1. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait First HAYAT Annual Patients Forum 21 st March 2010 Al Hashimi II Ballroom – SAS Hotel Kuwait

2. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait About Breast Cancer Dr. Salah Fayaz Consultant Radiation Oncologist Head of Breast Cancer Unit, Radiation Oncology Department - KCCC

3. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait The majority of breast tumors are benign tumours (almost 90%) The incidence of BC in the US is as follows: 1 out of 8 ladies in the US is subject to developing BC & this incidence increases yearly by 1 to 2 % As for Kuwait, the incidence of BC is increasing yearly as per the Cancer registry issued by KCCC. The median age of patients is 10 years less than the international statistics. The BC incidence in Kuwait for the year 2006 is 46.9 cases for each 100,000 ladies. Death from cancer causes comes in the third place after death from heart diseases & car accidents. In The Name of God

4. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Although the incidence of cancer in increasing globally but the incidence of death due to that cause is decreasing due to the following 2 reasons: Early detection through the screening programs done by radiological Scientific advances in the treatment approaches

5. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Ladies role in prevention from BC in regards to habits & nutrition: Breast feeding Decrease alcohol drinking Decrease the exposure to hormonal replacement therapy Weight control, no obesity Healthy food like vegetables, fresh fruits & decreasing fats

6. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Risk factors of BC: Age at the start of monthly period (puberty) The date of first pregnancy Repetition of pregnancy Breast feeding Abortion Menopause Hormonal replacement therapy after menopause Family history with BC Improper nutrition & increased fats Exposure to pollutants like tobacco, raditions Benign breast tumours & repetitive surgical interventions with it

7. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Ways of diagnosis: Disease history, physical examination & finding a mass, breast pain, secretions, etc Breast imaging, CT scans, MRI Tumour biopsy Pathology test for the specimen

8. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Identifying the stage of the disease: Blood testing Lung imaging, liver, bone scans if needed After the investigations, the stage is identified which can be 1 of 4 stages according to the tumour size, involvement of lymph nodes, extent of metastasis

9. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Main ways of treatment: Surgery Chemotherapy Radiotherapy Hormonal therapy Targeted therapy Palliative therapy

10. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Surgical treatment Breast conservative surgery, some lymph nodes, plastic surgery in the early stages Mastectomy, other lymph nodes in advanced cases Plastic surgery after mastectomy

11. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Radiotherapy What is radiotherapy? 1) Treatment with high energy radiation equipments on the breast area & lymph nodes 2) Radiotherapy comes after conservative surgery 3) Radiotherapy comes after mastectomy at some stages 4) Palliative radiotherapy for some advanced BC cases Side effects: 1) Superficial effects on skin in some cases which is easily managed 2) Technological advances have decreased the side effects on other body organs as lungs & heart

12. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Chemotherapy: Medications administered Intravenously or orally Can be started before surgical intervention in order to help on breast conservative surgery or mastectomy Adjuvant treatment after surgery which aims to decreasing the probability of disease recurrence and increasing cure rates

13. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Side effects: Depends on the type of chemotherapy or targeted therapy An important side effect for women is hair loss Nausea, vomiting, diarrhea Immuno-suppression Many treatments are now available to overcome those side effects

14. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Hormonal treatment Depends on the lady’s age Many hormonal treatments as: - Ovarian oblation, stopping ovarian activity by radiation for ladies who don’t need to get pregnant - Medicines taken either intravenously or orally according to the case

15. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Side effects: Depends on the age & type of treatment Stopping the activity of ovaries in young age, side effects similar to menopause might appear Some medications have side effects like osteoporosis & joints pain

16. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait At the end: Health Awareness & routine check ups are the main ways of avoiding cancer & if happens then the cure from it Changing the daily life style to the better

17. First HAYAT Annual Patients Forum – 21 st March 2010 – SAS, Kuwait Thank You Dr. Salah Fayaz Consultant Radiation Oncologist Head of Breast Cancer Unit, Radiation Oncology Department - KCCC