Download here. - the Emer Casey Foundation

Female Cancers
SHARON O’TOOLE, DISCOVARY, TCD
AND
TESS CHAMBERS, MARIE KEATING FOUNDATION
A PATIENT’S PERSPECTIVE
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Outline
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Ovarian
Cervical
Endometrial
Discovary consortium
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Breast
Lung
Bowel
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A Personal Story -
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What is Cancer?
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Organs and tissues are made up of tiny building
blocks called cells. In healthy tissue these cells
replace or repair themselves when they get worn out
or injured. With cancer, the cells do not behave as
normal and keep on growing even when they there
is no need.
These groups of abnormal cells can form a lump or
tumour.
Benign tumours do not spread.
Malignant tumours spread from where they started
usually through the blood or lymph glands
(metastasis or secondary tumour)
Ovarian Cancer
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190,000 worldwide, 4th most common
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3% female cancers in Ireland ~350
~275
deaths per annum in Ireland
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70% diagnosed- Advanced disease
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Silent Killer
Risk Factors
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Age (Peak age 50-70)
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No children
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Late age first birth, early menarche, late menopause
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Family history of breast, ovarian or bowel
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Diet, environment, talc, ionising radiation
Protective factors
Parity, oral contraceptives, tubal ligation, physical activity,
breast feeding and ?diet
What are the symptoms of cancer of
the ovary?
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No symptoms in early stage, vague and mild
Poor appetite
Vague indigestion or nausea
Bloated feeling
Swollen abdomen – caused by a build-up of fluid
Pain or a dragging sensation in the lower abdomen or
side
Abnormal vaginal discharge or bleeding
Change in bowel or bladder habits, such as
constipation, diarrhoea or wanting to pass urine often.
Diagnosis of Ovarian Cancer
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GP Internal Exam
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A blood test called CA125 will be done. CA125 is a
chemical found in the blood, which is sometimes
released from ovarian cancer cells. Not all women
with ovarian cancer will have high levels of CA125
in their blood.
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Pelvic examination
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Ultrasound
Treatment of Ovarian Cancer
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Surgery [Remove tumour-staging]
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Chemotherapy [Carboplatin/Taxol]
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Tumours can grow back and become resistant to
chemotherapy
Cervical Cancer
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Cervix links uterus and vagina
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~500,000 worldwide, ~80% developing countries
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Ireland 275 cases per annum
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~85 deaths
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Screen for pre cancer [CIN]
Risk Factors
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Age (Peak age 40-50)
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Virus called the human papilloma virus (HPV)-spread
sexually. Most women’s immune system can clear virus.
Increased risk if you have had many sexual partners.
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Smoking can also increase your risk of pre cancer. The
chemicals in cigarettes can affect how your cervix fights
infection. For this reason, you may have trouble getting
rid of the HPV virus if you smoke
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Not having regular smears
What are the symptoms of cancer of
the cervix?
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Abnormal vaginal bleeding:
Periods may be heavier and last longer
Bleeding in between periods
Bleeding after sex
Bleeding after the menopause
Vaginal discharge that may have a foul odour
Discomfort or pain during sex or in the pelvis
These symptoms can be caused by conditions other
than cancer, it is important to have them checked out
Diagnosis of Cervical Cancer
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Regular smear tests can find abnormal cells early
and treat them, and so prevent cervical cancer.
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Colposcopy
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Imaging
Treatment of Cervical Cancer
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Pre cancer- excision
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Surgery [Remove tumour]
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Radiotherapy: If the cancer cannot be cured by
surgery alone, then radiotherapy may be used.
Radiotherapy is the use of X-rays to cure or control
cancer. It can be given externally or internally
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Chemotherapy [Platinum] with radiotherapy
www.cervicalcheck.ie
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Regular smears:
Every 3 years if you are aged 25–44
Every 5 years if aged 45–60
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Some of changes are known as precancerous
because they might become cancer cells if not
found and treated. These early changes have no
symptoms so you may be unaware of them
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The earlier a change is found, the easier it is to
treat
Vaccination
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Be vaccinated against HPV before you have been
exposed to the virus during sexual contact
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Young girls are vaccinated in the first year of
secondary school
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Continue with regular smear tests because it is not yet
known for how long vaccination gives protection and
not all types of HPV are covered by the vaccination.
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Two vaccines to prevent HPV infection have been
licensed for use in the EU. These vaccines are called
Gardasil® and Cervarix®.
Endometrial Cancer
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Endometrium- lining of your womb
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288,000 per annum worldwide
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~300 cases in Ireland
Risk Factors
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Age: after the menopause between the ages of 50 and 64
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Overweight
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Hormone replacement therapy (HRT)
Family history: Inherited faulty gene [hereditary
nonpolyposis colorectal cancer] womb or bowel cancer
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No pregnancies
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Polycystic ovaries: cysts grow in the ovaries.
What are the symptoms of cancer of
the endometrium?
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Bleeding after the menopause
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Bleeding between periods
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Heavier periods than normal
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Abnormal vaginal discharge
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Pain in your lower abdomen or back of legs
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Discomfort or pain during sex
Diagnosis of Endometrial Cancer
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Transvaginal ultrasound
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Hysteroscopy
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Biopsy
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Dilatation and curettage (D&C)
Treatment of Endometrial Cancer
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Surgery [Remove tumour]
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Radiotherapy
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Chemotherapy
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Hormone treatment
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>50 members [Gynaecologists, Oncologists,
Pathologists, Scientists, Bioinformaticians]
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3 Emer Casey PhD Fellowships
Challenges in Ovarian Cancer
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Early-stage disease that has a good prognosis
cannot be detected easily
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Standard chemotherapy approaches such as
paclitaxel and carboplatin often fail and patients
develop recurrent chemoresistant disease
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Bioresource
Infrastructure [SOLiD]
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Blood tests for diagnosis and assessing
response to treatment
Markers of recurrence/chemoresistance and
ways to overcome this [MMP-9]
Low oxygen within a tumour can increase its
resistance to chemotherapy
Stem cells-potential to regrow tumour
How do cancer cells evade immune system
when spreading in blood- “platelet cloak”
Why are ovarian cancer patients more prone t
clots
Lab-on-a-chip
Cancer Prevention
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Quit Smoking
Eat five servings a day of a variety of fruits and vegetables
Limit your intake of fatty foods
If you drink alcohol, limit your intake to no more than:
 Men – two standard drinks per day
 Women – one standard drink per day
Do brisk physical activity every day
Be a healthy weight
Protect from the sun, avoid sunburn, especially in children
 Women from 25 years should avail of cervical screening
 Women from 50 years should avail of breast screening
How often should you have a free cervical smear?
 Women aged 25–44: every 3 years
 Women aged 45–60: every 5 years
Cancer Awareness
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A new or unusual lump or swelling anywhere on your body
A sore that will not heal, anywhere on your body or in your
mouth
A change in the shape, size or colour of a mole
Blood in your urine or bowel motions
A cough, croaky voice or difficulty swallowing that lasts
longer than a few weeks
A noticeable change to looser or more frequent bowel
motions lasting longer than a few weeks
Difficulty passing urine
Unexplained weight loss
Bleeding from the vagina after the menopause or between
periods
Unexplained pain or ache that lasts longer than 4 weeks
Acknowledgements
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Juliette Casey
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The Emer Casey
Foundation and its
supporters
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Tess Chambers from
Marie Keating
Foundation