When the symptoms are ignored,the delay in treatment canprove to be fatal

HEALTH, an indispensable aspect of human life is the basic element which assures the well being of the society. There are many ailments which can disrupt the health of individuals, impacting their personal, professional and family lives. One such condition is Cancer, which occupies high significance while the problem can be addressed and dealt effectively only with awareness and knowledge, but not fear and hesitation.

Cancer…

What exactly is it?

Cells are the building blocks of living beings. Cancer is not a particular disease, but a condition involving the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells which grow out of normal cells in the body. There is a regular cycle in the body where normal cells multiply and die based on the body’s requirements. Cancer is one such condition where the growth of cells in the body goes out of control and cells divide too quickly or do not get killed even after their cycle has ended.

Incidence in women:

In our society, women are highly prone to cancer. There are different kinds of cancers in women. Cancer can develop in almost any organ or tissue, such as the breast, cervix, ovary, colon, lung, skin, bones, nerve tissue, etc. Cancer is caused by many factors like obesity, viruses (Human Papilloma Virus or HPV), genetic problems, exposure to organic pollutants, tobacco (smoking or chewing), consuming excess alcohol, environmental toxins, excessive exposure to sunlight and others. However, the exact cause of many cancers remains unknown to this day.

Common Cancers in Women:

Women are prone to cancers of the breast, cervix, uterus, ovary, gestational trophoblastic tumors, uterine sarcoma, and rarely of the vagina and vulva.

Breast cancer: Cancer that forms in tissues of the breast, usually the ducts that carry milk and glands that make milk. It occurs in both men and women, although male breast cancer is rare. Early menarche, late menopause, if the age at the time of first child birth is more than thirty years, family history of breast cancer, use of estrogen-containing hormone replacement therapy, obesity and a sedentary lifestyle are considered risk factors for breast cancer in females.

Cervical cancer: Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be detected with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope). Cervical cancer is mostly caused by human Papilloma virus infection. HIV infection, sexual promiscuity, use of oral contraceptives and tobacco smoking are usually associated with increased risk of cervical cancer.  

Ovarian cancer: Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).

Uterine sarcoma: A rare type of uterine cancer that forms in muscle or other tissues of the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). It usually occurs after menopause. The two main types are leiomyosarcoma, a cancer that originates in smooth muscle cells and endometrial stromal sarcoma which begins in connective tissue cells.

Lung and oral cavity (head and neck cancer): Cancer that originates in the lungs or the head and neck region is usually associated with tobacco smoking, both active and passive and/or tobacco chewing. Human papilloma viruses can also lead to cancer of the oropharynx.

Endometrial cancer: Cancer that forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

Gestational trophoblastic tumor: These represent the tumors that develop from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta) after fertilization of an egg by a sperm.

Vaginal cancer: Cancer that forms in the tissues of the vagina (birth canal). The vagina starts from the cervix (the opening of the uterus) to outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which starts in the thin, flat cells lining the vagina.

Vulvar cancer: Cancer of the vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina). 

Early Detection of Cancer

Women need to be extremely vigilant about symptoms they may experience in their body.  Cancers, related to gynecology produce symptoms early enough for them to be successfully treated. When the symptoms are ignored, the delay in treatment can prove to be fatal. If you are experiencing something abnormal in your body, consulting your doctor is highly important. There are chances that the symptoms may not be cancer related, but it's better to be safe than be sorry!

Breast cancer symptoms: These vary widely from lumps to swelling to skin changes and many breast cancers have no obvious symptoms at all. Symptoms that are similar to those of breast cancer may be the result of non-cancerous conditions like infection or a cyst.

Breast self examination should be part of your monthly health care routine, and you should visit your doctor if you experience any changes in breast. If you are over 40 or at a high risk for the disease, you should also have an annualmammogramand physical exam by a doctor. The earlier breast cancer is found and diagnosed, the better your chances of your treatment and survival.

Abnormal vaginal bleeding is the most common symptom experienced by women who are predisposed to gynecologic cancers. Heavy periods, bleeding between periods, and bleeding during and after sex are all considered abnormal vaginal bleeding and are symptoms of gynecologic cancers. The symptom of abnormal vaginal bleeding is linked tocervical cancer,uterine cancer,and ovarian cancer.

Abdominal swelling and bloating is one of the more common symptoms of ovarian cancer. It is also a symptom that is most ignored. The bloating may be so severe that one can't button their pants.

Pelvic Pain: Pelvic pain is characterized by pain or pressure below the navel. It is persistent and isn't limited to just premenstrual syndrome. Pelvic pain is associated with cancers of theendometrium,ovary,cervix,fallopian tube cancerand vagina.

Persistent Lower Back pain: Pain occurs in the lower back and often feels like a dull ache. Some women describe it as feeling like labor pains. Lower back pain can be a symptom ofovarian canceror locally advanced uterine cancer.

Persistent stomach upset or bowel changes: If you experience constipation, diarrhea, blood in the stools, gas, thinner stools, or just a general overall change in bowel habits, see your doctor. These changes are all symptoms ofgynecologic cancerandcolon cancer.

Unintentional weight loss: Losing more than 10% of your body weight without trying may be a nice surprise, but isn't quite normal. Although a woman's weight may fluctuate throughout the month, any weight loss of more than 10 kgs in less than 6 months should be reported to your doctor.

Persistent Fever: A fever that does not go away or lasts for more than 7 days on and off should be reported to your doctor. A stubborn fever is often a symptom of cancer and many benign conditions.

Vulva or Vaginal Abnormalities: With vulvar or vaginal abnormalities, you should be aware of any sores, blister, changes in skin color, and discharge. Women should exam their vulva and vagina regularly to gauge these abnormalities.

If the above symptoms persist, please consult your Doctor immediately!

Different means of treatmentCancer can be treated bysurgery,chemotherapy,radiation therapy,immunotherapy,monoclonal antibody therapyor other methods. The choice of therapy depends upon the location and grade of the tumor and thestageof the disease, as well as the general health condition of the patient. A number ofexperimental cancer treatmentsare also under development. Complete removal of the cancerous tissue without damage to the rest of the body is the main objective of treatment. This can be addressed by surgery, but the possibility of cancers invading adjacent tissue or spreading to distant sites sometimes limits its effectiveness. Therefore chemotherapy and/or radiation have to be given to increase the rate of successful treatment and prevent the recurrence of various cancers. In some cancers, radiotherapy in combination with chemotherapy might achieve cure.

Because cancer refers to a class of diseases, it is unlikely that there will ever be a singlecure for cancerwhen compared to commoninfectious diseases. Due to the latest targeted therapies and supportive therapies in place, the quality of life of patients has improved at a phenomenal rate in the last few years. Medical professionals in the modern society look forward for more such advances in the future as there is an intensive research being carried out in this area.

Treatment outcomes

With the advent of many latest therapies and drugs, the results of cancer treatment have improved drastically; the key to better result is early detection which can be achieved through implementation of regular screening.

A number of cancers can be considered curable. Many early breast cancers, early colon cancers and early cervix cancers can be cured; often with surgery alone and sometimes with surgery and other treatments. Statistics show that cancer patients are living longer, conquering the disease. The death rate from the dreaded disease has steadily decreased in the last few decades. From a survival rate of one in four during 1940's, it has now has reached a survival rate of 50%. Not only are the patients surviving, but they are experiencing a better quality of life while under treatment.

Surgery is becoming less painful, especially with minimally invasive surgery, the side effects with chemotherapy are reducing, and radiation is becoming more focused and effective.

The positive attribute of human life is that we never accept defeat even in the most difficult circumstances and something similar is being witnessed in the field of cancer treatment where no efforts are being spared to herald more advances in providing world-class and highly effective treatment procedures.

Let us keep the flame of Hope burning all the time, Hope is Eternal!

- Dr. Mohan Vamsy

Ms (Gen.) DNB (Surg.) MCh (Surgical Onco) FRCS (Edin) Dip. Lap. Sur (France)

Chief Surgical Oncologist, Omega Hospitals