Newsletter No. 540

07 # 5 4 0 | 1 9 . 0 6 . 2 0 1 9 居廉 Ju Lian 《牽車》 The Cart Puller 1874 絹本設色 Ink and colour on silk 26.5 厘米/ cm （何耀光先生、霍寶材先生、黎德先生及其他人士惠贈 Gift of Mr. Ho Iu-kwong, Mr. Fok Bo-choi, Mr. Li De and others) thus reducing her risk of breast cancer. The longer duration that a woman breastfeeds, the more the risk is reduced,’ said Prof. Emily Chan of the Jockey Club School of Public Health and Primary Care who led the study. Hormonal explanation aside, a lack of physical activity and obesity increase the risk of breast cancer. Around 80% of the surveyed patients had less than three hours of exercise per week, while obesity (BMI>25) increased the cancer risk by 46%. More than 40% of the patients reported high levels of stress, i.e., for more than six months in a year, double that of the control group. Diets rich in meat and dairy products also increase the risk. Like other cancers, family history is a risk factor. ‘For example, BRCA1 mutation may lead to ovarian cancer and breast cancer. Aware that she carried the mutation, actress Angelina Jolie had a double mastectomy to reduce the risk of cancer,’ said Professor Chan. The above research on local cases revealed that only slightly more than 10% of patients had a first- degree relative with breast cancer. Most other risk factors could be modified. It is possible for a woman to reduce the cancer risk by having early pregnancy, breastfeeding, doing exercise, managing stress and maintaining a balanced diet. M. Mak 乳癌目前是本港女性最常見的癌症，每十六名婦女便有一人在其一生中患上。乳癌有多個風 險因素，不少是個人可控制的。 女性患乳癌與雌性荷爾蒙有關，雌性荷爾蒙可以刺激乳房細胞生長，女性受雌性荷爾蒙影響 的時間愈長，患乳癌風險愈高。香港乳癌資料庫於2014至2017年間進行對照研究，從人口統 計特徵和生活習慣等方面，對五千一百零二名乳癌患者和五千五百二十名背景相若的健康市 民進行比較，發現從未生育或第一胎晚育（三十五歲以後）的女性患癌風險較高。反過來說， 曾經生育及年輕時生育的女性患癌風險則較低。負責這項研究的賽馬會公共衞生及基層醫 療學院 陳英凝 教授指出：「婦女餵哺母乳期間，雌性荷爾蒙會減少，同樣可以減少患癌機會。 餵哺愈久，患癌機會愈低。」 除了荷爾蒙外，缺乏運動和肥胖也會增加患癌風險，約八成病人每週運動少於三小時；肥胖 者（體重指數超過25）的風險高46%。逾四成病人表示感受到高度精神壓力，即一年內有六 個月或以上感受到壓力，比例是對照組的兩倍。多吃肉類和奶製品，亦增加患癌風險。 與其他癌症一樣，家族病史是乳癌的風險因素。陳教授說：「例如BRCA1突變基因可以誘發 卵巢癌和乳癌，影星 安祖蓮娜 • 祖莉 便是得知遺傳了該突變基因，進行切除乳房手術，以減 低患癌風險。」上述針對本港婦女的研究指出，只有一成多病人的直系親屬曾患乳癌。更多其 他風險因素卻非不可改變，如年輕生育、餵哺母乳等，個人或有選擇餘地；做運動、減壓和保 持均衡飲食習慣，個人也有較大空間可以控制。 Breast cancer is the most common cancer among women in Hong Kong. One in 16 local women are afflicted by breast cancer in their lifetime. While there are various risk factors leading to breast cancer, many of them can be modified by the individuals themselves. The female hormones which stimulate breast cells to grow are related to breast cancer. The longer the duration that a woman is exposed to these hormones, the higher the risk she develops breast cancer. The Hong Kong Breast Cancer Registry conducted a case-control study on 5,102 patients and 5,520 non-patients whose demographics match those of the patients. By comparing various factors among the two groups, it was found that not giving birth or giving birth to a first child after the age of 35 increases a woman’s risk of developing breast cancer. Comparatively, the risk is lower for a woman who has given birth or had an earlier pregnancy. ‘The level of female hormones is reduced when a woman breastfeeds, 防乳癌 求於己 Breast Cancer Prevention DIY 父親節剛剛過去，大家有沒有趁此機會好好向爸爸表達愛意呢？文物館在此為各位辛勤的 爸爸送上一份遲來的父親節禮物。這幅由清末廣東大師居廉（1828 – 1904）所畫的《牽車 圖》相信會令各位爸爸深有共鳴！ 這幅扇面的右方是兩個孩子坐在木頭車上玩耍，中間則是媽媽站在車頭一手揚鞭，一手執 韁。順着韁繩看過去，我們可以看到牽着車的不是牛，也不是馬，而是手腳繫上韁繩，兩手抓 着車把，還一面回頭笑得好疲倦也好溫柔的爸爸。爸爸心裏面在想甚麼呢？我們可以從畫上 題詩知道： 自嘆苦生涯。一個家，千觔車，精疲力竭為牛馬。兒飢叫爺，女寒叫爹；胭脂娘子鞭 還罵。勸渾家，休怨咱，都是命途差，世事太紛拏，相就些，莫嗟呀。猙牙慧舌何為 者，沁心有茶，養目有花，富貴榮華隨他罷，力不加，肩難卸，拖得似人蝦。 《牽車圖》這個題材並非居廉首創。揚州派畫家黃慎（1687 – 1770）也有《牽車圖》傳世，現 藏天津博物館。畫中的爸爸同樣「拖得似人蝦」地拉着一家大小，但卻愁眉深鎖，滿臉滿身的 不情願。相比之下，居廉筆下的爸爸雖然臉上也看得出疲態，但會笑着哄老婆說「罵到臉容扭 曲不是很無謂嗎？還是喝口茶潤潤心，賞賞花養養眼吧」，真的是個很有生活智慧的暖男呢。 比黃慎時代要晚的袁枚（1716 – 1798）在《小倉山房詩集》中亦有詩回應一幅由許滄亭所畫的 《牽車圖》。從他的詩中，我們可以看到相當類似此圖的元素，例如「全家置一車，主人牽以 走。車中坐妻孥」和主人「精神難抖擻。猶有眷戀心，一步一回首」的設定、狗與尊罍的出現 等。詩中「試問牽車人，何如車上狗！狗態尚安閒，汝身能逸否？」的感慨，相信居廉筆下的爸 爸聽到也會大力點頭，表示認同吧。 文物館藏的這張《牽車圖》，純粹是畫家的「戲筆」，是一個辛苦愛家的平凡爸爸的自白，表 現作者生活化的幽默感，也讓我們看到當爸的不容易。 Heidi Wong 爸爸辛苦了！ Bittersweet Fatherhood 醫 醫 筆 寫 / D octors ’N otes 雅 共 賞 / ART iculation