Though breast cancer affects almost exclusively women, it still claims ten of thousands of lives every year. Keep reading to learn about other gynecological cancers.
About one woman in eight will develop breast cancer at some time in her life; one woman in 28 will die from the cancer. (Breast cancer is the most common cancer of women, but lung cancer is the leading cause of cancer-related deaths in women.) The high-risk group includes women over 35, women who have never had children or who had a child for the first time after the age of 30, and women who began menstruation early or who experienced late menopause. Breast cancer also occurs with greater frequency in women who have already had breast cancer. The most important risk factor for breast cancer is family history, however, especially if a woman's mother or sister has been diagnosed with breast cancer.
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Self-examination of the breasts may lead to early detection. All women should perform these examinations monthly at the end of the menstrual period. About 90 percent of all breast tumors are discovered by self-examination.
If a lump is discovered in a breast, the doctor will probably order an X-ray examination of the breast, known as a mammogram. (The American Cancer Society recommends yearly mammograms for women older than 50 years of age.) The doctor may also take a biopsy specimen from the lump to test for the presence of cancer. If cancer is identified, surgery will probably be performed. Women with breast cancer often dread surgery because of the disfigurement that can result; however, surgery for a breast tumor is often less extensive today than in the past.
At one time, all breast cancer patients received a radical mastectomy (removal of the breast, underlying chest muscles, and lymph nodes in the armpit). Now it is known that in many cases the removal of the breast, or even the tumor alone, may be equally effective. In addition, there are techniques for reconstruction of the breast after surgery and for rehabilitation of muscle tone in an arm that has been weakened by surgery. In some cases, radiation therapy and chemotherapy will be used after surgery to destroy remaining cancer cells.
The cervix is the lower part of the uterus (womb), which extends into the vagina. Cancer of the cervix is the second most common cancer among American women. The death rate from this disease has decreased 50 percent over the last 50 years or so, largely as a result of early diagnosis. Early cervical cancer has no symptoms but can be detected by means of a Pap smear. A Pap smear is performed routinely in a doctor's office by scraping the surface of the cervix. The collected material is then tested for indications of cancer. Today, two out of three cases of cervical cancer are detected with this test before symptoms occur.
You are more likely than most women to develop cervical cancer if you have had a sexually transmitted viral infection, such as genital warts or herpes; if you began having sexual intercourse before age 18; or if you have had many sexual partners. A particularly aggressive type of cervical cancer appears in HIV-positive women.
If a Pap smear indicates the possibility of cervical cancer, a biopsy of the affected area will likely be done. Treatment depends on how far the disease has advanced; early forms are almost always curable by surgery. If a patient still hopes to bear children and the cancer is in an early stage, this surgery can sometimes be put off until after children have been born. However, this is possible only if the disease does not seem to be progressing, and the cancer must be monitored carefully during this phase. The uterus should be removed eventually.
This is the most dangerous form of cancer of the female reproductive organs, because it is so difficult to diagnose in its early stages. Women older than 50 years of age have a higher incidence of the disease, as do childless women and those with a family history of ovarian cancer and breast cancer.
Symptoms may include pelvic discomfort, constipation, abdominal swelling, and irregular menstruation. Diagnosis is often not possible without an exploratory operation known as a laparotomy, in which a surgical incision is made in the abdominal wall. Laparoscopy, in which a lighted tubelike instrument is inserted through a small incision in the abdominal wall, has become a very useful tool in detecting ovarian cancer. Sometimes removing only one ovary is sufficient, but usually it is necessary to remove both ovaries and the uterus.
This disease is most common in women older than 50 years of age. Especially susceptible are women who have never given birth, those who are obese or diabetic, and those who suffer from high blood pressure. Women who have taken the female hormone estrogen without progesterone are at higher risk than those who have not.
Vaginal bleeding after menopause is the most common symptom of uterine cancer. If a Pap smear shows no abnormalities, a minor surgical procedure known as dilation and curettage (D&C) may be performed. This involves scraping the interior walls of the uterus to examine the tissue for cancer. If cancer is identified, a hysterectomy (surgical removal of the uterus) is usually done. Uterine cancer is usually detected early because of the bleeding symptom, and so rarely progresses to metastasis before being detected.
Once confined to women over 50, vaginal cancer has begun to appear in women between ages 17 and 20. The mothers of most of these young women took artificial estrogens, particularly diethylstilbestrol (DES), during pregnancy to prevent miscarriage. A woman whose mother took artificial estrogens during pregnancy should have a Pap smear twice a year. (A Pap smear involves scraping the surface of the cervix and testing the collected material for signs of cancer.) Symptoms of vaginal cancer include vaginal pain and bleeding. The disease is usually treated with radiation and surgery.
On the next page, we will learn about leukemia, a cancer that originates in the bone marrow, and the extremely rare bone cancer.
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