it comes to reducing cancer risk, there are some no-brainers. Stuff like ditching the cigarettes, cutting back on the alcohol, and laying off the junk food—it’s pretty much universal knowledge. Along with that, making sure you’re getting enough vitamin D, squeezing in a quick 15-minute walk every day, and eating a balanced diet can go a long way in keeping you healthy.
But here’s the real game-changer—getting the HPV vaccine. Seriously, boys and girls alike should be getting this vaccine. It’s a powerful tool in the fight against cervical cancer. And don’t forget about routine screenings for cancer – mammography every year once you hit 40 while undergoing self-check.
At the end of the day, it’s all about taking control of your health.
12. What is your advice to women in general about conserving their health?
My advice to all women is – to be selfish towards themselves.
Don’t sacrifice too much, and don’t let anyone else’s needs overshadow your own, especially when it comes to your health. And let’s talk about delaying childbirth for career reasons. Now, I’m not here to judge anyone’s choices. It’s entirely up to you when you want to tie the knot and start a family. But let’s face it—many of us feel the pressure to postpone marriage and kids because of workplace expectations.
Wouldn’t it be great if Indian companies took a leaf out of the overseas playbook and supported their female employees? I’m talking about things like providing breastfeeding spaces and daycare facilities. It’s high time we had that kind of support here.
Now, here’s something I firmly believe: kids can actually be a huge asset to their moms’ careers. It’s all about setting the right example and teaching them to support their mom’s ambitions. Women are incredibly resilient—we can tackle any obstacle that comes our way.
But let’s not forget to enjoy life along the way. It’s not all about stress and hardships. Take the time to savour the moments and live life on your own terms. And while you’re at it, don’t forget to prioritize your health. After all, what good is success and achievement if we’re not healthy enough to enjoy it?
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