Breast Cancer  Cervical Cancer  Uterine Cancer  Ovarian Cancer

What is Cancer ?

Cancer is a disease that starts in our cells. Our bodies are made up of millions of cells, grouped together to form organs or tissues such as the lungs, the liver, muscles and bones. Genes inside each cell order it to grow, work, reproduce and die. Normally these orders are clear, our cells obey and we remain healthy.

Sometimes a cell’s instructions get muddled and it grows abnormally. After a while, groups of abnormal cells form lumps or tumors.

If the abnormal cells stay in one place in the body, the tumour is benign. Benign tumours are not usually life-threatening.

Sometimes abnormal cells invade the tissues around then and spread to other parts of the body. When this happens, the tumour is malignant and the person has cancer. Tumour cells that spread to other parts of the body are called metastases. Often, the first sign that a malignant tumour has spread is the swelling of near by lymph nodes, but cancer can metastasise to almost any part of the body. A malignant tumour can be dangerous and it is important to find it and treat it quickly, before it spreads.

Cancers are named after the part of the body where they start. For example, cancer that starts in the colon but spreads to the liver is called colon with liver metastases.

BREAST CANCER

There is something you can do for yourself….. Give yourself the gift of a lifetime.

Because, when you find a breast tumour in its earliest stages, you have a better than 90 per cent chance of long-term survival. So, here is another statistic to think about : thousands of women who found their breast cancer early are living happy, active lifestyles. When you practise early detection you give yourself the gift of a lifetime.

Why it is increasingly important as a woman ages.

You can develop breast cancer at any stage, but your risk increases as you grow older. You are twice as likely to develop the disease at the age 70 as at 50. So, the older you are, the more vital it becomes that you are careful.

The earlier it is detected, the better.

Tremendous progress has been made in treating breast cancer. Many women no longer have to lose a breast to this disease. And those who do, may be able to have immediate plastic surgery, allowing them to leave the hospital with essentially the same silhouette. There are also many new drug therapies that help control the spread of breast cancer. But the key to taking advantage of this progress is finding cancer as early as possible.

What is breast cancer ?

Breast cancer starts in the breast tissue, which covers a larger area than just the breast. It expands from the armpit to the breastbone, up to the collarbone. Behind the breast tissue are the muscles of the chest and the upper arm. Made of milk glands, milk tubes (ducts) and fatty tissue, the main function of the breast is to produce and secrete milk. The glands where the milk is madder are grouped into lobules and ducts carry the milk to the nipple. The circle of darker skin around the nipple is called the areola. Glands and dusts, within the breast, are surrounded and protected by fatty tissue. Breast tissue changes with age; from mostly, milk ducts during adolescence, to mostly fatty tissue in older women.

Almost all breast cancers start in the glandular tissue of the breast and are known as adenocarcinomas. Breast cancers are often classified according to the type of breast tissue in which they first develop - lobular carcinoma if they started in the lobules and ductal carcinoma if they started in the ducts. Ductal carcinoma is the most common type of breast cancer. Other types of breast cancer start in other tissues of the breast. These develop differently and may require different treatment. Ask your doctor for details if you have one of these.

When breast cancer is diagnosed early, it may be very small and still within the few ducts or lobules where it has started. This is the earliest stage of breast cancer and the cancers are called in-situ cancers.

What are the best means of early detection?

Regular mammography is the single best to detect breast cancer at an early stage. Begin mammography screening at age 40. when you reach 50, get a mammogram once a year.

How is breast cancer diagnosed ?

Usually, there are three ways to detect breast cancer –

•   Breast examination by your doctor or nurse, every year

•   Breast self-examination every month

•   Routine mammogram (every year, after age 40 or over)

If you have a history of breast cancer in your family, talk with your doctor about how often and when you should have a mammogram.

What is a mammogram ?

A mammogram is a special x-ray that can find breast tumours up to two years before you or your doctor or healthcare provider can feel them. When you have a mammogram, you stand next to x-ray machine, and a technologist helps you place your breast on a plastic tray. Another tray is put on top of your breast and, for a few seconds, pressure is applied to flatten the breast while the x-ray is conducted. Usually two views of the breast are taken.

When is the best time to get a mammogram ?

A mammogram does involve applying pressure to the breast so some women find it little uncomfortable. If you are still menstruating, one thing you can do to minimize this possible discomfort is to schedule your mammogram during the middle of your menstrual cycle, when your breasts are least likely to be swollen and sensitive.

Is a mammogram safe ?

Mammograms today use a very low level of radiation and are completely safe when done at an accredited facility.

Where should I go for a mammogram ?

There are accredited mammography facilities all across India. Your health provider may be able to recommend one. Many national cancer organizations are also happy to help you find an accredited facility.

What else can I do for myself ?

Experts recommend you also have a clinical breast exam from your health provider at least once a year, and that you perform breast self-exam once a month. Ask your health provider to tell you when and how to perform a breast self-exam properly.

Why is breast self-exam important ?

No one knows your body better than you do.

Breast self-exam may help you detect a change in your breast – not only in how it feels, but also in how it looks –before anyone else might notice it.

Why do I need a clinical breast exam ?

Your health provider may be able to find a change in your breast which you might have missed, or simply would not have known to look for. The key word here is ‘change’. Many women have lumps in their breasts that are perfectly normal.

What you and your health provider are looking for is change in your breast that might be signal of breast cancer. It is the combination of their professional expertise and your knowledge of your own body that gives you the very best chance of detecting change.

Would changing my diet reduce my chances of getting breast cancer ?

Although many experts suspect that high-fat diets increase the risk of breast cancer, the results of recent studies are inconclusive. This means that there is no guarantee that modifying your diet will make you less likely to get the disease. Of course, there are many other health benefits to limiting your fat intake.

Will there ever be a cure for breast cancer ?

Scientists all over the world are looking for a cure to this diseases. They are also studying to ways to prevent healthy women from ever developing it. Although, these two most important breakthroughs – cure and prevention – are probably still some years away.

The progress already made in the detection and treatment of the diseases is very promising. No generation of women before you has ever had a better chance of surviving this disease and of going on to lead a happy, active lifestyle.

Remember, early detection can give you the gift of a lifetime.

•  Every woman is at the risk for breast cancer

•  Every woman needs to be diligent about breast health, especially as she grows older.

•  Get regular mammograms and clinical breast exams.

•  Perform breast self-exam once a month. Practice early detection.

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CERVICAL CANCER

What is cervical cancer ?

The cervix is the portion of a woman’s womb or uterus and plays an important role during childbirth. Except during pregnancy, the lining of the uterus is shed monthly through the cervix into the vagina (menstruation).

The most common type of cervical cancer (squamous cell cancer) starts in the cells that line the surface of the cervix. Adenocarcinoma starts in the mucous secreting glandular tissue of the cervix and is less common.

What causes cervical cancer ?

There is no single cause of cervical cancer but there are a number of factors that put some women at a higher risks of developing the disease. The factors include sexual intercourse before age 19, multiple sex partners, being infected with some types of the human papilloma virus (HPV) or having condition that suppresses your immune system such as AIDS.

Women who smoke, who have used oral contraceptives for long time or who have mothers who took the drug diethylstilbestrol (DES) during pregnancy, also face an increased risk of cervical cancer. Some woman get cervical cancer without any of these risk factors.

How is cervical cancer diagnosed ?

Cancer of the cervix is usually first suspected when your doctor checks the results of your Pap test. Regular Pap tests are an excellent way to find cervical cancer at an early stage when it can be treated successfully. Most abnormal Pap tests result from precancerous conditions that can also be treated successfully.

Your doctor may also have suspected cervical cancer after talking with your about your health and completing a physical examination to look for signs of cancer. A number of special tests are usually necessary to confirm a cancer diagnosis. They include –

Imaging studies such as x-rays, ultrasound, CT (computerized axial tomography) scans and MRIs (magnetic resonance imaging). They allow organs and tissues to be examined in more detail. They may be uncomfortable, but they are usually painless.

Blood tests indicate if the different types of blood cells are normal in number and appearance. They show how well your organs are working and may suggest that cancer is present.

A biopsy is usually necessary to make a definite diagnosis of cancer. Cells or tissues are removed from the body and checked under a microscope. It the cells are cancerous, they may be studied further to see how fast they are growing.

There are many ways to do a biopsy. In the case of cervical cancer, a specimen of the suspected tissue may be remover during a procedure called a colposcopy. The doctor uses a speculum with a built-in microscope to see the tissue clearly before removing a piece of tissue. A colposcopy is usually done with a local anaesthetic. Sometimes a cone-shaped piece of the cervix is removed. This is a cone biopsy.

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UTERINE CANCER

What is uterine cancer ?

The uterus or womb is a small pear-shaped organ in the pelvis. The neck of the uterus is the cervix and this leads into the vagina. The uterus is mostly muscle, but it has an inner lining made up of glandular tissue called the endometrium. The endometrium develops each month in case there is a pregnancy and then sheds itself during menstruation or your monthly period.

In most cases, uterine cancer develops in the glandular tissue of the endrometrium and is called adenocarcinoma. If the cancer is found and treated early, treatment is usually very successful.

What causes uterine cancer ?

There is no single cause of uterine cancer, but there are a number of factors that put some women at a higher risk of developing the disease.

These factors include age (especially between 50-74 years), obesity, women who have never had children and those who bean menopause later than the average age.

Prolonged use of hormones or medications containing the hormone estrogen (without progesterone) may increase the risk of uterine cancer, as may a history of pervious radiation therapy to the pelvis, or the use of the drug Tamoxifen. Some women get uterine cancer without any of these risk factors.

How is uterine cancer diagnosed ?

Your doctor may have suspected uterine cancer after a physical examination and talking with you about your health to look for signs of cancer.

Sometimes the diagnosis is suspected when the doctor checks the results of your Pap test (the screening test for cervical cancer).

Some special tests are usually necessary to confirm the diagnosis. They include -

Imaging studies as x-rays, ultrasound, CY scans and MRIs. They allow organs and tissues to be examined in more detail. A hysterogram is a special x-ray of the uterus a dye to show the uterus clearly. These may be uncomfortable, but they are usually painless.

Hysteroscopy, wherein the doctor uses a type of telescope or endcoscope to see the inside of the uterus. Endoscopy usually requires a mild anaesthetic.

A biopsy is usually necessary to make a definite diagnosis of cancer. Cells or tissues are removed from the body and checked under the microscope.  If the cell are cancerous they may be studied further to see how fast they are growing. There are many ways to do biopsy. To diagnose Uterine Cancer, your doctor may arrange for :

Dilatation and Curettage (D&C) wherein the cervix is dilated, endometrial tissue is scrapped away with a curette and an electrical current (cautery) is then used to stop the bleeding and seal the tissue. This is usually done as an outpatient procedure with a local anaesthetic.

Laparotomy wherein, using a general anaesthetic, a surgeon opens the abdomen and removes part or all of the tumour. Nearby tissues and lymph nodes may be examined and removed.

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OVARIAN CANCER

What is an Ovarian Cancer ?

Ovarian cancer is a cancer that starts in the ovary or ovaries. The ovaries are two small, almond shaped reproductive organs each about five-cm long, located deep within a woman’s pelvis on either side of her uterus (womb), close to the end of the Fallopian tubes. The ovaries produce an egg or ovum each month, which travels down a Fallopian tube to the uterus. The ovaries also produce the female hormones estrogen and progesterone. These help regulate reproduction, menstruation and the structure and function of the breasts, vagina and uterus.

There are three main types of ovarian caner, depending on the part of the ovary where the cancer starts. The most common types is epithelial cell cancer. This starts in the outer covering (epithelium) of the ovary. The other types are germ cell tumours (which start in the cells that form the structural framework of the ovary).

What causes ovarian cancer ?

There is no single cause of ovarian cancer, but there are a number of factors that appear to increase or decrease a woman’s risk of developing it. For epithelial cancer factors that increase risk include being between 40 and 80 years of age, beginning to menstruate at early age, reaching menopause later than the average age, some fertility drugs, family history of ovarian cancer or breast cancer (especially if the genes BRCA1 or BRACA2 are present).

The factors that decrease the risks, include pregnancy, breast-feeding, taking the birth control pill and tubal ligation. Germ cell tumours may occur in much younger women- even in children.

How is ovarian cancer diagnosed ?

Your doctor have suspected ovarian cancer after talking with you about your health and completing a physical examination to look for signs of cancer.

A number pf special tests are usually necessary to confirm a cancer diagnosis. They include –

Imaging studies such as x-rays, ultrasound, CT scans and MRIs. They allow organs and tissues to be examined in more detail. They may be uncomfortable, but they are usually painless.

Blood tests show if the different types of blood cells are normal in number and appearance. They show how well your organs are working and may suggest that cancer is present. A blood test that measures a marker called CA-125 is useful.

A biopsy is usually necessary to make a definite diagnosis of cancer. Cells or tissues are removed from the body and checked under a microscope. If the cells are cancerous, they may be studied further to see how fast they are growing. There are many ways to do a biopsy. In the case of ovarian cancer, it may also be necessary for the doctor to examine the tissues around ovaries. This may be done using a small instrument (a laparoscope) under a local anaesthetic or it may require surgery to open the abdomen (a laparotomy) under a general anaesthetic.

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