International Day of Action for Women's Health: What are the tell-tale signs of gynecological cancer?

There are several gynecological cancers, namely: breast, cervical, uterine and ovarian. A brief overview of these cancers and their symptoms.

What is breast cancer?

Breast cancer is the second most common and deadly cancer found in women in the United States. It affects around 1 in 8 women over the course of her lifetime and represents more than a quarter of new cancer cases in women worldwide. It is caused by a cellular dysfunction which triggers uncontrollable cell replication leading to the formation of a tumor. It's worth noting that breast cancer is also found in men, with a ratio of one man for every 100 women.

What the symptoms of breast cancer?

Breast cancer can appear in different ways. The main symptoms of breast cancer are the following:

• The appearance of a growth (lump) in the breast, fixed or mobile, often with irregular outlines, found during self-examination;
• Swollen and hard glands in the armpit, not painful;
• A change to the shape of the breast;
• A change in the appearance of the breast skin (redness, edema, orange appearance of the skin) or the nipple or the areola which is the area that surrounds the nipple (retraction, change in color, etc.);
• Less frequently, spontaneous discharge from a nipple;
• Musculoskeletal pain.

What is uterine cancer?

Cancer that starts in the uterus is called uterine cancer. The most common type of uterine cancer is also called endometrial cancer, because it forms in the lining of the uterine walls, the endometrium. Uterine cancer is the most common gynecological cancer, with around 66,570 new cases diagnosed each year. It mainly affects menopausal women; the average age for diagnosis is 60.

Different factors increase the risk of developing endometrial cancer. Note for example, obesity, diabetes or taking tamoxifen (a breast cancer treatment).

What are the symptoms of uterine cancer?

Endometrial cancer can appear in several different ways, here are the most common symptoms:

• Leukorrhea (white or yellow vaginal discharge);
• Vaginal bleeding in menopausal women or outside menstruation for non-menopausal women;
• Abdominal pain;
• Fever;
• Frequent bouts of cystitis.

Even though these symptoms are not specific to endometrial cancer, if they appear, contact your doctor.

What is ovarian cancer?

Ovarian cancer develops from the outer layer of cells (epithelium). These cells will transform and multiply in an uncontrolled way, thus forming a cancerous mass or tumor. If left untreated, the tumor continues to grow until the capsule is broken (this surrounds the outside of the ovary). Once it is broken, the cancerous cells can invade the neighboring tissues (fallopian tube, uterus, the other ovary, etc.) or organs further away such as the liver or the lungs.

Ovarian caner is second most common gynecological cancer in the US and causes more deaths than any other cancer of the female reproductive system. There were around 20,500 new cases reported in 2017.

What are the symptoms of ovarian cancer?

Unfortunately, this type of cancer causes few symptoms until it reaches the peritoneum (membrane lining the inner wall of the abdomen). The first signs of ovarian cancer include, among others, the following:

• Abdominal pain, pelvic or thoracic;
• Digestive issues (false need for a bowel movement for example);
• Pollakiuria (frequent urge to urinate);
• Deterioration in overall health (weight loss, fatigue...);
• Prolonged shortness of breath;
• Appearance of an ovarian mass;
• Increased size of the abdomen or ascites (accumulation of liquid).

What is cervical cancer?

The cervix is the narrow lower part of the uterus connecting upper uterus to the vagina (birth canal). This cancer specifically affects the cells of the mucous membrane cervix. Cervical cancer used to the the leading cause of cancer death in women in the US, however in the past 40 years, the number of cases and deaths from cervical cancer have significantly declined, largely due to more frequent Pap tests encouraged by doctors.

Around 13,000 new cases of cervical cancer are diagnosed each year in the US and more than 4,000 women die from it every year.

The main cause of cervical cancer is a persistent infection (10-15 years) with HPV (human papillomavirus), a family of sexually transmitted viruses of which 12 can cause this type of cancer. In addition, it is understood to be the most frequent sexually transmitted infection with around 80% of women infected at least once in their lifetime. Although, in most cases, a HPV infection resolves spontaneously, in around 10% of cases the infection persists in the lining of the cervix. The virus can also create precancerous lesions that can evolve into cancer.

A vaccine against HPV currently exists. However it does not provide protection against all types of the papillomavirus. This is why women aged between 25 and 65, even if vaccinated, must have screening tests (Pap smear).

What are the symptoms of cervical cancer?

In the earliest stages, the cancer doesn't cause any symptoms. However, during its development, the following symptoms may appear:

• Vaginal bleeding after sexual intercourse or spontaneously (outside of menstruation);
• Pain in the lower abdomen;
• Pain in the lower back;
• Pain during sexual intercourse;
• Leukorrhea (whitish or yellowish vaginal discharge)

To conclude, the majority of symptoms of these cancers is non-specific. Furthermore, an early diagnosis greatly improves the prognosis of this disease. This is why screening is essential.

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