Ahn Se-hyeon, a professor of breast surgery at Ewha Womans Cancer Hospital, has long been known as the best doctor in the field of breast cancer. As of the end of last year, he has performed a cumulative 26,000 breast cancer surgeries over 30 years. He averages 2.6 times a day.
Professor Ahn is famous for his surgery that minimizes scarring by making an incision of less than 2cm when performing breast-conserving surgery. He is the first in Korea to attempt nipple reconstruction surgery for breast cancer patients, which is now performed by several hospitals. When Professor Ahn recently moved from Asan Medical Center in Seoul to Ewha Womans Cancer Hospital, about 20% of his patients followed him to the hospital.
When the Dong-A Ilbo selected the 10 best cancer doctors among university hospital professors nationwide in 2018, and then, when Forbes selected Korea’s top 100 doctors in 2021, Professor Ahn was all named. We heard from Professor Ahn how to deal with female cancers such as breast cancer.
To prevent cancer in women, it is necessary to prevent obesity first.
Professor Ahn predicted that “for at least the next 20 years, the number of breast cancer patients will increase.” In addition to genetic problems, hormonal problems are the cause of overexposure. In addition, △ westernization of diet, delayed childbirth, and aging population are also cited as reasons for the increase in cancer patients. It’s not just breast cancer. Endometrial cancer and other female cancers are also on the rise. However, cervical cancer is on the decline due to an increase in vaccination against the human papillomavirus (HPV), a known cause. In general, there is no significant correlation between different female cancers. Just because you have breast cancer doesn’t mean you’re more likely to get cervical cancer. However, if there is an abnormality in the BRCA gene, there is a high risk of developing ovarian cancer in addition to breast cancer. In addition, certain hormones used to treat breast cancer can sometimes increase the risk of developing endometrial cancer.
In order to prevent cancer in women, it is necessary to manage the diet first. Avoid high-calorie, high-fat diets to avoid becoming overweight. At the same time, proper exercise is essential. In general, it is recommended to exercise at least 3 times a week for at least 30 minutes. Professor Ahn said, “It looks a bit obvious, but if you follow this principle, you can prevent cancer.” He especially warned that he was obese. Mast cells secrete more female hormones, which increases the risk of breast cancer.
Are there any specific foods that are particularly good for cancer? Professor Ahn said, “There is no such food. If there is, it would have already been developed as a treatment.” It is also important to have regular health check-ups.
Increase your chances of getting pregnant even if you have cancer
In the case of women in their 20s and 30s who have been diagnosed with cancer, in addition to having to fight the disease, they have a lot of worries about childbirth. Can I have a baby if I get cancer? “Absolutely not,” said Professor Ahn. “If the patient’s will is strong, pregnancy may be possible.” Five years ago, Kim Mi-young (pseudonym), a breast cancer patient in her mid-30s, visited Professor Ahn after visiting two of her hospitals. Kim was in her second month of pregnancy. She said that she wanted to give birth to a baby that was hard to get, but they all shook their heads at other hospitals.
In general, surgery can be performed on cancer patients after 7 months of pregnancy. Because the baby has grown enough. If the pregnant woman is okay, ‘toxic’ chemotherapy is possible. However, chemotherapy and surgery itself are often impossible before the fetus is 3 months old.
Professor Ahn first examined the patient’s condition with ultrasound. Fortunately, the size of the cancer was small. It did not appear to have metastasized to the lymph glands. Then, as a result of the cancer recurrence possibility test, the result was a ‘middle’ score. I saw hope in that the likelihood of a recurrence is not high. He discussed the results with Mr. Kim. Kim said she would put off medication until the baby was born and put up with it.
Because of the effect on the fetus, only the chest area was anesthetized and the cancer was removed. After 3 months, she confirmed lymph node metastasis by ultrasound. After that, no cancer was found until Kim gave birth and finished breastfeeding. It was only then that Kim started anti-hormonal treatment. Professor Ahn laughed, saying, “I recently got a call from Mr. Kim that the child was four years old.”
Prof. Ahn decides a cancer patient’s fertility after consulting with the patient in consideration of the stage and size of the cancer, age, and experience of childbirth. “Since each patient’s condition is different, it cannot be said that pregnancy is possible or impossible,” he said. For this reason, Prof. Ahn emphasized that sufficient counseling and the experience of doctors are very important.
●Patient association activities help treatment
In 2000, Professor Ahn created a group called ‘Saehwan’, centered on patients who underwent breast cancer surgery. Members visited the ward twice a week to communicate with patients. In 2003, a patient group called ‘Pink Ribbon Society’ was also established. On the second Wednesday of every month, the entire public bath was rented for 4 hours from 10 am to the Pink Ribbon Society. Professor Ahn had a question-and-answer session with patients at the site. The two meetings were suspended in 2020 due to the novel coronavirus infection (COVID-19), but are expected to resume soon.
Separately, Professor Ahn built an apartment near the hospital at his own expense in May 2005 to provide a shelter for breast cancer patients who came from the countryside to receive radiation treatment. At the time, Professor Ahn borrowed 170 million won to buy an apartment. Patients could stay in this ‘shelter apartment’ for 5 to 6 weeks and receive treatment at a minimum cost of 5000 to 10,000 won per night. This shelter apartment was operated for 9 years until May 2014, and after that, the operation was stopped as a lot of indemnity insurance that compensates for hospital room charges became active.
There is a reason Professor Ahn is so active in patient gatherings. At that time, the Internet was not developed, so there were not many channels through which patients could find out about disease information. The more important reason is that the patient’s treatment effect increases and the likelihood of returning to daily life increases through patient association activities. In fact, there are many studies that support this.
For this reason, Professor Ahn tends to encourage the activities of the patient association. Professor Ahn said, “It is a great comfort and strength for cancer patients just by telling them about their experiences.” Even if the times change and information overflows, healing through such comfort is still a big role for the patient association.
 Endometrial cancer is cancer that develops in the lining of the uterus. While cervical cancer is on the decline, the incidence of endometrial cancer is steadily increasing. Kim Mi-kyung, a professor of obstetrics and gynecology at Ewha Womans Cancer Hospital (pictured), cited aging, obesity, and westernized eating habits as the causes. In the case of stage I and II, before the invasion into the lymph glands (lymph glands), surgery is mainly performed. According to Professor Kim, more than 80% of patients are diagnosed at an early stage. In this case, the 5-year survival rate is more than 90%. However, if the cancer is advanced, the survival rate may drop to less than 30%. This ‘advanced’ endometrial cancer has a high recurrence rate of 20-50% or more. Fortunately, with the recent introduction of immuno-oncology drugs, research results have been published one after another that the therapeutic effect is improving. As a result, expectations are growing that the survival rate of advanced and recurrent endometrial cancer, which has been at a standstill until recently, will increase. In the case of Ewha Womans Cancer Hospital, Ewha Womans Cancer Hospital is actively conducting clinical trials for patients who have failed standard treatment and basic research on anticancer drug resistance, Professor Kim added. For young patients, conservative treatment may be performed without resection of the uterus for conception. It is only possible when the cancer is stage 1 and the cancer is less lethal or has not penetrated deep into the uterus. This does not apply to all patients, so it is best to consult with your doctor before making a decision. Professor Kim emphasized, “The method of preventing endometrial cancer is similar to that of female cancer including breast cancer, and there is no specific drug. |
Correspondent Kim Sang-hoon [email protected]