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Cancer screening for women A presentation by Dr. Luitgard Darko to the staff of The British Embassy
1.0 What is cancer? We want to talk about Cancer screening for women today. We have all heard about cancer, but do we know what it is? Cancer is the second most common cause of death in Europe and America after cardiovascular disease and third most common cause of death in Africa after infections and cardiovascular disease. Cancer is a condition where some body cells, the smallest components that build up body tissues, get out of control and start growing independently from the rest of the organism. Cancer cells grow and multiply fast, forming lumps that put pressure on their surroundings, destroying their surroundings and growing into neighbouring organs thereby destroying healthy tissue. Cancer cells do no longer perform the tasks that the original cells of the organ used to perform (like producing milk in the case of breast cancer). Cancer cells can also affect the whole body by swarming into the lymph and blood system like parasites. The blood or lymph stream carries them to other organs, mostly the lungs, liver, brain or bones where they can grow new lumps, which are called metastasis, and destroy the surrounding tissues. This destruction of vital tissues is the means through which the cancer that started in a small spot in one organ can kill the whole body if it is not stopped in time. 1.1 Most common cancers for women

It is also the most common cause of cancer deaths for women worldwide. thanks to the fact that the majority of women go the cancer screening test called PAP smear. unfortunately. which is the neck of the womb. In Europe it is no more very common. but the risk for women is a 100 times higher than for men. The second most common type of cancer for women in Ghana is cancer of the cervix.2 The most common cancer for women worldwide is the breast cancer. . It is estimated that one women out of 9 in Europe and America will develop breast cancer in her lifetime. 2. the peak age for breast Ca is 35 to 45 years. What is the peak age for breast cancer? In Europe and America it is around 55 years.1 Risk factors Who is at risk for breast Ca? First and foremost it is women. Breast cancer has best chances to be healed if it is found in an early stage. that means when the breast lump is still small (2 cm or less) and has not developed any metastases. most breast cancers are found by the woman herself. 2. but the risk increases when the woman gets older.0 Breast cancer Let us talk about breast cancer first. Though screening tests are very helpful. though men also might get breast Ca. In Ghana. that finds abnormal cells before they have reached the cancerous state. Thus it has become possible to destroy those cells by minor procedures before the actual cancer has developed.

which we call risk factors. after the age of 55. Some of them we cannot influence. others we can. that those. If your relative has breast ca and you want to find out if is the hereditary type. opt for earlier and more frequent screening tests or even subcutaneous removal of both breasts with subsequent implants to prevent the ca from developing.Lack of exercise . This may be the hereditary type of breast ca. There are other risk factors that we can influence: . We also have markedly higher risk if a first degree female relative. which is excessive weight with a body mass index above 27. Large studies on thousands of nurses in England showed clearly that these lifestyle issues increase the risk of a . as well as those who have their menopause later than the average. . Those who had breast cancer before or where exposed to radiation either by accident or as treatment for another cancer have an increased risk as well.Weight gain of 10 kg or more around menopause. you can undergo a lab test for the breast ca gene and if positive. have a higher risk.3 Apart from these basic facts there are some circumstances and conditions which increase the risk for a woman to develop breast ca. sister or daughter had breast ca. who had their first menses early and started having sexual relations at an early age. that is a mother.Alcohol intake of more than one drink a day - High intake of red meat and fatty foods. We know through large statistics. .Obesity.

but should nevertheless be checked out. • Lumps in the armpit or above the clavicle. 2. regular exercise. Breast ca only causes pain in advanced stages.4 woman to develop breast ca as well as ca of the large intestine and cardiovascular disease. • dimpled skin that may look like the skin of an orange. called peau d’orange. 2.2 Signs and symptoms of breast ca. The most common and earliest sign is a usually painless lump in the breast. • flattening or retraction of a nipple. healthy diet .3 Prevention and early detection of breast ca How can we prevent breast ca? By avoiding the risk factors as much as possible: keeping or achieving a healthy body weight. Other important signs are: • changes in the shape or size of the breast. • Swelling and redness without pain or fever. • Bloody or brownish/ greenish discharge from the nipple. • rashes around the nipple that do not respond to treatment. Painful conditions in the breast are usually harmless. • skin retraction. when it is very difficult to cure.

The cervix is the neck of the womb. Why mammography? M. changes there are not easily detected by the woman herself.1 Risk factors Who is at risk? Every woman who is or ever has been sexually active.5 with low quantities of red meat and saturated fats. yearly mammography after the age of 40. low or no intake of alcohol. 3. earlier if you have a family risk. What is cx ca? it is a malignant growth on the surface of the cx. many women who have breast ca do not have any obvious risk factors at all and others. that is the part of the womb that is bulging into the top of the vagina. Unfortunately.0 Cervical Cancer The second important cancer for women in Ghana is cervical cancer or cancer of the neck of the womb. best monthly after the menses. How can we detect it early? Regular self examination. . can see the smallest changes in the breast structure that are not yet palpable. regular yearly examination by a trained health professional. 3. As it is a hidden part of the body. who have the risk factors never fall ill.

The peak age for cervical cancer is above 55 years and the risk increases with age. and over 90 % of women get into contact with it around the time of their first sexual contact. especially bleeding in between menses and after intercourse • Restart of bleeding after menopause • Bloody.. foul smelling discharge • Pain 3.6 There is no cervical cancer without an infection with Human Papilloma Virus or HPV. 3. Signs: • Irregular bleeding. this cancer makes only symptoms at a very late stage. Additional risk factors that make it more likely to get cervical cancer are the HIV infection and smoking. but those causing cervical cancer are transmitted only through sexual intercourse.2 Signs and symptoms of cervix ca Unfortunately. that can cause different types of diseases. There are different types of HPV. This infection does not have any symptoms at all. unlike other STDs. when cure is very difficult.3 Prevention and early detection of cervical ca .

Thus very early changes can be detected and cured by minor procedures such as cryotherapy. Older women may still be vaccinated up to the age of 30 years.7 The real preventive measure apart from never having unprotected sex is the vaccination against the HPV virus. These changes of cervical cells can be detectected by a simple test called PAP smear. 4. We do not have studies proving that it is of benefit for older women yet. Those cells can be stained with special dyes and analysed under the microscope. which is transferred either on a glass slide or in to a special preserving liquid. It is recommended to vaccinate all girls before the age of first sexual contact. LEEP or cone biopsy. For this test a trained health person takes a swab from the surface of the cervix. We should avoid smoking and moderate alcohol. Early detection: Cervical ca undergoes a slow development of changes from normal slightly abnormal to cancer cells. This vaccine is on the Ghanaian market under the name Cervarix.0 Cancer screening for women What are our options? To prevent or cure these cancers we should all lead a healthy life style with low fat and low meat diet. preferably between the ages of 10 and 15 years. . we should exercise regularly and achieve and maintain a healthy weight. laser. This is well established in Europe and America for many years and for that reason the rate of cervical cancer has dropped remarkably there in the last 50 years.

if our mother. We should go for yearly cancer screening with examination of the breast and PAP smear from the age of 30 or even 20. sister or daughter had breast cancer. if we had our menarche at 12 or earlier and started our sexual life before the age of 16. . We should go for a yearly mammogram from the age of 40 or earlier.8 And by all means we should vaccinate our daughters and ourselves and practice and advocate safer sex. We should learn the self examination of our breasts and practice it every month after the menses. And we should tell other women and our men about the need to do all these things. We should report any perceived changes in the breast as soon as possible to a skilled health provider.

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