Most frequent cancers in women
Elementary facts on early prevention and treatment
By Dr. Clarence O. Addo Yobo, MB, BcH, MD, FACOG, ABOG

Health observation on the status of women's health   in Ghana might not be pleasing to some members of the population, physicians and other health care providers. But this information is not intended in any form as an insinuation to castigate any person or persons.

Health providers are doing their outmost best under current circumstances and ill-equipped health facilities.

The most frequent cancers in women are :

1. Breast cancer

2. Lung cancer

3. Cervical cancer

4. Colorectal cancer

5. Uterin-Endomentrial cancer

Knowing about these cancers, i.e. the basic elementary facts by women of reproductive age: perimenopausal and menopausal age can save many lives.

The best defense is early detection by your Doctor who will work with you diligently and meticulously for treatment. There are other instances when signs and symptoms are very minimal. Routine yearly check up with your Doctor or at the Clinic is of utmost importance and very beneficial. Needless to say, confidentiality and some assurance from your Doctor are the pearls of your well being.

Sequentially, each of the above enumerated subjects will be explained in its simplistic terms and subsequent prudent advice given.

As the saying goes "never say never", and "a stitch in time saves nine".  Never panic at the sight of the doctors in white coats. They are as human as you or anybody else. They are never tin Gods. Your mindset should be, "it is going to be alright faithfully".

The other advice is to contact or seek for a second opinion for better assurance. Some of the cancers in early stages may be more assuring as treatment may prevent further spread of disease.

A wonderful breakthrough in research has shown that three are about 200 toxins or cancers causing agents in cigarettes. The advice is to quit smoking as of now or adolescents should not start smoking.  And remember certain food items such as low fat diets and green vegetables are very useful.

What is cancer?

These are questions still not adequately answered or explained to the average individuals. Just imaging that your fingernails instead of growing outwardly, begin to grow inwardly- in the reverse order.

That means that, inward growing nails will invade your entire fingers and hand and destroy the functions or the movements of your hands with swelling and bleeding as the vessels are all invaded.

Thus the simplest definition of cancer is abnormal occurrence of the cells of the body tissues gone wild and therefore invading other areas of the body resulting in death.

It can happen with blood cells going wild, bony tissues getting wild and crawling to vital area where they don't belong.

Interestingly, our forefathers had known about this disease in Ghana for which names were given in Twi, Ga and Ewe as:
(1) Nantwi pompo (2) Tsina asane (3) Avumastor nyita

And they advised never to cut the swelling with knife to cause the spread to other vital organs of the body.

A. Breast cancer

Most women afflicted with breast cancer have no family history of the disease. But immediate family members such as mothers, sisters and daughters are at risk. Breast cancer notoriously can occur at any age but becomes more common as women get older. Other possible risk factors, which could be suggested are:

1.. Women who had their first pregnancy and child after age 30; the best defense is early detection.

2.Monthly self breast examination. A detection of hard mass, or nodule, sometimes deviation of the nipples, abnormal or bloodly discharge from the nipple. Husbands and fiances could be sometimes be helpful with palpation. Do contact your Doctor for proper evaluation.

3. Age 40 and over should have clinical breast exams by their doctors. Monthly self breast examination is very important for all. Your Doctor will order other tests such as mammogram (X-ray) of the breast for a proper diagnosis and management.

B. Cervical Cancer

Most cervical cancers could be caught early and cured, although about 30% of these case will result in the patient's death.. It is rather unfortunate, that in the developing countries, women who have passed their childbearing age do not see their doctors. Doctors, especially Gynecologists, on yearly or regular basis, therefore are presented with advance stages of  cervical cancer among this group.

• Cervical cancers can affect any woman who is sexually active;

• She is especially at risk if she is engaged with multiple male partners;

• Others at high risk are those infected with HIV

• Others are those with recurrent sexually transmitted Disease such as Gonorrhea and Chlamydia;

• Women who smoke cigarettes are also vulnerable.

There are about 100 toxic substances in Cigarettes. One of which is known as Cotinin which is a cancer causing agent.

Best defense:

1. Yearly Pap test by your Doctor. Be advised that there can be false negative results and therefore you should report any abnormal or unusual vaginal discharge to your doctor or health care provider.

Be sure to abstain from douches some few days or a week prior to seeing your Doctor or Health care provider.

Be sure abstain from douches some few days or week prior to your Pap test. This is to avoid washing away the suspected bad cervical cells.

Recent research studies have demonstrated the presence of "HPV" Human Papilovirus in Cerucal cultures.

Several of the HPV's had been blamed for the primary causative factors for cervical cancers.

These oncogenic viruses are many. About 100 different types recorded) V 13, 6,11, 16,18,33,31, 35,39,42,43, 44,51,52,54.

Of the above 16 and 18 account for approximately 70% of Cervical Cancers.

16 accounts for almost 50% of the Cervical Cancers.

Vaccines:  These is now an approved HPV vaccine for types 6 - 11 - 16 - 18 "GARDASIL" given in 3 injections apart within 6 months to young female of 16 to 26 years old.

2. Selected questionable results will alert the Doctor to perform more tests such as Culposcopy, and cervical biopsy.

C. Ovarian cancer
Ovarian cancer could be the fifth or probably the fourth most common and lethal cancer in women. Most cases are detected at a late stage. It is usually silent with no obvious signs and symptoms until late stages.

• The risk of getting ovarian cancer increases with age, especially among women who have never conceived and have no children.

• Women with family history of the disease.

• Women with history of breast cancer are at risk.

Nonetheless many of the ovarian cancer  patients do not belong to the above at all.

Note that statistics demonstrate that the risk decreases significantly as the number of pregnancies and year of use of oral contraceptives increases. Some of the signs and symptoms may be:

   1. Progressive enlargement of lower abdomen,  very often in the absence  of uterine fibroids.
   2. Mild to moderate deep pelvic pains
   3. Secondary risk factor of family history

The best defense is to consult your Gynecologist.

D. Uterine/Endometrial cancer

This disease constitutes about 14% of the female cancers. Frequently occurs at the peri and post menopausal age. About 30% may be detected during Pap test with proper technique.

The best direct method is collecting cell samples from inside the uterus, or D&C for proper diagnosis.

Women of the above age group may present with vagina spotting or bleeding. Depending on its advanced stage, your doctor will take it from there for treatment and management.

Uterine body or wall cancer may also be associated with fibroids especially when there is progressive enlargement of pre-existing fibroids, pains and uterine bleeding. Consult your Doctor as early as possible.  It is in your best interest to seek a specialist.  Be sure you let your Doctor know as in some instances your primary Doctor may feel offended and become non cooperative.

E. Lung Cancer

Recent report is putting cancer of the lungs in women as no. 2 cancer killer. The irony is that it can almost totally be prevented. Current research had concluded that cigarette smoking among women is the greatest culprit of this disease. It seems that the female hormones does not tolerate the habit of consuming tobacco..

Prevention:
(1) Quite the smoking habit; your Doctor can help you to kick the habit
(2)Most Government in the developed countries are on campaign trial aggressively advising women to stop smoking, as well as teenagers not to start at all.

F. Colorectal Cancer

This is a disease of the lower digestive tract, which afflicts men and women usually above 45 years of age. Signs and symptoms are very elusive but the most common are;

• Change of bowel habits

• Blood stained feces; or hidden blood in feces

• Persistence low backache in the  absence of Bone deformities or arthritis should be  a possible warning sign.

Contact your Doctor for proper examination and tests including colonoscopy

Best defense:

• Colonoscopy usually after age 50 years every 5 years.

• Eating food low in fat and high in fiber appear to be Mostly advisable or preventive.

  A Word To The Wise Is Enough!