More breast cancer survivors say no to reconstruction surgery

CHENNAI: After double mastectomies, chemotherapy cycles and radiations, women undergoing therapy for breast cancer, across income groups, are increasingly avoiding breast reconstruction surgeries even if they are free. For nearly a year now, the Government Stanley Medical College Hospital, which promised free surgeries, hasn’t had any survivor go under the knife for reconstruction. “We tried counselling some cancer survivors but many refused. They didn’t want to spend more time in the hospital,” said the hospital’s head of plastic surgery Dr V Ramadevi.

Breast cancer is the most common cancer in women in India and accounts for 27% of all cancers. Though the disease is curable, many women die or are advised to remove one or both breasts because they come late for treatment. But the treatment is so cumbersome that women decide against breast reconstruction. Thirty-eight-year-old Savitha (name changed), who works with an IT company, said the post-surgical period was traumatic. “I was wondering if I was ‘feminine’ enough,” said the mother of two, adding that she went through counselling to come to terms with her ‘new’ body. The reconstruction surgery would have cost her Rs 3 lakh to Rs 4 lakh. “The insurance wasn’t willing to cover it. I could afford breast reconstruction but I decided against it because the thought of putting something foreign into my body scared me,” she said.

Breast reconstruction can be primary — done at the time of breast removal — or delayed secondary. “Results of reconstruction can change after chemo and radiotherapy, which can take six to eight months, doctors may not do reconstruction surgery at the time of breast removal for some patients,” said Dr Selvi Radhakrishna of Chennai Breast Centre. “So women have to wait for a year or more for reconstruction. By then, however, they may have grown comfortable with their prosthesis and don’t feel motivated to come back for another surgery,” she added.

Since insurance too doesn’t cover it, some women prefer cheaper options such as prosthesis. Epsilon Services, which launched Poorthi — a silicone gel-based breast prosthesis from Germany — six months ago, has sold about 95 of them across the state. They come in sizes one to 10, costing between Rs 6,000 to Rs 8,000 each.

“Most women who come to try these are referred by doctors as they don’t want to undergo reconstruction surgery,” said Priya Anadraj of Epsilon Services.

Neerja Malik, cancer counsellor and inspirational speaker, said usually only women from very affluent families, who are also often in the public eye, opt for breast reconstruction in India. “Some go for surgery because they are afraid their marital life would be affected. But many others choose to just remain the way they are,” she said.

For instance, interior designer Rahima Babu decided not to wear prosthesis nor undergo surgery. “I decided to be just me so I can live a happy and healthy life,” she said. But some like Savitha prefer to wear prosthesis when they step out. “I have come to terms with my body and am not ashamed to be my natural self,” she said. “I have been cancer-free for two years and for me, (these are) a sign of my victory.”