Golden News

Volume 14 No 16 October 24, 2000   

The Weekly Bulletin of the Rotary Club of Kowloon Golden Mile
www.rckgm.org

OCTOBER IS VOCATIONAL SERVICE MONTH

   Last Meeting

Speech by Dr Polly Cheung Suk Yee, private surgeon and Honorary Director, Hong Kong Sanatorium & Hospital Breast Care Centre 

I feel much honoured to be invited to speak to you on the topic of Breast Cancer in Hong Kong. I appreciate your interest in this subject, which may concern your wife, girlfriend, mother, daughter and yourself, because breast cancer is diagnosed in men also and each year we see a few male patients with this disease.

Why are we concerned about breast cancer?

Breast cancer is the most frequent cancer diagnosed in Hong Kong women and is the second most frequent cause of cancer death. It occurs most frequently in women after the age of 50 but in the last 5 years we have seen more women being affected in their thirties and forties. A woman has a 1 in 24 chance of having breast cancer in her life time until the age of 75, as reported by the Hong Kong Cancer Registry. More than 1600 women were found to have breast cancer in 1997 in contrast to 900 women affected in 1987.

Why is there a rise in breast cancer incidence in Hong Kong?

We know that in the seventies, breast cancer is a disease affecting western women more and studies comparing daily Oriental and Western diet show that the animal fat content is half in Oriental food, measured to be about 75 gm per day. We ate more carbohydrates and vegetables than steak in those days. However, our diet now, even if we eat fast food like hamburgers and fried chicken, the calculated dietary fat content is double those before, at 150 gm per day. This is a study undertaken by dietitians in the eighties.

Other social factors may come into play; women marry late in their life, therefore have pregnancy later, or no childbirth and less breast-feeding. These are all considered to be risk factors associated with breast cancer.

With this rising incidence, are we doing any better in tackling this disease?

In the seventies and eighties, 40% of breast cancer was diagnosed at an advanced stage of stage III and IV, meaning either the tumour is > 5 cm in diameter with lymph node spread, or distant metastasis affecting other organs. Obviously the chance of cure then was much reduced.

With the wide availability of low dose mammography in Hong Kong since the early nineties, the pattern of breast cancer diagnosis has shifted to an earlier stage. Nonpalpable or tumours less than 2 cm, which were rarely diagnosed in the eighties, account for more than half of breast cancer seen today.

Stages               Eighties                Nineties

       0 & I                 10%                       50%

                 II                      50%                      40%

                 III & IV            40%                       10%

Women Centres for breast screening are now widely available, run by the Department of Health, voluntary organizations and many public and private hospitals. Although there is no data on population screening, the increased use of mammography in diagnosis breast screening undertaken by health conscious individuals and the willingness of women to seek medical advice concerning their breasts, all contribute to the shift to earlier staging of the cancer.

The breast is a sex symbol and a female and a motherly figure is of importance not only to the woman herself but to her babies and her spouse. As it is the most commonly affected organ by cancer, breast health is therefore of vital importance as it may take away the life of our beloved ones.

How do we detect breast cancer early?

Breast screening has been proven in worldwide studies in the last quarter of a century in that it can reduce cancer death by 25 to 35%. You may be jealous as a man. Why screen women for cancer, there are well women clinics but no well man clinics? Statistics today show that mass screening has only proven to be cost-effective in breast and cervical cancer, both of which unfortunately affect women. Many countries, as you may well be aware, are providing this screening service free of charge to their citizens.

What is breast screening?

Breast screening consists of breast self examination (BSE), clinical breast examination by doctors or health care professionals (CBE), and mammography. Of the three, mammography produces the greatest impact on the reduction of the mortality rate.

In 1999, the American Cancer Society recommended the following:

The age to start screening and the frequencies vary in different countries. In the United Kingdom, national breast screening start from the age of 50 to 64, with mammography at 3 yearly intervals. In Australia and Canada, screening starts at the age of 40 with mammography at 2 yearly intervals.

How do we see our future?

An effective cancer screening programme is one that targets a relatively common disease, is cost-effective and employs a test that  must be safe. Among all cancers, breast and cervical cancer are the two that fit into the above criteria.

Women from the age of 35 to 63 constitute one-third of the female population in Hong Kong, i.e. approximately 500,000. Among these, only 50,000 women have undergone breast screening in a ten year programme which has had the longest history in Hong Kong. Data from other centres are unknown. In the USA the National Cancer Institute and the Department of Health and Human Services have issued a Year 2000 goal to increase the proportion of women who get regular mammograms to 80%. Ask yourself whether your partner or your family members have participated in any breast screening locally or overseas. If they haven't, they are falling behind in the health trend of prevention and early detection.

N.B. To keep the size of Golden News down I have omitted Dr Cheung's reference list and a chart entitled New  Cases and Deaths Registered, Breast Cancer (1985 - 1996). Should any member like copies I would be glad to fax them. Urchin

A handsome, middle-aged man walked quietly into the cafe and sat down. Before he ordered, he couldn't help but notice a group of younger men at the table next to him.  It was obvious they were making fun of something about him, and it wasn't until he remembered he was wearing a small pink ribbon on the lapel of his suit that he became aware of what the joke was all about.
The man brushed off the reaction as ignorance, but the smirks began to get to him.  He looked one of the rude men square in the eye, placed his hand beneath the ribbon and asked, quizzically, "This?". With that the men all began to laugh out loud.  The man he addressed said, as he fought back laughter, "Hey, sorry man, but we were just commenting on how pretty your little ribbon looks against your blue jacket!" The middle aged man calmly motioned for the joker to come over to his table, and invited him to sit down.  As uncomfortable as he was, the guy obliged, not really sure why.  In a soft voice, the middle aged man said,

"I wear this ribbon to bring awareness
about breast cancer. I wear it in my  mother's honor."  "Oh, sorry dude.  She died of breast cancer?"

"No, she didn't.  She's alive and well.  But her breasts  nourished me as an  infant, and were a soft resting place for my head when I  was scared or lonely as a little boy.  I'm very grateful for my mother's  breasts, and her  health."

"Umm", the stranger replied, "yeah".
"And I wear this ribbon to honor my wife", the middle aged man went on
"And she's okay, too?", the other guy asked.
"Oh, yes. She's fine. Her breasts have been a great source of  loving pleasure for both of us, and with them she nurtured and  nourished our beautiful daughter 23 years ago. I am grateful for my wife's breasts, and for her health."
"Uh huh. And I guess you wear it to honor your daughter, also?" "No. It's too late to honor my daughter by wearing it now.  My daughter died of breast cancer one month ago.  She thought she was too young to have breast cancer, so when she accidentally noticed a small lump, she ignored it.  She thought that since it wasn't painful, it must not be anything to worry about."
Shaken and ashamed, the now sober stranger said,
"Oh, man, I'm so sorry mister".
"So, in my daughter's memory, too, I proudly wear this little ribbon, which allows me the opportunity to enlighten others. Now, go home and talk to your wife and your daughters, your mother and your friends. And here.

" The middle-aged man reached in his pocket and handed the other man a little pink ribbon. The guy looked at it, slowly raised his head and asked, "Can you help me put it on?"

A CANDLE LOSES NOTHING BY LIGHTING ANOTHER CANDLE.

In the midst of our busy life, we often forget the
importance of LIFE...this reminds us to treasure our lives and those around us.

 

Alex Lau’s Vocational Spot

Vocation – Law Practice - Immigration

 I come from an ordinary family. Being the only child, the single instruction from my parents was to get good grades. I did not always manage to do that and in the process I lost most of my spare time, which should have been devoted to extra-curricular activities. I entered the law, as my old man would only pay for the fees if I read one of the six “preferred” disciplines. (There is no prize for guessing them right). Once I started, I could not stop. I have attended seven law schools and three other universities… and counting. After practicing law for nine years, I realized that my interest was in teaching. So in 1995, I joined the academia and have since remained. On hindsight it is very interesting to see that even the people closest to me do not know what I really want. In the end, we all have to decide for ourselves. I am grateful to my parents for providing me which the best education they can afford-literally down to their last penny; as well as teaching me to become a fighter (accomplished) and a gentleman (still trying).

 I now have three “jobs”. Aside from my full time teaching post at the Hong Kong Baptist University, I have a part-time law practice in immigration, as well as reading towards a part-time Ph.D. degree at the University of Aberdeen in Scotland (founded in 1495). My dissertation is to compare between the Listing Rules in London and Shanghai. If I am lucky to graduate, I hope to get two more doctorates from the USA and the PRC respectively. People ask me why I punish myself by studying on and on, when I already have numerous qualifications. I ask them why they punish themselves by making more and more money, when they are already quite wealthy. I guess everyone is different.

 I was married 11 years ago. Many senior club members attended my wedding. My wife Gabrielle spends all her daylight hours caring for our children. She is a great housewife, mother and wife (in no particular order). I have two boys, Solomon Tien Je (aged 9) and Jeremiah Tien Zhen (aged 6). The older boy used to, and the younger boy is currently, attending a so-called elite co-educational school on Macdonnel Road. But having spent 13 miserable years there, I know there are better schools. This year, I put Solomon into an English School Foundation member institute. After one month, his remarks to me summed up the big difference. He said there are three things which impressed him: 

  1. Everyone is very supportive to everyone else,
  2. Even a bad performance gets encouragement, and
  3. The teachers are very patient and clear in explaining difficult issues.

 Now that’s an education.

 

 

Joke of the Weak

 

Just think, if it weren't for marriage, men would go through life thinking they had no faults at all.

 

The trouble with being the best man at a wedding is that you never get to prove it.

 

Young son: Is it true, Dad, that in some parts of Africa a man doesn't know his wife until he marries her? Dad: That happens in every country, son.

 

Brain Teaser

What noise annoys a noisy noise?

Presidential Quotation

(week before last)

Success in life has nothing to do with what you gain in life or accomplish for yourself. It's what your do for others.

(Danny Thomas)

(last week)

You can't enjoy your success without your health. So take care of it. (President Cassidy Lam)

URCHIN