We all know someone that has been affected by Breast and Gynaecological cancers. In Australia approximately 20,000 women will be diagnosed this year – that’s over 50 women every day! Although breast cancer is very common, with modern medical advances, those diagnosed today have a 90% chance of surviving greater than 5 years. Gynaecological cancers include ovarian, cervical, uterine, vaginal and vulvar cancer. When it comes to Women’s Cancers – early detection is what saves life, and we can do this by:
* Getting to know your body – checking and being aware of your lady bits!
* Regular health checks with your doctor. You get your car checked twice yearly or yearly for a grease and oil change – when did you last get your body serviced?
Let start from the top…
When did you last check your breasts?
We know breast cancer is common with 1 in 8 women affected by the age of 85 – so why wouldn’t we be checking our breast regularly.
There is no method of breast examination that is recommended over another, as long as it is done regularly – e.g. every month. Make sure you stand in front of the mirror and inspect yours breasts. Are there any nipple changes, nipple discharge, change in skin colour, visible lumps or dimpling of the skin. Use the palm of your fingers to palpate your breasts in small circular movements ensuring you cover the entire breast. Make sure you include under your arm and nipple. Is there any pain or tenderness when feeling your breasts? If you notice a change or a lump then please see your doctor.
Mammograms – Medical guidelines recommend that low risk patients with no symptoms be screened every 2 years between the age of 50 – 74 years. If someone has a higher risk of breast cancer such as a strong family history of breast cancer screening may commence earlier. Please discuss your risk with your doctor.
Let’s go down lower …….
Cervical Cancer occurs when abnormal cells grow in the lining of the cervix. The discovery of the association of Human Papilloma Virus (HPV) with cervical cancer has been a medical breakthrough. HPV goes with having sex, just like catching a cold, with 8 in 10 women being infected at some stage. Some types of high risk HPV can cause cell changes that lead to cervical cancer if not detected. This discovery has led to the development of the HPV vaccine and changes to cervical screening program.
HPV vaccines – immunises against high risk HPV strains 16 and 18 (which causes 70% of cervical cancer) and also type 6 and 11 (which cause 90% of genital warts). It is exciting to finally have a vaccine that can help protect against cancer and the government funded school based program is available to girls and boys aged 12 – 13 years of age. Don’t forget that HPV can also cause vaginal (65%), vulval (50%) penile (35%), anal (90%) and throat (60%) cancer!
Cervical Screening changes – in December 2017 the 2 yearly pap test was replaced by the 5 yearly HPV test, called the Cervical Screening Test. It was changed due to the discovery of the link between HPV and cancer, new HPV testing technologies and the success of the vaccine program. Initially the Cervical Screening Test was recommended to be collected using the same collection techniques as the traditional pap smears – with a speculum and cytobrush so the sample can be taken from the cervix. However, studies showed that self-collected samples using PCR technology was just as accurate as doctor collected samples. This was another important breakthrough as 74% of women diagnosed with invasive cervical cancer have never been screened or were overdue for their cervical screening test at time of diagnosis. To improve the low screening rates, the option of HPV testing on self-collected samples was introduced in July 2022 as an alternative to doctor collected samples. This is dependent on if you have any symptoms (such as abnormal bleeding or pain) or previous abnormal results so it is essential to have a consultation with your doctor or women’s health nurse to see if you are eligible. Remember there are other things doctors check when they do your pap smear such as vulval skin changes and vaginal prolapse.
HPV is common in sexually active women and is usually transient, the recommended age of screening has been extended to age 25 – 74 to prevent overtreatment of common abnormalities that were going to resolve anyway. Cervical cancer is extremely rare in young women and takes 10 – 15 years to develop, however women of all ages should present to their doctor if they have any unusual symptoms like vaginal bleeding in between your periods or bleeding or pain after intercourse.
Although it isn’t the most talked about, Uterine cancer is the most common of the gynaecological cancer’s. It can arise in the lining of the uterus (endometrial cancer) or in the muscle. There has been a 22% increase in endometrial cancer in the last 20 years which has been linked to obesity. The most common symptom is unusual vaginal bleeding such as after menopause. Always report any abnormal vaginal bleeding to your doctor
Ovarian cancer is the 8th most common cancer but the 6th most common cause of cancer deaths. The scary thing about Ovarian cancer is often there are not any symptoms early on or they can be vague such as abdominal bloating and/or pain, loss of appetite, urinary frequency, constipation, menstrual irregularities, fatigue, or pain during sex. Those at higher risk include those over 50, early age of onset of periods and late menopause, no children or first child after 30, fertility treatment, a family history of ovarian cancer, and breast cancer gene carriers of BRCA 1 or 2. If experiencing any new symptoms please see your doctor – you may require a physical examination, pelvic ultrasound and blood tests.
Vaginal cancer is the rarest of the gynaecological cancer and often occurs in older women . HPV is sometimes the culprit and also smoking increases your risk. Symptoms may include pain or bleeding after sex , the presence of a lump in the vagina or abnormal vaginal bleeding.
Cancer of the vulvar occurs in the outside part of the female genitals and commonly develops in the labia minor (inner lips) , labia majora (outer lips) and perineum . Causes include HPV and some skin conditions such as lichen sclerosis and vulval intraepithelial neoplasia (VIN). Symptoms may include itching, burning or soreness in the vulval area, lumps, thickened skin, changes to genital moles, and swollen lymph nodes in the groin. The
vulva is a bit tricky to self-examine so if you notice any pain or changes please see your doctor.
Although this article mainly discusses breast and gynaecological cancer don’t forget regular full body skin checks to monitor for any signs of skin cancer. If you notice a new skin lesion or a change in an existing mole or freckle please see your doctor.
And please don’t throw out those bowel screen kits for early detection of bowel cancer. The risk of bowel cancer is 1 in 23, and 90% can be successfully treated if detected early. By 2020 the government will be providing free bowels screens 2 yearly for those aged between 50 and 74. Again if you notice any change in bowel habit, abdominal pain or change in colour of stool please discuss with your doctor.
So get to know your body and your ‘lady bits, have a regular ‘’service’’ with your doctor, and if you notice any changes or symptoms – please see your friendly GP. And spread the word to your girlfriends to do the same……