This is the subject of a series of profiles that the Estadão publishes from this Thursday, 1st, one per week, about the new directions of patients after the most acute phase of treatment. The stories, still under construction, capture difficulties in returning to work because of prejudice or the dynamics of the market itself, personal achievements, such as children and new hobbies, and, above all, dreams that have changed their face or given way to others that remain there. , lurking.
Marília Biscuola discovered that she had breast cancer when she underwent pregnancy tests at age 31. She felt like a death sentence when she most thought about life, in her words. Her mother, Lairce, was crying in secret. The ground began to form again under the civil servant’s feet after the breast removal surgery, successful treatment and a lot of therapy. It took four years for her to make plans again and some have already come to life. Literally. This is the case of this 8-month-old girl who is now on the living room rug, trying to crawl and showing five little teeth. Nicole.
That’s how it was: Marília managed to get pregnant after the disease, without the need for treatment. She was natural. The big belly was a flick in that sentence, but it was difficult to overcome the emotional barrier. “That cancer ghost keeps haunting you and you’re afraid to have it again. I didn’t want to orphan a child. I worked my emotional part a lot.”
From a physical point of view, there are no restrictions for cancer patients to become mothers in most cases. There are situations, however, in which chemotherapy reduces the egg reserve. “People are starting to think about having children later on. The chance of getting pregnant is decreasing, regardless of having breast cancer or not”, says oncologist Daniela Rosa, professor at the UFRGS School of Medicine and coordinator of the Breast Tumors Committee at Brazilian Society of Clinical Oncology (SBOC).
The big question, as Débora Gagliato, oncologist at BP – A Beneficência Portuguesa de São Paulo observes, is after how long a woman can get pregnant after the end of treatment. “There are still controversies in the medical community.”
And Marília went further by being able to breastfeed. It’s four times a day or according to the appetite of the laughing girl who doesn’t take her big eyes off the camera flash. Marília always uses the same breast. The other, submitted to conservative surgery, the removal of a part of the organ, does not produce the liquid.
Nicole is in that sweet phase (for the parents) where the child doesn’t do the pranks, he just imagines them. You can understand why she is the center of attention at the house in Pirituba, north of the city of São Paulo. It symbolizes the overcoming of a disease that worries women.
According to the National Cancer Institute (Inca), breast cancer is the most common cancer in women in all regions, right after skin tumors. Oncologist Débora Gagliato brings the numbers closer to our reality: one in eight women will be diagnosed with breast cancer.
Giving birth and breastfeeding were the turning point in a score that seemed lost, but the game was not over. Marília faced obstacles to return to work. She had an appointment revoked for public office because of her health history and had to go to court to sit in the chair. She got it right. And she is in the same job to this day.
After the repercussion of the case, published by the Estadão in 2020, she started receiving messages from people who had similar issues. It was there that she realized the collective dimension of her individual drama. From her volunteer work at the Institute of Chemotherapy and Beauty, she prepared the Oncology Patient Orientation Manual, a bê-á-bá with the main doubts about patients’ rights.
Marília is articulate, but avoids looking directly at the camera in the recording. Even with her voice a little shaky at times, she doesn’t give in to crying. We only notice the index finger helping the lower eyelid for a solitary tear not to overflow. Makeup remains intact.
I had breast cancer, but I want to have children. What to do?
See questions and answers
Is breast cancer curable?
The treatment of breast cancer depends on the stage of the disease and the type of tumor. When the disease is diagnosed early, treatment has the greatest curative potential. If the disease has already metastasized (when the cancer has spread to other organs), treatment seeks to prolong survival and improve quality of life.
I had breast cancer, but I want to have children. What to do?
You need to talk to doctors about strategies to preserve fertility. One of them is the use of a drug, given along with chemotherapy, to protect the eggs. It’s called ovarian protection.
Is it possible to freeze eggs?
This is the safest strategy in the opinion of doctor Débora Gagliato, an oncologist at BP. You need to align with doctors before starting treatment.
Is it possible to freeze eggs through health insurance? And for SUS?
Fertility preservation is not on the National Supplementary Health Agency’s (ANS) list of coverage, but there are judgments that determine that plans pay for treatment during cancer treatment. In other words, you have to go to court. There are places that do fertility preservation, through the freezing of eggs, free of charge by the Unified Health System, such as the Pérola Byington Hospital, in São Paulo, for example.
How to prevent breast cancer?
According to the National Cancer Institute, about 30% of breast cancer cases can be avoided by adopting healthy habits. Among them is the decrease in the amount of alcohol ingested. “We need to talk more about this. Alcohol consumption is a social and cultural practice, but it is important to say that excessive alcohol use is a risk factor for breast cancer”, says Daniela Rosa, professor at the Faculty of Medicine. from UFRGS.
See other expert recommendations
– Avoid menopausal hormone replacement therapies, such as estrogen and progesterone implants.
– Avoiding overweight and obesity is fundamental in reducing risk. Having a normal body mass index makes a lot of difference.
– Practice regular physical activity or more exactly 150 minutes per week of moderate aerobic activity, such as walking, cycling or swimming.
– Know the family history in relation to illnesses
When do I have to have a mammogram?
The mammography exam is the main technology at the service of women for the early diagnosis of breast cancer, which means greater chances of overcoming the disease. According to guidance from the Brazilian Society of Mastology (SBM), women over 40 should take the exam annually. Yes, the exam is a little uncomfortable. The mammographer compresses the breasts to spread out the breast tissue so that it can be seen more clearly on the image. Mammography is available through SUS, preferably for women between 50 and 69 years of age.
How to do the self-exam?
Also according to SBM, breast self-examination should be done in front of a mirror, preferably in the period after menstruation. You should lift one of your arms and analyze one of the breasts with your hand and then repeat the process on the other side. The idea is to look for small lumps or some kind of deformation. But don’t despair if you find something strange: not every lump is cancer. And always talk to your doctor or gynecologist.
Can self-examination replace mammography?
Not. It’s different things. Self-examination is very important for you to identify any abnormalities, but obviously it is not a substitute for mammography. This exam identifies nodules that are imperceptible to touch.
Where to look for help in case of breast cancer?
– Beat Cancer Institute – https://vencerocancer.org.br/
– Brazilian Federation of Philanthropic Institutions to Support Breast Health (Femama) – https://femama.org.br/site/
– Oncoguia Institute – http://www.oncoguia.org.br/
– Brazilian Society of Mastology – https://sbmastologia.com.br/
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