Cancers in Women
An Article Published in “ THE HINDU” Newspaper
on 4th February, 2013.
- Dr. Mohan Vamsy
Ms (Gen.) DNB (Surg.) MCh (Surgical Onco) FRCS (Edin) Dip.
Lap. Sur (France)
Chief Surgical Oncologist, Omega Hospitals
HEALTH, an indispensable aspect of
human life is the basic element which assures the well being of the society.
There are many ailments which can disrupt the health of individuals, impacting
their personal, professional and family lives. One such condition is Cancer,
which occupies high significance while the problem can be addressed and dealt
effectively only with awareness and knowledge, but not fear and hesitation.
Cancer…
What exactly is it?
Cells are the building blocks of
living beings. Cancer is not a particular disease, but a condition involving
the uncontrolled growth of abnormal cells in the body. Cancerous cells are also
called malignant cells which grow out of normal cells in the body. There is a
regular cycle in the body where normal cells multiply and die based on the
body’s requirements. Cancer is one such condition where the growth of cells in
the body goes out of control and cells divide too quickly or do not get killed
even after their cycle has ended.
Incidence in women:
In our society, women are highly
prone to cancer. There are different kinds of cancers in women. Cancer can
develop in almost any organ or tissue, such as the breast, cervix, ovary,
colon, lung, skin, bones, nerve tissue, etc. Cancer is caused by many factors
like obesity, viruses (Human Papilloma Virus or HPV), genetic problems,
exposure to organic pollutants, tobacco (smoking or chewing), consuming excess
alcohol, environmental toxins, excessive exposure to sunlight and others.
However, the exact cause of many cancers remains unknown to this day.
Common Cancers in Women:
Women are prone to cancers of the
breast, cervix, uterus, ovary, gestational trophoblastic tumors, uterine
sarcoma, and rarely of the vagina and vulva.
Breast cancer: Cancer that forms in tissues of the breast, usually the
ducts that carry milk and glands that make milk. It occurs in both men and
women, although male breast cancer is rare. Early menarche, late menopause, if
the age at the time of first child birth is more than thirty years, family
history of breast cancer, use of estrogen-containing hormone replacement
therapy, obesity and a sedentary lifestyle are considered risk factors for
breast cancer in females.
Cervical cancer: Cancer that forms in tissues of the cervix (the organ connecting
the uterus and vagina). It is usually a slow-growing cancer that may not have
symptoms but can be detected with regular Pap tests (a procedure in which cells
are scraped from the cervix and looked at under a microscope). Cervical cancer
is mostly caused by human Papilloma virus infection. HIV infection, sexual
promiscuity, use of oral contraceptives and tobacco smoking are usually
associated with increased risk of cervical cancer.
Ovarian cancer: Cancer that forms in tissues of the ovary (one of a pair of
female reproductive glands in which the ova, or eggs, are formed). Most ovarian
cancers are either ovarian epithelial carcinomas (cancer that begins in the
cells on the surface of the ovary) or malignant germ cell tumors (cancer that
begins in egg cells).
Uterine sarcoma: A rare type of uterine cancer that forms in muscle or other
tissues of the uterus (the small, hollow, pear-shaped organ in a woman's pelvis
in which a fetus develops). It usually occurs after menopause. The two main
types are leiomyosarcoma, a cancer that originates in smooth muscle cells and
endometrial stromal sarcoma which begins in connective tissue cells.
Lung and oral cavity (head and neck
cancer): Cancer that originates in the lungs
or the head and neck region is usually associated with tobacco smoking, both
active and passive and/or tobacco chewing. Human papilloma viruses can also
lead to cancer of the oropharynx.
Endometrial cancer: Cancer that forms in the tissue lining the uterus (the
small, hollow, pear-shaped organ in a woman's pelvis in which a fetus
develops). Most endometrial cancers are adenocarcinomas (cancers that begin in
cells that make and release mucus and other fluids).
Gestational trophoblastic tumor: These represent the tumors that develop from trophoblastic
cells (cells that help an embryo attach to the uterus and help form the
placenta) after fertilization of an egg by a sperm.
Vaginal cancer: Cancer that forms in the tissues of the vagina (birth
canal). The vagina starts from the cervix (the opening of the uterus) to
outside of the body. The most common type of vaginal cancer is squamous cell
carcinoma, which starts in the thin, flat cells lining the vagina.
Vulvar cancer: Cancer of the vulva (the external female genital organs,
including the clitoris, vaginal lips, and the opening to the vagina).
Early Detection of Cancer
Women need to be extremely vigilant
about symptoms they may experience in their body. Cancers, related to
gynecology produce symptoms early enough for them to be successfully treated.
When the symptoms are ignored, the delay in treatment can prove to be fatal. If
you are experiencing something abnormal in your body, consulting your doctor is
highly important. There are chances that the symptoms may not be cancer
related, but it's better to be safe than be sorry!
Breast cancer symptoms: These vary widely from lumps to swelling to skin changes
and many breast cancers have no obvious symptoms at all. Symptoms that are
similar to those of breast cancer may be the result of non-cancerous conditions
like infection or a cyst.
Breast self examination should be
part of your monthly health care routine, and you should visit your doctor if
you experience any changes in breast. If you are over 40 or at a high risk for
the disease, you should also have an annualmammogramand physical exam by a
doctor. The earlier breast cancer is found and diagnosed, the better your
chances of your treatment and survival.
Abnormal vaginal bleeding is the most common symptom experienced by women who are
predisposed to gynecologic cancers. Heavy periods, bleeding between periods,
and bleeding during and after sex are all considered abnormal vaginal bleeding
and are symptoms of gynecologic cancers. The symptom of abnormal vaginal
bleeding is linked tocervical cancer,uterine cancer,and ovarian cancer.
Abdominal swelling and bloating is
one of the more common symptoms of ovarian cancer. It is also a symptom that is
most ignored. The bloating may be so severe that one can't button their pants.
Pelvic Pain: Pelvic pain is characterized by pain or pressure below the
navel. It is persistent and isn't limited to just premenstrual syndrome. Pelvic
pain is associated with cancers of theendometrium,ovary,cervix,fallopian tube
cancerand vagina.
Persistent Lower Back pain: Pain occurs in the lower back and often feels like a dull
ache. Some women describe it as feeling like labor pains. Lower back pain can
be a symptom ofovarian canceror locally advanced uterine cancer.
Persistent stomach upset or bowel
changes: If you experience constipation,
diarrhea, blood in the stools, gas, thinner stools, or just a general overall
change in bowel habits, see your doctor. These changes are all symptoms
ofgynecologic cancerandcolon cancer.
Unintentional weight loss: Losing more than 10% of your body weight without trying may
be a nice surprise, but isn't quite normal. Although a woman's weight may
fluctuate throughout the month, any weight loss of more than 10 kgs in less
than 6 months should be reported to your doctor.
Persistent Fever: A fever that does not go away or lasts for more than 7 days
on and off should be reported to your doctor. A stubborn fever is often a
symptom of cancer and many benign conditions.
Vulva or Vaginal Abnormalities: With vulvar or vaginal abnormalities, you should be aware of
any sores, blister, changes in skin color, and discharge. Women should exam
their vulva and vagina regularly to gauge these abnormalities.
If the above symptoms persist,
please consult your Doctor immediately!
Different means of treatmentCancer can be treated bysurgery,chemotherapy,radiation
therapy,immunotherapy,monoclonal antibody therapyor other methods. The choice
of therapy depends upon the location and grade of the tumor and thestageof the
disease, as well as the general health condition of the patient. A number
ofexperimental cancer treatmentsare also under development. Complete removal of
the cancerous tissue without damage to the rest of the body is the main
objective of treatment. This can be addressed by surgery, but the possibility
of cancers invading adjacent tissue or spreading to distant sites sometimes
limits its effectiveness. Therefore chemotherapy and/or radiation have to be
given to increase the rate of successful treatment and prevent the recurrence
of various cancers. In some cancers, radiotherapy in combination with
chemotherapy might achieve cure.
Because cancer refers to a class of
diseases, it is unlikely that there will ever be a singlecure for cancerwhen
compared to commoninfectious diseases. Due to the latest targeted therapies and
supportive therapies in place, the quality of life of patients has improved at
a phenomenal rate in the last few years. Medical professionals in the modern
society look forward for more such advances in the future as there is an
intensive research being carried out in this area.
Treatment outcomes
With the advent of many latest
therapies and drugs, the results of cancer treatment have improved drastically;
the key to better result is early detection which can be achieved through
implementation of regular screening.
A number of cancers can be
considered curable. Many early breast cancers, early colon cancers and early
cervix cancers can be cured; often with surgery alone and sometimes with
surgery and other treatments. Statistics show that cancer patients are living
longer, conquering the disease. The death rate from the dreaded disease has
steadily decreased in the last few decades. From a survival rate of one in four
during 1940's, it has now has reached a survival rate of 50%. Not only are the
patients surviving, but they are experiencing a better quality of life while
under treatment.
Surgery is becoming less painful,
especially with minimally invasive surgery, the side effects with chemotherapy
are reducing, and radiation is becoming more focused and effective.
The positive attribute of human life
is that we never accept defeat even in the most difficult circumstances and
something similar is being witnessed in the field of cancer treatment where no
efforts are being spared to herald more advances in providing world-class and
highly effective treatment procedures.
Let us keep the flame of Hope
burning all the time, Hope is Eternal!
