The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Around 46 000 South African women are diagnosed with cancer every year. According to the Cancer Association of South Africa (cansa.org.za), the top five cancers affecting us are breast, cervical, colorectal, uterine and melanoma. Each type of cancer has its own risk factors, symptoms, and treatment options.
As with other diseases, the sooner you get treatment, the better your outcome tends to be. Understanding the risk factors, symptoms, and screening recommendations for various types of cancer can help women take proactive steps to protect their health and seek medical attention if needed. Early detection is key to improving outcomes for women with cancer, so it is important to have regular screening.
Healthy lifestyle choices can also lower your risk of developing cancer:
- Maintain a healthy weight
- Get regular exercise
- Eat plenty of fruit and vegetables
- Don’t smoke
- Limit alcohol consumption
COMMON CANCERS FOR WOMEN IN SOUTH AFRICA
CERVICAL CANCER
Cervical cancer affects the cervix, the lower part of the uterus. Cervical cancer is the second most common cancer among South African women, but the cancer women die of most. Women in South Africa have a 1 in 42 lifetime risk of developing cervical cancer. According to the international HPV Information Centre, every year over 10 000 new cases of cervical cancer are reported in South Africa, and almost 6 000 die from the disease.
MoreBREAST CANCER
This is the most common cancer among women worldwide. In South Africa, one in 27 women have a lifetime risk of breast cancer. This number is increasing, and along with cervical cancer, breast cancer has been identified as a national priority.
MoreOVARIAN CANCER
Ovarian cancer is cancer of the cells of one or both ovaries. The ovaries form part of the female reproductive organs that house the ova and are also responsible for the release of hormones that control the menstrual cycle, as well as the production of sex hormones. 1 in 434 South African women have a lifetime risk of developing ovarian cancer.
MoreCOLORECTAL CANCER
Your colon is also known as the large intestine, and your rectum is the passageway that connects your colon to your anus. Colorectal cancer is cancer that occurs in the colon and rectum and is often referred to as either colon cancer or rectal cancer, depending on where the cancer starts. While men are more prone to developing colorectal cancer, CANSA quotes the Globocan Cancer Observatory who estimate almost 4 000 women in South Africa are diagnosed with colorectal cancer every year.
MoreUTERINE (ENDOMETRIAL) CANCER
Uterine cancer affects the lining of the uterus, or womb. Although the exact cause of uterine cancer is unknown, increased levels of oestrogen appear to play a role. High levels of oestrogen cause the lining of the uterus to thicken. If the lining builds up and stays that way, cancer cells may start to grow. Most cases of uterine cancer occur between the ages of 60 and 70 years, but a few cases may occur before age 40.
Your risk for uterine cancer may be increased by:
- Diabetes
- Oestrogen replacement therapy without the use of progesterone
- A history of endometrial polyps
- Infertility (inability to become pregnant)
- Infrequent periods
- Tamoxifen, a drug used for breast cancer treatment
- Never being pregnant
- Obesity
- Polycystic ovarian syndrome (PCOS)
- Starting menstruation before the age of 12
- Starting menopause after the age of 50
- Having had radiation treatment to your pelvic area
- A family history of uterine cancer
- Ethnicity – white women are at higher risk than other ethnic groups
- Women with diabetes (which is often associated with obesity)
As with other cancers, being inactive, consuming alcohol, poor dietary habits, and smoking also contribute to your risk.
Symptoms include:
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Abnormal vaginal discharge or bleeding (high volumes between periods)
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Long and heavier than normal menstrual bleeding
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Pain or pressure in the pelvic area (especially when urinating or during sex)
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Any vaginal bleeding or spotting after menopause
Research has shown that certain factors can lower your risk of uterine cancer:
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Taking birth control pills, as they reduce the risk of an overgrowth of the uterine lining, especially when taken over a long period
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Using a progestin-secreting intrauterine device (IUD), which is a form of birth control
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Using a combination of oestrogen and progesterone for HRT may help lower risk
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Maintaining a healthy weight
If your doctor suspects you have uterine cancer, he/she will send you for further investigation such as a transvaginal ultrasound which can show atypical growths in the uterus or a biopsy. This involves harvesting a small amount of tissue from your uterus and testing it for cancer cells. The survival rate for uterine cancer is excellent if detected early enough.
MELANOMA
Melanoma is an aggressive skin cancer that starts in the cells (melanocytes) of your skin. Melanocytes are responsible for giving your skin its colour (melanin). Melanoma is much less common than some other types of skin cancers, but it is more dangerous because it’s much more likely to spread to other parts of the body if not found and treated early. It has a poor survival rate when diagnosed late.
Skin cancer is the most common cancer in South Africa with about 20 000 reported cases every year and 700 deaths. The risk of melanoma seems to be increasing in people under 40, especially women. People with fairer skins are more at risk for melanoma, however it can also affect people with darker skins.
Skin cancer is caused when over exposure to ultraviolet radiation (from sunshine or tanning beds) damages the skin cells, which triggers mutations and leads to melanoma formation. For women, melanoma is more often found on the arms and legs.
At least 80% of sun-induced skin damage occurs before the age of 18 and only manifests later in life. Therefore, it is imperative to take special care of children in the sun. Babies younger than one year should never be exposed to direct sunlight.
Risk factors for skin cancer:
- Having a lighter skin colour.
- A family or personal history of skin cancer.
- Exposure to sun through work and play.
- Having blue or green eyes, blonde or red hair.
- Having many moles.
- Having a skin that burns, freckles or reddens easily in the sun.
Recent studies have also shown evidence of a link between breast cancer and melanoma. These the studies recommend that all melanoma patients with a history of breast cancer be referred to a breast clinic, and that all women over the age of 40 with melanoma undergo an annual mammography. All breast cancer patients should be made aware of the significance of changing moles and those with suspicious lesions should be referred to a dermatologist for an evaluation.
For melanoma to be treated successfully, it must be found early. This makes screening essential: check your skin carefully every month and ask a family member or friend to examine your back and the top of your head. Melanomas often resemble moles, and some develop from moles. If you notice any of these warning signs, see a doctor or dermatologist immediately:
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A is for asymmetry: a mole or mark with one half unlike the other – common moles are round and symmetrical.
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B is for border irregularities: scalloped or poorly defined edges – common moles have smooth and even borders.
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C is for colour variations and inconsistency: tan, brown, black, red, white and blue – common moles are usually a single shade of brown or black.
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D is for diameter: any mole larger than 6mm.
Your annual medical examination should also include a skin check.
You can lower your risk with sun smart behaviour:
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Avoid direct sunlight between 10 am and 3pm, when the sun’s rays are most dangerous. Stay in the shade or under an umbrella as much as possible. Be aware that UV rays reflect off cement, water, sand, glass and grass and can therefore cause sunburn, even in the shade.
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UV rays are not the same as heat. You can get overexposed even in cool weather – so take care on windy or overcast days. Cover up by wearing thickly woven hats with wide brims and loose-fitting clothes, made of tightly woven, fabric that is cool, but will block out harmful UV rays. Look out for UV protective swimsuits and beach wear as UV radiation can penetrate fabric.
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Always apply sunscreen with a Sun Protection Factor (SPF) of 20 to 50 to all exposed skin areas, preferably one bearing the CANSA Seal. Re-apply regularly (at least every two hours), after towel-drying, sweating, or swimming. Apply it liberally to all exposed skin; including the back of the neck, tips of ears, arms, feet and hands. Be aware that the use of sunscreen lotion is not a license to spend lots of time in the sun.
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Protect your eyes by wearing sunglasses with a UV protection rating of UV400.
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Use lip balm with a minimum of SPF 20 and apply regularly.
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Avoid sunlamps and tanning beds.
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Take special care to protect children and babies.
FURTHER READING
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