A study of lifestyle of women in breast cancer in kailash cancer hospital and research center

A STUDY OF WOMEN IN BREAST CANCER IN KAILASH
CANCER HOSPITAL AND RESEARCH CENTER, GORAJ.
AUGUST 2017 RESERCHERS
GORAJ ARCHANA BHATT
ANITA RAKHE

A STUDY OF WOMEN IN BREST CANCER IN KAILASH
CANCER HOSPITAL AND RESERCH CENTER, GORAJ
A
Project Submitted to
Department of Social Work
Sardar Patel University
In The Partial Fulfilment
Of the Master Degree of
Social Work (MSW)
2017
Semester 3rd
PROJECT GUIDE SUBMITED BY
DR. MRS. BIGI THOMAS ARCHANA BHATT
READER ANITA RAKHE

CONTENTS
Preface …………………………………………………….. 1
Acknowledgement ………………………………………. ...2
List of Tables & Figures …………………………................3
Chapter List of Contents Page No.
1
Introduction & Organization Profile
&Research Methodology
1.1 Introduction to study of women in breast
cancer
1.2 Organization Profile
1.3 Research Methodology
2
Data Analysis & Interpretation
2.1 Study of women in breast cancer

3
Findings, Suggestions, Conclusion
3.1
3.3 Conclusion
Bibliography
Annexure

PREFACE
A Study on “Study of women in breast cancer ’’ was carried out in
Kailash cancer hospital and research center.The main objective of the
research was to find the situation of women in breast cancer.
A Study of women at the time of cancer is essential to know how their
family support, what are physical changes, mentally changes in
thoughts, and so on…
The study was done as part of Descriptive Research. Sampling
technique used was simple random sampling, for selecting the sample.
The primary data was collected by means of questionnaire. The
secondary data was collected from the organization records and
websites. The study includes various tools and techniques used to
collect data by using Interview Schedule, Observation and
Discussion. The data was analysed using percentage method. Utmost
care has been taken from the beginning of the preparation of the
questionnaire till the analysis, findings and suggestions. The analysis
leads over to the conclusion that majority women are complaint of
tumour in breast. It was found that most of the women was illiterate.
Valuable suggestion and recommendations are also given to the
women for their healthy and happy life.
Another study on “Study of women in breast cancer” was done in
Kailash Cancer Hospital. The main objective of research was to find
the situation of women in cancer.
Kailash cancer hospital plays a major role in taking care of their
patients and they aim for services provide to middle class and poor
sections of the society. The study was mainly focusing on patient‘s
satisfaction of the treatment provided by the health canter.
The study was exploratory cum descriptive Research. Sampling
technique used was purposive and accidental technique for selecting
the sample. The primary data was collected by means of

questionnaire. The secondary data was collected from various
websites. The study includes various tools and techniques used to
collect data by using Interview Schedule, Observation and
Discussion. The principle of confidentiality and dignity was
maintained while conducting the research and adding to it care has
been taken from the beginning of the preparation of the questionnaire
till the analysis, findings and suggestions. Valuable suggestions and
recommendations are also given to the organization for the better
prospects.

ACKNOWLEDGEMENT:
I am graceful to almighty, for the blessing showed upon me for the
successful completion of my project. I express my deep sense of
gratitude to Mrs Dr. Shivani Mishra, The HOD of Department of
Social work, vidhyanagar, for her encouragement and support.
I express my deep sense of gratitude and profound thank to my
project training guide, Dr.Bigi Thomas for her constant
encouragement throughout my project training report.
It is an honour to show my deepest and heartily gratitude to our
external guide from Social work head of Kailash cancer hospital, Mr.
Bipin Solanki for their support in completing this project. This project
would not have been possible without the unconditional support and
inspiring information of my respondents. I‘m heartily grateful to them
for their support throughout the study.
I want to thank my parents, friends and staff members from the
bottom of my heart for their unconditional support, who never showed
their disagreement in regards to the topic
Archana Bhatt
Anita Rakhe

LIST OF TABLES
SR.NO TABLE PAGE
NO
1 Marital status of respondent
2 Education qualification
3 Occupation of respondant
4 Age at first child birth
5 how long your child was breast fed
6 stages of diagnoses
7 How did you feel about the diagnosis
8 Symptoms of the breast cancer
9 Attitude about treatment?
10 how have your thoughts changed
11 how has your life change since you
found out you had breast cancer
12 How your husband support?
13 if any change in their behaviour after
knowing your situation
14 what are the biggest challenges
15 if any person have face same problem
in family
16 Situation of cancer is curable or not?
17 Under what scheme you get treatment

CHAPTER 1
INTRODUCTION,
ORGANIZATION PROFILE &
RESEARCH METHODOLOOGY

INTRODUCTION:
Kailash cancer hospital is a public charitable trust working with
the Muni Seva Ashram in and around Vadodara district of Gujarat. Its
mission is to work for betterment of health in rural communities of
Central Gujarat. It is now a Community health organization, working
mainly on reproductive and human health.
INTRODUCTION OF STUDY:
Breast Cancer Definition:-
American Cancer Society states that “breast cancer is a malignant
tumour that starts in the cells of the breast. A malignant tumour is a
group of cancer cells that can grow
into (invade) surrounding tissues or spread (metastasize) to distant
areas of the body”
(American Cancer Society, 2012). This disease comes in many forms
and is not equal in all women; it varies according to the speed of
tumour growth and its ability to spread to other parts of the body. It is
impossible to predict the consequences of the disease, since the
degree of malignancy varies and also because people react differently
to the disease. Regarding aetiology, there is no single cause that
explains breast cancer. Currently there is speculation about the causes
of increasing breast cancer in the world. Most of the authors point to
lifestyle as primary causes. Breast cancer is associated with the
Combination of
increasing age and genetic, hormonal and environmental factors.
Being a woman and growing older are the most
Significant risk factors for breast cancer. Breast cancer is strongly
related to age; only 5% of all breast cancers occur in women less than
40 years of age and over 80% of all female

breast cancers occur among women aged 50 or more years. The older
a woman gets, the higher is her risk of developing breast cancer. The
majority of breast cancers are not hereditary. About 85% of breast
cancers occur in women who have no family history of breast cancer.
These occur due to genetic mutations rather than inherited mutations
that happen as a result of the aging process and life in general. Only
about 5-10% of the women who get breast cancer have a family
member diagnosed with it.
What is breast cancer?
The female breast is made up mainly of:
Lobules–the milk-producing glands
Ducts–tiny tubes that carry the milk from the lobules to the nipple
Stroma–fatty tissue and connective tissue surrounding the ducts and
lobules, blood vessels, and lymphatic vessels…
Cancer is the growth of abnormal cells.
The cells can invade and damage normal tissue.
Breast cancer can start in any part of the breast.
Causes of breast cancer:-
Most likely cause is related to changes in the genetic material (DNA)
in our cells.
DNA changes are often related to our lifestyle, but some can be due to
age and other factors.

Breast cancer risk factors:-
Risk factors are anything that can increase or decrease a person’s
chance of getting a disease, such as cancer.
There are many known risk factors for breast cancer. Some of these
cannot be changed, but some can…
Gender
Being a woman is the main risk factor for developing breast cancer
Aging
Breast cancer risk increases as a woman gets older
Genetic risk factors
About 5% to 10% of breast cancer cases are thought to be hereditary,
caused by gene changes (mutations) inherited from a parent.
Women with BRCA mutations have a high risk of developing breast
cancer during their lifetime. When they do develop it, they are often
younger than other women with breast cancer who are not born with
one of these gene mutations.
Mutations in other genes are less common causes of inherited breast
cancer.
Family history of breast cancer
Women who have a close blood relative with this disease have a
higher risk for breast cancer.

Personal history of breast cancer
A woman with cancer in one breast has an increased risk of
developing a new cancer in the other breast or in another part of the
same breast.
Certain non-cancer breast problems:-
Previous chest radiation
Women who had radiation to the chest for another cancer as a child or
young adult are at a much higher risk than those who did not.
Post-menopausal hormone therapy (PHT)
Increased risk in women who use or recently used combined PHT for
many years
Race
African American women are more likely to die of this cancer.
Dense breast tissue
Women with denser breast tissue (as seen on a mammogram) have a
higher risk of breast cancer.
Not having children or having them later in life (after age 30) puts a
woman at slightly higher risk
More menstrual cycles
Slightly higher risk if a woman started menstruation early or went
through menopause late

Not breastfeeding
Some studies suggest that breastfeeding may slightly lower breast
cancer risk.
Physical activity
More active-lowers risk
Overweight
Obesity raises risk of having breast cancer, especially for women after
menopause
Alcohol use
Clearly linked to increased risk
Risk goes up with the amount of alcohol you drink
Preventing breast cancer:-
How all women can lower risk:
Get to and stay at a healthy weight
Be physically active
Limit alcohol use

Some women can also think about things like:
Breast feeding
Not using hormone therapy to deal with the symptoms of menopause
If a woman is known to be at increased risk (due to personal or family
history, or known gene mutations) there are some things she can
consider to decrease her chances of breast cancer:
Chemoprevention—the use of drugs to reduce the risk of breast
cancer
Preventive surgery for women with very high breast cancer risk there
is no sure way to prevent breast cancer. But there are things allwomen
can do that might reduce their risk and help increase the odds that if
they do get breast cancer, it’s found at an early, more treatable
stage…
Breast cancer screening:-
Screening is testing to find cancer, or other diseases, early in people
who have no symptoms.
Screening can help find cancers when they are small and have not
spread –when they have a better chance of being cured.
Breast cancer screening is done with
Mammograms
In some cases, breast MRI

Why screen for breast cancer?
The size of a breast cancer and how far it has spread are important
factors in predicting the prognosis
Breast cancers found during screening exams are more likely to be
small and still confined to the breast (survival outlook).
Screening for breast cancer:
Mammogram
In some cases, Breast MRI (magnetic resonance imaging)
For women at high risk of breast cancer based on certain factors, both
MRI and mammogram exams of the breast are recommended.
A mammogram is an x-ray of the breast.
For a mammogram, the breast is pressed between 2 plates to flatten
and spread the tissue.
It produces a picture of the breast tissue.
Clinical breast exam:-
A clinical breast exam (CBE) is an exam of your breasts by yourself
or health care professional. Research has not shown a clear benefit of
physical breast exams done by either a health professional or by
yourself for breast cancer screening
Breast MRI
For certain women at high risk for breast cancer, a screening MRI is
recommended along with yearly mammogram.
MRI scans use magnets and radio waves (instead of x-rays) to has a
higher false-positive rate (where the test finds something that turns

out not to be cancer), which results in more recalls make detailed,
cross-sectional pictures.
THEORIES ON THE NATURAL HISTORY OF
BREAST CANCER:-
1. The Halsted Theory: Spread from One Source
For 60 years, starting in 1894 (or perhaps earlier), breast cancer was
seen in medical literature to be a disease that arose in one location
(the breast) and, if left untreated, spread through the lymphatic system
first to nearby lymph nodes and subsequently to other organs in the
body. This theory of "contiguous" development of metastases was
articulated by Dr. W.S. Halsted, inventor of the Halsted radical
mastectomy. It has thus become known as the Halsted theory, Halsted
hypothesis, Halsted paradigm, Halsted model, or "halstedian view."
2. The Alternative Theory: Systemic Disease
In 1954 and 1967 an alternative theory was formulated and, after
studies were done, was put forth in rather definitive terms in a 1980
lecture by Dr. Bernard Fisher. He stated "that breast cancer is a
systemic disease . . . and that variations in effective local regional
treatment are unlikely to affect survival substantially."
Following the therapeutic implications of this "systemic theory," the
systemic disease has been attacked in recent years by chemotherapy
and hormone therapy to the whole body. Under a pure version of this
theory, the only purpose of so-called "local or regional control"
(breast surgery and local or regional radiotherapy) is to prevent a local
tumour from getting out of hand and causing harm in that location,
not to prevent future metastases to other parts of the body. That is,
under this theory any distant metastases of any significant have

already occurred at the time that a breast tumour is found by touch
(palpation) or in a mammogram.
3. Citizens and Doctors, Halsted or Systemic Theories
I think that the average citizen instinctively holds a basically
Halstedian theory in her mind. One commonly hears the notion that
"getting the tumour out" is the most important step. Chemotherapy is
seen as a kind of "mopping up operation" in case any metastases had
occurred earlier from the breast to other parts of the body (the
contiguous route for development of tumours). I know that I was quite
surprised when I learned that my friend's oncologist recommended
delaying surgery while doing chemotherapy, something that seemed
contrary to the goal of getting rid of the "main problem" first.
Subsequently, I came to understand that to do surgery first can
actually be viewed as delaying chemotherapy, and why one might
want to do the chemotherapy first.
Doctors trained in the past 15-20 years are more likely to have been
trained under the "systemic theory," in which distant metastases of
some size are considered to be probable in the case of any breast
cancer that has been detected (other than DCIS, ductal carcinoma in
situ). Such doctors may instinctively discount the new studies
showing a *survival* advantage in some women from having
radiotherapy after a mastectomy (though they seem to have little
problem with studies showing survival advantages from radiotherapy
that follows lumpectomies).
Or perhaps some of those who accept the evidence that radiation after
lumpectomy improves survival statistics, but do not conceive of
getting survival advantages from radiation after mastectomy, hold a
basically Halstedian viewpoint, but cannot imagine what tumour
burden might be left after a mastectomy with clean margins.
At any rate, what are we to make of the facts that (a) controlling
regional disease with radiation after mastectomy helps some women
survive longer (meaning that the site from which "secondary
dissemination" could have occurred got eradicated by the

radiotherapy -- a neo-Halstedian fact, perhaps you could call it) and
(b) controlling distant disease with chemotherapy and/or tamoxifen
helps some women survive longer (meaning that the disease had
already disseminated or was systemic in the first place -- a systemic-
theory-supporting fact)? One answer could be to construct a theory or
hypothesis that accounts for both kinds of therapy successes.
Dr. Samuel Hellman of the University of Chicago did just this in a
1994 lecture, and labeled it a "spectrum theory."
4. The Spectrum Theory, or Combined Theory
In the 1994 Karnofsky Memorial Lecture, Dr. Hellman reviewed the
history of theories of breast cancer development ("natural history")
from 1894 to present, and then proceeded to state the case for what he
calls the "spectrum theory." My discussion of the Halsted and
systemic theories, above, is based in part on his lecture.
One of the reasons that he felt called upon to formulate a new theory
was that the studies showing a survival benefit from radiation therapy
after mastectomies could not be adequately explained by the reigning
systemic theory that has the attention of most oncologists -- yet he
believes that the studies, regardless of any limitations they may have,
are providing important information that should not be ignored. Since
data that contradicts a reigning theory can sometimes be disregarded,
he thought it important to describe why it is the current theory (the
"conventional wisdom") that should yield, not the data.
In his lecture, "Natural History of Small Breast Cancers," J. of
Clinical Oncology, 12:2229 (1994) (but do not think that this
involves only small cancers), Dr. Hellman wrote, in part:
"[Under the Halsted model, the] underlying premise is that breast
cancer is an orderly disease that progresses in a contiguous fashion
from primary site, by direct extension, through the lymphatics to the
lymph nodes, and then to distant metastatic sites. It implies that
effective treatment must recognize this orderly, contiguous disease
spread. . . . . [It] was not until recently that an alternative hypothesis
was accepted. That hypothesis suggests that breast cancer is a

systemic disease and implies that small tumours are just an early
manifestation of such systemic disease, which, if it is to metastasize,
has already metastasized. This was first suggested [in 1954 and 1967
and then in 1980 by] Karnofsky lecturer, Bernard Fisher [who said the
things I quoted earlier in this message]."
HOWEVER, "A third hypothesis considers breast cancer to be a
heterogeneous disease that can be thought of as a spectrum of
proclivities extending from a disease that remains local throughout its
course to one that is systemic when first detectable."
Now, friends and colleagues, listen to what he says next:
"This hypothesis suggests that metastases are a function of tumour
growth and progression. Lymph node involvement is of prognostic
importance not only because it indicates a more malignant tumor
biology, but also because persistent disease in the lymph nodes can be
the source of distant disease." [Most italics here and throughout these
pages are added by John Bonine, with no further notation of the fact.]
Note the implications of that quotation: tumour-containing lymph
nodes (and perhaps other sites) might be a SECOND source from
which cancer can spread to the rest of the body.
"Persistent disease, locally or regionally, may give rise to distant
metastases and, therefore, in contrast to the systemic therapy [that is,
the chemotherapy or tamoxifen], locoregional therapy is important."
In other words, better surgical removal of residual tumors may be
important. He labels his new theory a "third, or spectrum, theory" and
says in some instances inadequate treatment of potential local or
regional tumors may lead to additional metastasis occurring.
Radiotherapy may be important, even after "local" control has been
done through a lumpectomy or even a mastectomy, so that "regional"
problem is addressed, to prevent it from becoming the source of a
later systemic problem through additional metastases.
Dr. Hellman expresses it this way:

"The first general question useful in distinguishing among the the
three hypotheses is at what time in the natural history of breast cancer
do distant metastases occur? The systemic disease hypothesis
suggests that these occur before clinical detection and argues that
local eradication of disease makes little or no difference."
Run that last sentence by your eyes again. Doctors are generally
stating these days that breast cancer is "a systemic disease" by the
time that we can detect its existence in any person's body. Systemic
diseases are attacked systemically -- through chemotherapy or anti-
estrogen therapy (or ovarian ablation, as recently noted), and under
the systemic theory, "local eradication of disease makes little or no
difference."
But Dr. Hellman of the University of Chicago thinks that breast
cancer is not always ONLY a systemic disease by the time it is
discovered, but instead can be a disease in which, some of the time,
the continued presence of local tumors can lead to additional
metastases in the future and thus we must in some instances try to go
after even those whose presence we cannot detect.
He says that persons with small breast cancers might be of two types -
- a group of that has "indolent and clinically unimportant cancers,"
and a "second group" of persons who have "a localized cancer that, if
left to grow, will become disseminated and result in the patient's
death." Unfortunately, when patients are seen with small breast
cancers detected only by mammography (and this would ipso facto
mean also those who have small cancers that cannot be detected at all)
"we cannot tell whether the tumor detected is one of these indolent
and clinically unimportant cancers or not."
But Dr. Hellman says that the evidence suggests that there are at least
some patients who have small cancers that, if left untreated, will
eventually metastasize -- but that if treated by radiation therapy may
not, producing greater survival.
"The randomized trial performed in Stockholm of adjuvant radiation
following mastectomy bears directly on this point. The study is
important since the treatment would be acceptable by today's

standards" (among "This study shows the expected reduction in
locoregional recurrences, but is also shows an accompanying
decrease in distant metastases and deaths due to breast cancer." Read
that sentence again.
A group of researchers looked at all randomized trials of mastectomy
with or without radiotherapy, and concluded, earlier in 1994: "'The
reduction of breast cancer deaths suggests that radiation therapy may
have a value beyond the clearly established improvements obtainable
for local control.'" (Dr. Hellman cites Cuzick, et al., "Cause-specific
mortality in long-term survivors of breast cancer who participated in
trials of radiotherapy," J. Clin. Oncol. 12:447-453 (1994).)
Dr. Hellman says that there are tumors "that are destined to remain
localized," others "that metastasize as a function of size," others "that
possibly disseminate from persistent lymph node disease," and finally
some that "have occultly disseminated by the time of diagnosis, since
locoregional treatment is not universally effective in preventing
metastases." This last group benefits from systemic therapy, such as
chemotherapy. The first group needs little concern. The second, and
possibly third, group is where regional and local radiotherapy can
make a difference -- even after mastectomy. The problem is knowing
what kind of tumor one is seeing, and in part one cannot know which
are which.
He suggests that if a tumor is quite small (less than or equal to 2 cm in
size) it may be sufficient to use local and regional treatment (surgery
and radiation), even with "some axillary node involvement," because
even if there has been some metastasis to distant sites in the body, the
body may be able to deal with a small number of cells (or they not be
very malignant). "When tumors are larger, the likelihood for
metastasis increases. . . ."
In conclusion, Dr. Hellman wrote:
"Both the Halsted and the systemic hypotheses are too restricting. The
hypothesis most consistent with the data is that breast cancer is best
thought of as a spectrum of disease with increasing proclivity for

metastasis as a function of tumor size, but for anytime size there is a
proportion of patients with distant metastasis." (My emphasis.)
Colleagues, I will have much more to write about this, for I am trying
to read and understand all the major scientific journals articles on the
use of radiation therapy after mastectomy for some persons. This first
posting can stand as an attempt to demonstrate why radiation therapy
after a mastectomy might(theoretically) help prevent distant
metastases and promote long-term survival.
My later postings will survey the literature of the past two years
saying that radiation therapy for some post-mastectomy patients HAS
INDEED proved to lead to more survival for some women. I'll also
summarize the results of my survey soon. And I'll quote from the
views of some other prominent researchers, such as Dr. Abram Recht
of Harvard University Medical School.

ORGANIZATION PROFILE
KAILASH CANCER HOSPITAL:-
The Purpose
Pujya Anuben Thakkar came to Goraj in 1980 and looking at the
plight of the people of this area. She called on doctors from Vadodara
to provide a weekly health care camp and gradually MSA began to
give basic medical facilities to the people of south-western Gujarat. In
1981 A small dispensary as started and gradually with the support of
philanthropists, a 95 bed ultra modern hospital, Akshar Purshottam
Arogya Mandir was established in 1988. Now APAM offers a full
range of inpatient services to meet needs of the community. Our
professional, qualified staff is able to deliver laboratory, nursing,
physical therapy, radiology, social and surgical services with the
personalized touch designed to make the patients feel relaxed and at
home. The service provided to people is irrespective of their financial,
religious or any other considerations. Needy patients are provided
treatment and financial assistance as per their requirements. The
people of this area had to travel long distance like Ahmadabad and
Mumbai for advanced treatment for disease like Cancer which was
not possible for them due to financial and other constraints. So in
2001 Pujya Shree Anuben Thakkar and Dr.Vikram Patel decide to
build a State of Art Hospital which will provide the people of this area
excellent health services under one roof and this laid the foundation to
Kailash Cancer Hospital & Research Centre. Unlike any other
hospital, this hospital is situated in the rural area of Gujarat to serve
the people of the region who are deprived of technologies and
advanced facilities for the lack of knowledge and economic strength.
At KCHRC we offer specialised an basic treatment in nearly every
branch of medicine. We have a panel of trained experts who are
available to review individual cases through referrals to highly skilled

specialists who support and monitor during every phase of diagnosis
and treatment.
 Critical Care Services: Our outstanding staffs of specialist are
on their toes to provide care in case of critical situations.
 Diabetics Services: Understanding diabetics and all of its
aspects leads to better diabetes management and control.
Diagnostic Medical Services
Kailash Cancer Hospital & Research Foundation has provided the
finest medical care service to the people of South eastern Gujarat. Our
mission is to provide the best quality medical facility to every section
of society irrespective of religion, caste, financial status just on
humanitarian ground. We believe that every person has a right health
care and we try to provide the same.
Cancer Care Service
We are ranked as one of the leading cancer hospitals in India for the
number of patients diagnosed and treated annually. The hospital is
designed to provide curative and preventive treatment, post therapy
support service, palliative care in hospice and domiciliary facility.
Other Service
 Gynaecology and Obstetric
 General Surgery
 Children Services: It is the only hospital in the area to work for
child care. We are able to provide families in this area with
comprehensive range of specialised pediatric services close to
home.
 Imaging/Radiology: Radiology/16 Slice C.T. Scan/X Ray is a
full service department which strive to meet al patient and
clinician needs in diagnostic imaging and image-guided
procedures. We were the first Hospital in Gujarat to have a 16
Slice C.T. Scan.
 Urology

Organization Profile:-
Registered Office: Muni seva ashram campus, Waghodiya road,
Vadodara- 390025 (At post Goraj)
Legal Advisor: Dr.Yogendra Shah
Dr.Bansi Shah
Bharat Patel
Ashok Thakkar
Present board of Trustees comprises of the following:
Sr. No Name Designation
1 Dr.Vikrambhai Patel Chairmen
2 Dr. Vikrambhai Patel
Dr.Tushar Vaishnav
Dr.Chetan Shah
Cor. committee members
3 Dr.Rajesh kanthariya Medical director
4
Swatiben Pandya
Haidar Ali Zangarwala
Management staff
Administrator
H.R.Manager

RANGE OF SERVICES OF KAILASH CANCER
HOSPITAL, MUNI SEVA ASHRAM, GOARJ:-
VISION
Many charitable institutions first develop a mission and then structure
an organization to accomplish that mission. In contrast, Muni Seva
Ashram started without any formal mission or objectives. The
founder, Anuben Thakkar, under her Guruji’s direction, only sought
to serve the needy and deprived of Goraj.
Three decades later, the Ashram has emerged as a clean, serene and
tranquil place where love for humanity abundantly bubbles through
all corners, exploiting natural resources in the most sustainable
manner using cutting edge technologies in renewable energy even
though tucked in a remote tribal belt. This has made the ashram a self-
reliant homogeneous unit. This is the handy-work of Ashram's
chairperson, Dr. Vikram Patel who as Anuben's right-hand man
developed Ashram's infrastructure while paying full respect to nature.
Thus, the Ashram's vision can now be simply stated as :
"To serve, strengthen and sustain the well being of the less fortunates
without any discrimination and build organisational resilience through
agriculture, health, education, welfare programmes and alternative
energy by deploying most appropriate technologies in total harmony
with nature, culture and human values"
In the last two decades Muni Seva Ashram has increased its scope of
activities by many folds, credit for this exemplary growth goes to
Pujya Anuben, for her love for humanity and to Dr. Vikrambhai who

integrated education, health care, alternative energy, social services
and agriculture to create an Ashram that Mahatma Gandhi would have
been truly proud of. He wouldn't have hesitated to move from
Sabarmati ashram to the Muni Seva Ashram!. Banter apart; the
Ashram is an amazing place and these pages will provide only
glimpses of what it is really like. There is no equal to visiting the
Ashram. We invite you to visit at least once in your life time. We
guarantee that the moments will be cherished for the remainder of
your life.
MISSION:
 HEALTH CARE
To integrate clinical excellence, appropriate advanced technologies
and systems, passion and compassion to provide superior and ethical
healthcare at affordable price which contributes to the physical,
psychological, social and spiritual well being of the patient
communities with the spirit of equality, dignity and interfaith.
To fulfil its mission, Muni Seva Ashram has setup two independent
hospitals on the same campus that provide state-of-the-art medical
care to the rural population: Akahar Purshottam Arogya Mandir,
which provides general medical care and the Kailash Cancer Hospital
and Research Canter, which focuses on oncology and nuclear
medicine. Both hospitals charge a token amount for care, which is
fully subsidized by Muni Seva Ashram if patients cannot afford it,
thereby providing 100% free care to the most needy.

Akshar Purshottam Arogya Mandir
The Purpose:
When Anuben first came here, she found that the people of this area
did not have even the basic amenities. There was complete lack of
Government infrastructure, health care and educational facilities.
Many lives were lost or rendered useless due to diseases or health
complications, this moved Anuben and she decided to provide basic
health care service to the backward tribes of this area. She went to
S.S.G. Hospital of Baroda and convinced Dr. Kapadia, an intern of
SSG Hospital, to visit Goraj on weekly basis and this way the weekly
outdoor clinic was started in Goraj in 1981. Dr. Vikram used to visit
Goraj along with Dr. Kapadia, after completion of his Medical studies
Dr. Vikram joined Goraj and gradually under Anuben's guidance and
with Dr. Vikrambhai's unwavering support this small clinic has turned
into 95 bed ultra modern Hospital. Today nearly 150 villages around
Goraj have benefited from this hospital's facilities
Details for Akshar Purshottam Arogya Mandir:
 ECG 1,584
 Vaccine 700
 Out Door Patient 44,301
 Indoor Patient 4,956
 Indoor Patient 82.6
 Major Surgeries 888
 Free Cataract Surgeries 72
 Complicated Deliveries 157
 Pathology 22871

Facilities:
A brief list of some of the major specialties treated at the hospital:
 ENT
 Ophthalmology
 Sonography
 Gynaecology and
Obstetric
 Gastroenterology
 Laparoscopy
 Endoscopy
 Dentistry
 Orthopaedic
 Dermatology
 Urology
 Nephrology
 Plastic Surgery
 Oncology
 Neurosurgery
 Vascular
surgery
Specialties:
Arogya Mandir is equipped with the best and latest patient care
systems. For providing such quality health care delivery systems.
Arogya Mandir is the first hospital in India to have anaesthesia
monitoring systems like Physio Flex and Cicero EM, used for
monitoring anaesthesia in critically ill patients
In the many years of Ashram's existence we came across rural patients
suffering from Cancer. As there was no diagnostic centre, most of the
patients came to know about the disease in an advanced stage where
cure was not possible. Also in absence of Cancer hospital near
Vadodara, the villagers had to travel to Ahmadabad or Mumbai. Most
villagers feeling lost in big cities avoided going there. The main idea
behind the hospital is not just having world class facilities, but
making these facilities available to every segment of the society.
Since inception, the Ashram has always come across patients of
cancer who:
 live in villages

 have no local access to early-detection and treatment services
 avoid travelling to big cities due to cost, language, and cultural
barriers, and
 usually lose their lives to the disease
To help stop this almost entirely avoidable cause of the destruction of
so many families and so much human-wealth, Muni Seva Ashram,
together with many philanthropists and donors around the world,
founded the Kailash Cancer Hospital and Research Centre. This
canter of healing and research makes available the best and the most
affordable healthcare to everyone in the society, regardless of their
religion, caste, creed.
KCHRC was the first hospital in the state of Gujarat to offer:
 High-energy linear accelerator, with a multileaf collimator, an
inverse-planning system for intensity modulated radiotherapy, and
a simulator. These are used to shape radiation beams as per the
dimensions of tumors, to deliver precise doses, and spare damage
to nearby normal tissue. At present, some 90 to 95 patients are
treated every day. Many more fail to benefit, as we have only one
such machine and an increasing number of people are being
diagnosed today than ever before.
 Multi-detector, 16-slice CT scan - a high speed scanner for
Radiology that takes takes ultra-thin sections and true 3D images
 Full-field digital mammography unit, used for early detection and
treatment of breast cancer
 Positron emission tomography with STE technology, helpful in
diagnosing, staging, and monitoring treatment in Oncology,
Neurology, Cardiology, and other conditions.
The hospital also has:
 Conventional radiology, sonography and doppler units
 A well-equipped histopathology lab with Thermo Scientific
equipment
 A pathology lab with Dry Chemistry Analyser, a fully-automated
ELISA reader, and an Enhanced Chemilunminescence Analyser
(ECI) kit

 Blood Banking and Component Therapy to test donated blood, and
minimise immunologic complications of transfusion
 10 operation theaters to perform all kinds of cancer-related
surgeries
The hospital at Muni Seva Ashram treats 60,000 patients each year.
Till date the hospitals have treated nearly 12, 00,000 patients
suffering from various diseases and medical interventions. KCHRC
has treated nearly 15,000 patients of various types of cancer.
Education
To provide opportunities for learning and realising and enhancing the
inner potential of the students through integral education and value
based life-skills to mould them into confident, professionally sound,
socially responsible and spiritually awakened generations of noble
citizens who wilfully shoulder leadership to make this world a
wonderful place to live.
For Ex...
16 Creche Centers
Sharda Mandir Residential Primary School
Vivekanand Residential High School, Vankuva
Nursing College
School of Clinical Research

Social
To enable, empower and encourage comprehensive care and
rehabilitation of the less privileged, the challenged and the needy and
to improve the quality of their lives by providing care, respect and
fulfilment
For Ex..
Bhagini Mandir
Parivar Mandir
Vanprasthashram:
Gokul
Mathura
Vrindavan
Govardhan

RESEARCH METHODOLOGY:-
Title- A Study of women in breast cancer.
OBJECTIVES OF STUDY:-
 What are the situation of women in cancer
 How their family support.
 What are the physical changes
 What are the symptoms of cancer
 What are the main reason of breast cancer
 Patient have any information about cancer or not
 What are their financial condition
 How they feel about their situation of cancer
 How their social life is change
 Under what schemes his/her get a treatment.
SIGNIFICANCE OF STUDY:-
 To spread awareness about breast cancer among women.
 To spread awareness among people about symptoms of
breast cancer.
 To spread awareness among women about
monthly/yearly regular check-up.

RESEARCH DESIGN:-
Exploratory cum Descriptive in nature
Exploratory research because it is the initial research into a
hypothetical or theoretical idea. This is where a researcher has an idea
or has observed something and seeks to understand more about it. An
exploratory research project is an attempt to lay the groundwork that
will lead to future studies, or to determine if what is being observed
might be explained by a currently existing theory. Most often,
exploratory research lays the initial groundwork for future research.
Descriptive research because once the groundwork is established, the
newly explored field needs more information. The next step is
descriptive research, defined as attempts to explore and explain while
providing additional information about a topic. This is where research
is trying to describe what is happening in more detail, filling in the
missing parts and expanding our understanding. This is also where as
much information is collected as possible instead of making guesses
or elaborate models to predict the future - the 'what' and 'how,' rather
than the 'why.'
POPULATION: -
The total element of the universe from which sample is selected for
the purpose of study is known as population. The
Population of our research is a study of women in kailash cancer
hospital and research center.
Population size is small so all the respondents are deemed as
population as well as sample.

TOOL OF DATA COLLECTION
The data source: Primary and Secondary
The research approach: Survey Method
The research instrument: Questionnaire Method
The Respondent for study of women in breast cancer, are the patients
of breast cancer
QUIESTIONNEIR SCHEDULE: -
Questions are framed in such a way that the answers reflect the ideas
and thoughts of the respondents with regard to lifestyle, family
support and awareness in women in breast cancer.
LIMITATIONS OF THE STUDY:-
This study is only limited to Kilash cancer hospital.
The method of random sampling is suitable for small populations
only.
To create good image, respondents may give responses vary from the
facts.
Some respondents hesitated to give the actual situation.
This study covers only those patients who were currently admitted in
hospital.
This study covers only those patients who are treated in this hospital.

CHAPTER 2
DATA ANALYSI
&
INTERPRETATION

TABLE1.1
Q4.Marital status of respondent
Sr. No Percentage Total
Married 100% 20
Unmarried 0% 20
total
0%
20%
40%
60%
80%
100%
120%
married
unmarrid
As per the table all of the respondent ladies are
married.

Q5. Education qualification
Sr.no Education
qualification
Respondent Percentage
1 Illiterate 9 45%
2. Primary 6 30%
3 S.S.C 2 10%
4 H.S.C 1 5%
5 Graduate 0 0
6 Post-
graduate
0 0
7. Total 20 100
Total number of respondent is 20 but in total
number of respondent only 5% ladies are clear
H.S.C exam. And only 10% of ladies are attempt
S.S.C exam means only 2 ladies of the 20
respondent. And only 30% of the ladies get there

primary education and the most of the ladies the
ration of 45% was illiterate. The conclusion of that
table most of the ladies is illiterate.
Q6. Occupation of respondant
Sr. No Occupation Respondent Percentage
1 Housewife 19 95%
2 Labour work 0 0
3 Private sector 0 0
4 Government 1 5%
5 TOTAL 20 100%
Out of total number of respondent the major
respondent are illiterate so the work as a house
wife. In this table show that 95% of respondent are
work as a house wife. And only 5% of respondent
are work in Government sector.

Q.8 Age at first child birth
Sr. No Age group Respondent Percentage
1 15-19 4 20%
2 21-25 14 70%
3 25-30 2 10%
4 Total 20 100%
the above As per table shows that major
respondent have age group of 21-25 years age
group when they give a birth to their 1st child.
Q.9 how long your child was breast fed?
Sr. No Year group Respondent Percentage
1 < 1 years 3 15%
2 1 year 9 45%
3 2 year 7 35%
4 3 year 1 5%
5 3< year 0 0
6 Total 20 100%
As par the above table we show that 35% of the
ladies feed their child to 2 year and 45% of the
respondent feed their child to 1year and less 15%

respondent feed their child to less than 1 year and
only 5% respondent feed their child to 3 years.
11. Stages of diagnose
Sr. No Stages Respondent Percentage
1 1st stage 1 5%
2 2nd stage 12 60%
3 3rd stage 7 35%
4 4th stage 0 0
5 Total 20 100
As per the above table only 5% of total respondent
belong to 1st stage of breast cancer. And only 35%
of respondent are belong to 3rd stage of the breast
cancer. The major respondent belongs to the 2nd
stage of the cancer.
12. How did you feel about the diagnosis?
Sr. No Feel Respondent Percentage
1 Anger 2 10%
2 Anxiety 1 5%
3 Depressed 5 25%
4 Sad 9 45%
5 Loosed 3 15%
6 Total 20 100

As per the above table the majority of respondent
feel sad about their condition and 25% if the
respondent are depressed about their condition.
And 15% respondent thinks that they loosed
something after knowing the situation of breast
cancer.
16. Attitude about treatment?
Sr. No Attitude Respondent Percentage
1 Positives 15 75%
2 Negative 5 25%
3 Total 20 100
The 75% of respondent have a positive attitude
related their treatment. They give positivity to
treatment.
17. How have your thoughts changed?
Sr. No Thoughts Respondent Percentage
1 Socially 7 35%
2 Physically 7 35%
3 Emotionally 6 30%
4 Total 20 100

The 35% of respondent done operation so they
have physically loose so their thoughts change
physically. And other 35% of respondent does not
feel socially completed so they doesn’t survive in
society normally because of hair loose and the
operation of the breast.
18. How has your life change since you found out
you had breast cancer?
19. How your husband support?
Sr. No Support Respondent Percentage
1 Positive 12 60%
2 Negative 2 10%
3 Average 6 30%
4 Total 20 100%
Sr.
No
Changed Respondent Percentage
1 Socially 7 35%
2 Physically 7 35%
3 Emotionally 3 15%
4 Family
related
3 15%
5 Total 20 100

13. Symptoms of the breast cancer?
Sr. No Symptoms Respondents Percentage
1 Change in
size
4 20%
2 Discharge
form nipple
0 0
3 Lumps or
swellings
0 0
4 Dimpling on
the skin
0 0
5 Change the
appearance
0 0
6 Tumour 16 80%
7 Total 20 100%

20. If any change in their behaviour after knowing
your situation?
Sr. No Change Respondent Percentage
1 Positive 14% 70%
2 Negative 6 30%
3 Total 20 100
21. What are the biggest challenges?
Sr. No Biggest
challenge
Respondent percentage
1 Socially 7 35%
2 Emotionally 6 30%
3 Physically 7 35%
4 Total 20 100

22. If any person have face same problem in
family?
As per the surrey 85% of Respondents does not
have any related problem in family.
23. Situation of cancer is curable or not?
Sr. No Situation Respondents Percentage
1 Curable 13 65%
2 Non
curable
7 35%
3 Total 20 100
Sr. No Problem Respondent Percentage
1 Yes 3 15%
2 No 17 85%
3 Total 20 100

24. Under what scheme you get treatment?
Sr. No Scheme Respondent Percentage
1 Maa yojana 13 65%
2 I.C.S 0 0
3 Mukhymantri
rahat fund
0 0
4 Trust 3 15%
5 By own 2 10%
6 Total 20 100

CHAPTER – 3
MAJORFINDINGS,
SUGGESTIONS
&
CONCLUSION

MAJOR FINDINGS:
The major findings are as follow:
Table no 1 indicate that the majority of respondent is
married. So we find that breast cancer ration is high after
the marriage.
 Table no.2 indicates that major of the respondent are
illiterate. There are 45% of respondent are illiterate. And
the second highest ration of respondent is only study on
primary level. And only 1 respondent complete their
higher secondary education.
Table no. 3 indicates that occupation of the respondent.
That shows that 95% of the respondents are work as a
house wife. And only one respondent that is 5% of
respondent works in a government sector.
Table no.4 indicates that the age of the woman for birth
of their first child. That table also show that the age of the
marriage of the woman. Majority of the respondent give
the birth of the child in the age group 21-25. That is show
70% of all over respondent. And 20% of respondent give
their child birth on the age of 19th year. That covers 20%
of the all over respondent.
Table no.5 indicates that the period of the breast feeding
of their child. The majority of respondent feed their child
as long as 1 year. The shows 45% of the all over
respondents. And the second highest period of the feeding
id 2 year. Those cover 35% of all over respondent.
Table no.6 shows that the stage of the diagnoses. That
show that majority of the patient is under the stage. The
major respondent id on 2nd stage of the diagnosis. That
shows the 60% of the respondent. And the second
highest majority of respondent is in 3rd stage of the breast
cancer.

Table no.7 indicates that feeling of the respondent after
knowing the cancer. The majority of the patients feel sad
about their conditions that ration is 45%. The other
respondent feel depressed after knowing their situation of
cancer. That respondent ration id 25%. Other 3
respondent feel lost after knowing the situation. That
ration is 15%.
Table no 8 indicate the symptoms of the breast cancer.
The major respondents have complained about tumour in
their breast. That ration is 80 %( 16) if the all over
respondent.
Table no. 9 indicate that the respondent attitude about
their treatment. That shows 2 types of attitude Positive
and Negative. The majority of respondent show positive
attitude about their treatment. That show 75 %( 15) of the
ration.
Table no 10. Indicate that how respondents thoughts was
changed during the treatment. That show that 35% of
respondents socially thought changed and also the
physically because of the operation on the breast.
Table no. 11 indicates that how respondent lives change
during the treatment. The majority of the respondent life
was change on physical basis because of operation on
their breast and all most the respondent lost their breast
during the treatment so their physically and socially life
was change.
Table no. 12 indicates that how respondent husband
support them during the treatment. The majority of
respondent said that their husband support them
positively that ration cover 60 %( 12).
Table no. 13 indicate that what the major change in
respondents husband behaviour after knowing their
situation. The majority of the respondent said that their

husband was change positively they support them and
also give a support to them.
Table no.14 indicates that what respondent biggest
challenge was. The majority of the respondent said that
the biggest challenge in their treatment is the physical
challenge because they lost their breast.
Table no. 15 that table indicate the ration of the same
problem face on family by any other in past? The
respondent said that there are no one of the family
member have same type of cancer problem in the past of
the family.85 %( 17).
Table no. 16. Indicate that the situation of the respondent
is curable or not. The majority of the respondent is in
curable situation of the cancer. That show the ration of
the 65 %( 13).
Table no. 17 indicates that under which scheme
respondent get a treatment. The majority of the
respondents get a treatment under the Maa Yojana. That
is the Gujarat government scheme. The 65% of breast
cancer
patient get a treatment under that scheme.

SUGGESTIONS
 Take a more improvement in behaviour of nurses with
patients and their family members, it must be humble
behaviour.
 Change in the structure of chemo therapy ward so we can
reduce fights for turn for chemo between patients.
 There are also change in structure of radiation therapy
ward for balancing the patient’s time who up-down daily
from far areas and also doctor’s time.
 Management department also take strict steps on
cleanliness in garden area so that patient’s n their family
members do not throw garbage at any place.

CONCLUSION
 As a part of our project work, we got an opportunity to
spend a period of 45 days in Kailash cancer hospital
and Research center, Goraj. We conducted major
studies in the organization i.e. A Study on breast
cancer in women. It helped me to analyze the working
of the organization which helped as to convert our
theoretical knowledge into practical.
 It is important to show that what are the main causes
of breast cancer, what are the symptoms of it, what are
the treatments of it etc...
 Based on available study we suggests the women to
maintain a limit in alcohol, maintain healthy weight ,
avoid long term hormone therapy, stay physically
active, eat foods high in fiber , emphasize olive oil ,
avoid exposure to pesticides , continue some exercise
or yoga in their daily life.

BIBLIOGRAPHY
http://scholarcommons.usf.edu/cgi/viewcontent.cgi?art
icle=5848&context=etd

ANNEXURE
DEPARTMENT OF SOCIAL WORK
KAILASH CANCER HOSHPITAL
GORAJ
STRUCTURE OF THE INTERVIEW
QUESTAION
1. Name:
2. Date of birth:
3. Age
4. Marital status:
married unmarried
5. Education completed:
Illiterate SSG HSC
Graduation post graduation
6. Occupation:
Farmer Labour Self employ
Government employ any other
7.
Number of
children
Gender Age

8. Age at first child birth :
9. How long your child was breast fed.
10. Date of diagnosis :
11. Stage of diagnosis :
1st stage 2nd stage
3rd stage 4th stage
12. How did you feel about the diagnosis?
Anger anxiety depressed
Sad loosed
13. Symptoms of breast cancer?
change in size or shape of one or both breasts
discharge from either of your nipples
a lump or swelling in either of your armpits
dimpling on the skin of your breasts
a change in the appearance of your nipple
14. What information do you have about your
condition?
15. What did you think about breast cancer before
you were diagnosed?

16. Attitude about Treatment
Positive Negative
17. How have your thoughts changed?
18. How has your life changed since you
found out you had breast cancer?
Socially
Physically
Emotionally
If any problem related to family life you face?
19. How your husband’s support?
Positive Negative
Average
20. If any change in their behavior after
knowing your situation
Positive
Negative
21. What are the biggest challenges?
Socially
Physically
Emotionally

22. If any person have face same problem in
family in past?
Yes No
23. Situation of cancer is
curable Incurable
24. If you know about various schemes of
government related to cancer?
Yes No
25. Under what scheme you get treatment ?
Maa-Yojana
Indian cancer society
Mukhyamnatri rahat fund
From muni sevashram trust
By own

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