CANCER AND WOMEN
Cancer is a disease where cells multiply without control and destroy healthy tissue. Cancer can endanger life and is the leading cause of death in many countries. · About 100 kinds of cancer affect human beings.Cancer can occur at any site of body across all ages.
The intention of this article is to aware the target population in terms of:
- Ability to recognise warning symptoms of cancer
- Ability to recognise the risk factors for cancer
- Understanding of the importance of seeking medical help early for symptoms
SYMPTOMS OF GYNAECOLOGICAL CANCER
- post-coital bleeding (bleeding after having sexual intercourse)
- inter-menstrual bleeding (bleeding between periods)
- post-menopausal bleeding (bleeding after you have gone through the menopause)
- abnormal vaginal discharge.
- You should always seek medical attention if you are having abnormal vaginal bleeding. However, bleeding between periods or having heavy periods is more commonly caused by benign (non-cancerous) problems.
- pelvic or abdominal pain
- bloating
- reduced appetite or feeling full quickly
- increased abdominal size
- altered bowel habits
- increased urge to pass urine more frequently.
These symptoms are more commonly caused by less serious conditions, but if you experience one of these symptoms for up to 12 days out of a month, it is worth arranging to see your gynae cancer specialist. If you are worried about ovarian cancer, it is important to mention it to your doctor.
FAMILY HISTORY
Around 5% of ovarian cancers happen because of an inherited gene. If you have family members who have had cancer you may be eligible for further investigations, particularly if:
you have two or more close family members (parent, aunt, uncle, sister, brother or grandparent) who have had breast and/or ovarian cancer and/or the family member(s) had breast cancer found before the age of 50 you have three or more relatives on the same side of your family with bowel, womb, prostate, stomach or ovarian cancer, itchiness, burning, pain/discomfort of the vulva an ulcer, swelling or lump that does not go away
- changes to the texture/feel of the skin
- changes to the colour of the skin bleeding from the vulva or vagina
RISK FACTORS
Factors That are Known to Increase the Risk of Cancer
a.Cigarette Smoking and Tobacco Use
Not smoking or quitting smoking lowers the risk of getting cancer and dying from cancer. Scientists believe that cigarette smoking causes about 30% of all cancer deaths
b.Infections
Certain viruses and bacteria are able to cause cancer. Viruses and other infection -causing agents cause more cases of cancer in the developing world (about 1 in 4 cases of cancer) than in developed nations (less than 1 in 10 cases of cancer). Examples of cancer-causing viruses and bacteria include:
Human papillomavirus (HPV) increases the risk for cancers of the cervix, penis, vagina, anus,and oropharynx.
- Hepatitis B and hepatitis C viruses increase the risk for liver cancer.
- Epstein-Barr virus increases the risk for Burkitt lymphoma.
- Helicobacter pylori increases the risk for gastric cancer.
c.Radiation
Being exposed to radiation is a known cause of cancer. There are two main types of radiation linked with an increased risk for cancer:
Ultraviolet radiation /Ionising radiations
d.Unprotected Intercourse/Multiple partners.Use of barrier contraceptives is known to reduce chances of HPV infections/STDs & hence reduce cancer incidence .
e. Multiparity
FACTORS THAT MAY AFFECT THE RISK OF CANCER
a.Diet
The foods that we eat on a regular basis make up your diet. Diet is being studied as a risk factor for cancer. It is hard to study the effects of diet on cancer because a person’s diet includes foods that may protect against cancer and foods that may increase the risk of cancer.
b.Alcohol
Drinking alcohol is linked to an increased risk of the following types of cancers:
- Oral cancer
- Esophageal cancer
- Breast cancer
- Colorectal /Liver cancer
you have two or more close family members (parent, aunt, uncle, sister, brother or grandparent) who have had breast and/or ovarian cancer and/or the family member(s) had breast cancer found before the age of 50 you have three or more relatives on the same side of your family with bowel, womb, prostate, stomach or ovarian cancer, itchiness, burning, pain/discomfort of the vulva an ulcer, swelling or lump that does not go away
- changes to the texture/feel of the skin
- changes to the colour of the skin bleeding from the vulva or vagina
PHYSICAL ACTIVITY
Studies show that people who are physically active have a lower risk of certain cancers than those who are not. It is not known if physical activity itself is the reason for this.
OBESITY
Obesity is linked to a higher risk of the following types of cancer:
- Postmenopausal breast cancer.
- Colorectal cancer.
- Endometrial cancer
- Cancer of the gallbladder
Because diabetes and cancer share these risk factors, it is hard to know whether the risk of cancer is increased more by diabetes or by these risk factors.
ENVIRONMENTAL RISK FACTORS
- Being exposed to chemicals and other substances in the environment has been linked to some cancers:
- Links between air pollution/secondhand tobacco smoke and cancer risk have been found. These include links between lung cancer, outdoor air pollution, and asbestos.
- Drinking water that contains a large amount of arsenic has been linked to skin, bladder, and lung cancers.
PREVENTION
1.VACCINATION
Raise awareness of HPV and continue to disseminate information about the vaccination programme HPV Vaccine protects against infection with strains of human papillomavirus (HPV) that cause cervical cancer.
2.AWARENESS
(i)About the risk factors & efforts in reducing them.
(ii)Increase women’s knowledge of the signs and symptoms of cervical cancer and encourage them to have symptoms checked by a doctor, while reassuring them that in most cases, the symptoms won’t be cancer.
(iii)Understanding the need of early detection of cancer & better outcome accordingly.
FERTILITY SPARING IN GYNAECOLOGICAL CANCERS
Never before have women with newly diagnosed gynecologic malignancies had more options for preservation of fertility.
Girls or women of childbearing age with several ovarian cancer subtypes have a high probability of unilateral ovarian involvement, and, thus, may be candidates for fertility-sparing surgery with preservation of a contralateral normal ovary and uterus. These subtypes include ovarian tumors of low malignant potential, malignant ovarian germ cell tumors, and ovarian sex cord-stromal tumors. For women with invasive epithelial ovarian cancer who have early-stage disease, fertility-sparing surgery may be an option. In some cases, fertility-sparing surgery may be followed by postoperative chemotherapy.
For women with invasive cervical cancer, fertility-sparing surgery may be possible. Options include conization alone for stage IA1 or IA2 disease, radical trachelectomy with stage IA2 or IB disease, or ovarian transposition for women undergoing chemoradiation.
Non-operative options, such as hormonal therapy, may be considered for women with early-stage, low-grade endometrial cancer.
For all women of childbearing age with gynecologic malignancies, in vitro fertilization techniques or cryopreservation of ovarian tissue may be an option prior to definitive treatment.
Key Recommendations:
- Continue to disseminate messages about the importance of screening amongst peer populationEarly help-seeking and ensure urgent appointment with gynaecologist or gynae cancer specialist
- Initiate more open discussion of gynaecological symptoms to minimise the role that embarrassment plays in preventing early diagnosis
- Seek information regarding HPV Vaccination & Pap smear testing from your gynaecologist