Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Serious Illnesses | Reproductive Cancers Health Manual Enter pictur Contents Overview p. 2 Breast Cancer in Women p. 3 Breast Cancer in Men p. 6 Cervical Cancer p. 8 Ovarian Cancer p. 11 Prostate Cancer p. 12 Overview Cancer is a serious illness that can affect many different parts of the body. If it is treated early, it is often curable. But if it is not treated or is not cured by treatment, cancer can cause death. Our bodies are made up of tiny cells that are too small to see with our eyes. Sometimes these cells change and grow in an abnormal way, causing growths (tumors). Some growths remain small, others may go away without treatment, but sometimes growths get larger or spread. The latter can cause serious health problems. Most growths do not become cancer, but some do. Cancer starts when some cells begin to grow out of control and take over parts of the body. When cancer is found early, it can often be removed with surgery or treated with medicines or radiation. Chances of it being cured may be good. Once cancer spreads, however, curing it is more difficult. Different kinds of cancer are named after the area of the body in which the abnormal cell growth starts. Cancers that affect female and male reproductive systems are called reproductive cancers. Two reproductive cancers commonly found in women are breast cancer and cervical cancer. Early detection and treatment can cure both these cancers—it saves lives. Ovarian cancer is another type of reproductive cancer commonly found in women. In men, prostate cancer is the most common form of reproductive cancer. Causes The direct causes of most cancers are not known. But these things may make you more likely to get cancer: » » » » » » » Smoking tobacco, which is known to cause lung cancer and increase the risk of getting most other cancers Certain viral infections, like HIV, hepatitis B, or certain types of human papillomavirus (HPV) Eating foods with too much fat or with harmful chemicals Taking the hormone estrogen by itself for a long time after your monthly bleeding has stopped Working with or living around certain chemicals (like pesticides, dyes, paints, and solvents) Hereditary risks (a person’s blood relatives having had a certain kind of cancer may mean he or she is more likely to get that same kind of cancer) Getting older Healthy Behavior Engaging in healthy behaviors is a way to reduce your risks of getting any kind of cancer. Healthy behaviors include eating healthy, exercising, and avoiding tobacco, toxic chemicals, and too much sun. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 2 Breast Cancer in Women Breast cancer is a cancerous tumor (not all tumors are cancerous) that develops from cells in the breast. Usually, breast cancer begins in the cells that produce milk or in the ducts where milk drains to the nipple. Cancer can also develop in the fatty tissue of the breasts. Breast cancer is caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5 to 10 percent of cancers are due to an abnormality inherited from your mother or father. About 90 percent of breast cancers are due to abnormalities that result from the aging process and 1 exposure to things in our environment. Most women have some small lumps in their breasts. These lumps can change in size and shape and become tender during her monthly cycle. Sometimes, a breast lump that does not go away can be a sign of breast cancer. Successful treatment depends on spotting the first sign of possible cancer and getting medical care soon. Surgery is usually necessary. Symptoms » » » The woman may notice a slow-growing lump during self‑examination of the breasts (see below). Or she may notice that her breast has an abnormal dent, dimple, or many tiny pits like the skin of an orange. Often there are swollen lymph nodes in the armpit, which may or may not be painful. » There may be redness or a sore on the breast that does not heal. » She may have abnormal discharge from a nipple. » At first it usually does not hurt or get hot. Later it may hurt. Self-Examination If you can catch breast cancer early on, there is a good chance that you can treat it early enough to be successful. Any woman can get breast cancer; it’s important for women to conduct a breast self-examination every month. Breast cancer usually grows slowly, so if it is found during early stages, it can sometimes be cured. Every woman should learn how to examine her own breasts for possible signs of cancer. She should do it once a month, preferably on the 10th day after her menstrual period started. Step 1: Begin by looking at your breasts with your shoulders straight and your hands on your hips. Look at your breasts to observe any changes. If you see any of the following changes, bring them to your doctor’s attention: » A lump, dimple, pucker, or bulge of the skin 1 Adapted from “What is Breast Cancer,” BreastCancer.org, www.breastcancer.org/symptoms/understand_bc/what_is_bc.jsp. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 3 » A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out) if this is not how your nipple was before » Redness, soreness, a rash, or swelling Step 2: Raise your arms above your head, and look for the same changes. Step 3: Squeeze your nipple gently to see if any fluid comes out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). Step 4: Look for unusual bumps or lumps in your breasts. To do this, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm touch with your first fingers, keeping them flat and together. Use a circular motion, covering an area the size of a large coin. Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows as if you were sewing parallel seams. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the surface to deep inside your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage. Step 5: If you notice anything irregular in your breasts, go to a doctor or clinic immediately. They will do further tests to determine if what you have found is a sign of cancer. If you find a lump that is smooth or rubbery and moves under the skin when you push it, don’t worry about it. But if it is hard, has an uneven shape, is painless, or does not move when you push it, get medical advice. Many lumps are not cancer, but it is important to have them checked as soon as you notice them. Mammograms Mammograms are the best tests for finding breast cancer early. Mammograms are a series of X-rays of the breast that allow doctors to look for early signs of breast cancer, sometimes up to three years before it can be felt. When breast cancer is found early, treatment is most effective, and many women go on to live long and healthy lives. Treatment » » » » Surgery: Doctors cut out and remove the cancer tissue during an operation. Chemotherapy: Using special medicines or drugs to shrink or kill the cancer. The drugs can be pills you take or medicines you are given through an intravenous (IV) tube—or sometimes both. Hormonal therapy: Some cancers need certain hormones to grow. Hormonal treatment is used to block cancer cells from getting the hormones they need to grow. Biological therapy: This treatment works with your body’s immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments. Biological therapy is different from chemotherapy, which attacks cancer cells directly. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 4 » Radiation: The use of high-energy rays (similar to X-rays) to kill the cancer cells. These rays are aimed at the part of the body where the cancer is located. Prevention To lower your risk of getting breast cancer: » » Eating healthy will not guarantee that you will not get cancer, but it may help reduce your risk. Eating healthy means eating plenty of fruits, vegetables and unprocessed foods; limiting the fats that you eat; and limiting how much alcohol you drink. Like eating healthy, exercise may help lower your risk of breast cancer and other types of cancers. As a general goal, include at least 30 minutes of physical activity in your daily routine. Walking every day is a good example of exercise that you can do and perhaps already do as you walk to and from work or the market. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 5 Breast Cancer in Men Breast cancer occurs mainly in women, but men can get it too. Many people do not realize that men have breast tissue and that they can develop breast cancer. The most common types of breast cancer in men are listed below. Ductal Carcinoma in Situ In ductal carcinoma in situ (DCIS or intraductal carcinoma), cancer cells form in the breast ducts but do not grow through the walls of the ducts into the fatty tissue of the breast or spread outside the breast. DCIS accounts for about 10 percent of cases of breast cancer in men. It is almost always curable with surgery. Infiltrating Ductal Carcinoma Infiltrating (or invasive) ductal carcinoma (IDC) breaks through the wall of the duct and grows through the fatty tissue of the breast. At this point, it can spread (metastasize) to other parts of the body. At least 80 percent of male breast cancers are IDCs (alone or mixed with other types of invasive or in situ breast cancer). Because the male breast is much smaller than the female breast, all male breast cancers start relatively close to the nipple and are, therefore, more likely to spread to the nipple. This is different from Paget disease (described below). Infiltrating Lobular Carcinoma Infiltrating lobular carcinoma (ILC) starts in the breast lobules (collections of cells that, in women, produce breast milk) and grows into the fatty tissue of the breast. ILC is very rare in men, accounting for only about two percent of male breast cancers, because men do not usually have much lobular tissue. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 6 Lobular Carcinoma in Situ In lobular carcinoma in situ (LCIS), abnormal cells form in the lobules, but they do not grow into the fatty tissue of the breast or spread beyond the breast. Although LCIS is sometimes grouped with DCIS as a type of noninvasive breast cancer, most breast specialists think it is a risk factor for developing breast cancer rather than a true noninvasive cancer. As with infiltrating lobular carcinoma, LCIS is very rare in men. Paget Disease This type of breast cancer starts in the breast ducts and spreads to the nipple. It may also spread to the areola (the dark circle around the nipple). The skin of the nipple usually appears crusted, scaly, and red with areas of itching, oozing, burning, or bleeding. The fingertips can be used to detect a possible lump within the breast. Paget disease may be associated with DCIS or with infiltrating ductal carcinoma. It accounts for about one percent of female breast cancers and a higher percentage of male breast cancers. Inflammatory Breast Cancer Inflammatory breast cancer is an aggressive, but rare type of breast cancer. It causes the breast to be swollen, red, warm, and tender rather than forming a 2 lump. It can be mistaken for an infection of the breast. It is very rare in men. 2 Adapted from “What Is Breast Cancer in Men?” American Cancer Society www.cancer.org , BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 7 Cervical Cancer Cervical cancer starts in the cells of the cervix, the passageway that connects the lower part of the uterus (womb) to the vagina. Sometimes the cells of the cervix start to change and become abnormal. These cells are precancerous, that is, they are not yet cancer. For instance, the virus called human papillomavirus (HPV) can cause an infection that can turn into cancer. Most HPV infections go away within one to two years, but some last for 3 many years and can lead to cancer. It is important to get tested so that abnormal cells can be found before they turn into cancer. If women have regular screening tests and follow up visits to catch it early, cervical cancer is the easiest female cancer to prevent and treat. Symptoms Cancer of the cervix does not have early warning signs. Getting tested regularly can help catch it early. You can get tested by your regular doctor or at a women’s clinic. Screening tests are designed to look for abnormal tissue on the cervix. To find cancer of the cervix early enough to treat it simply and successfully, women should be tested at least every five years, starting at about age 20. More frequent tests are important when you have a test that shows some abnormal cells. HPV, a virus that causes infections and abnormal cells, often goes away on its own without treatment. But since sometimes those abnormal cells could be early signs of cancer, you should have another test in one to two years to make sure cancer is not growing. If you are treated for pre-cancer because of HPV, you should have another test one year later to make sure the virus and precancerous cells are gone. 3 Adapted from “Cervical Cancer” Medical.Net, http://www.medicinenet.com/cervical_cancer/article.htm BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 8 Pap Smears Pap smears are one way to be tested for cervical cancer. This test is administered by a health worker in a clinic. Some women are afraid of Pap smears, but the process takes only a few minutes. First, you will sit at the edge of an exam table. Then, you will be asked to place your feet in stirrup-style footrests and to lie back on the table. The clinician will usually ask you to separate your thighs and remain calm so that the muscles are relaxed. The more relaxed and farther apart her legs remain, the more comfortable the woman will be and the faster the process will go. As a tip, wriggling the toes can be a great way to reduce tension in the legs, groin, or buttocks. The examiner usually touches the outside of the vulva with a gloved hand to separate the labia and view the external genitalia to make sure it is normal. A speculum, which is like a marker with a handle, is then gently inserted into the vagina to widen the opening. Different sizes and styles of speculums are used for different women. The speculum allows the clinician to view the vaginal walls and the cervix. The cervix is found high up in the vagina. The cervix is sometimes hard to see, but a skilled clinician can usually find it by gently shifting the speculum. Once the speculum is in place, the clinician can collect a sample of tissue from the outside of the cervix with a small spatula (like a plastic tongue depressor) and then another sample from the cervical canal to the womb with a small brush called a cytobrush. A small brush is used to swish the inside of the cervical canal, and a small plastic broomlike brush is also frequently used. Using these devices can feel strange for the patient, but it should not hurt. Some women are more 4 sensitive than others. Some have a fragile cervix that bleeds a bit when scraped, but this is generally not a serious concern. The health worker will send the tissue samples to a laboratory for testing, which takes a few days. The health worker should contact you if anything is abnormal. If you do not hear from them, follow up to get your results. Visual Inspection with Acetic Acid A visual inspection with acetic acid (vinegar), or VIA, is another way to check for cervical cancer. A Pap smear is the only test that can confirm abnormal cells, but the VIA can help identify more advanced cases of HPV and cervical cancer. If a health worker sees any changes in the cervix that might be abnormal, she will send you to get a Pap smear. The VIA is really quite simple. The health care provider swabs a little vinegar on the cervix and looks for areas that change color. Normal cervical tissue does not change, but abnormal tissue will turn white. The health worker might be able to remove the damaged tissue on the spot using cryotherapy or another technique, or they may send the tissue to a laboratory for further testing. 4 Adapted from “Sex & Fertility,” Women to Women, www.womentowomen.com/sexualityandfertility/routinepappelvicexam.aspx. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 9 A VIA is much less expensive than a Pap test, and results, though less accurate than those of a Pap test, are immediately available. Treatment There is no treatment for HPV, but there are treatments for the diseases that HPV can cause: » Visible genital warts can be removed with medication or treated by a health care provider. » » Cervical cancer is most treatable when it is diagnosed and treated early. Radiation: High-energy rays (similar to X-rays) are aimed at the part of the body where the cancer is located to kill the cancer cells. Prevention » » » » Testing: It is important to get tested for cervical cancer because 60 percent of cases of cervical cancer occur in women who have never received a Pap test or have not been tested in the past five years. See a doctor regularly for a test. HPV vaccine: Women can also be inoculated with the HPV vaccine, which protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. It is given in a series of three shots. The vaccine is recommended for 11- and 12-year-old girls. Use condoms during sex. Limit the number of sexual partners that you have, since getting sexually transmitted infections may increase your risk of contracting HPV and cervical cancer. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 10 Ovarian Cancer Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones and produce eggs. When cancer starts in the ovaries, it is called ovarian cancer. Ovarian cancer causes more deaths than any other cancer of the female reproductive system. All women are at risk for ovarian cancer, but older women are more likely to get the disease than younger women are. About 90 percent of women who get ovarian cancer are older than 40 years of age, with the greatest number being 55 years or older. Symptoms The symptoms of ovarian cancer are the following: » Vaginal bleeding that is not normal » Pain or pressure in the pelvic or abdominal area » Back pain » Abdominal bloating » Feeling full quickly while eating » Increased urination, constipation, or diarrhea Diagnosis There is no simple and reliable way to test for ovarian cancer in women who do not have any signs or symptoms, and the Pap test does not check for ovarian cancer. However, each woman can pay attention to her own body and know what is normal for her. Treatment Treatment depends on the type of ovarian cancer and how far it has spread. Treatments include surgery, chemotherapy, and radiation. People with ovarian cancer often get more than one kind of treatment. Treatment is most effective when ovarian cancer is found in its early stages. Prevention There is no known way to prevent ovarian cancer, however chances of getting ovarian cancer may be reduced for women who use birth control pills for more than five years, have a tubal ligation, or have given birth. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 11 Prostate Cancer The prostate is part of a man’s reproductive system. It’s an organ that is located in front of the rectum and under the bladder. The prostate is a gland that makes part of the seminal fluid that helps carry sperm out of the man’s body as part of 5 semen. If the prostate grows too large, it squeezes the urethra (the tube through which urine flows), which may slow or stop the flow of urine from the bladder to the penis. As for other forms of cancer, prostate cancer is a disease in which cells in the prostate gland become abnormal and start to grow uncontrollably, forming tumors. Prostate cancer is one of the most common forms of cancer in men, particularly among older men. Symptoms Symptoms of prostate cancer vary from person to person and some men do not 6 have any symptoms at all. The most common symptoms are the following : » Difficulty starting to urinate » Weak or interrupted flow of urine » Frequent urination, especially at night » Difficulty emptying the bladder completely » Pain or burning during urination » Blood in the urine or semen » Pain in the back, hips, or pelvis that doesn't go away » Painful ejaculation Diagnosis A blood test can be used to measure the level of a substance made by the prostate in the blood (prostate specific antigen). Other procedures include a digital rectal exam, which consists of manually checking for a hard, lumpy area in the prostate, or taking a biopsy (removing a small piece of tissue from the prostate to analyze it). Treatment7 Different types of treatments are available. In some cases, the best option is to closely monitor the patient’s prostate cancer by performing tests regularly. Where the prostate cancer causes symptoms or shows signs of growing, treatment includes removing the prostate completely (prostatectomy), radiation therapy (destroying cancer cells using X-rays), or hormone therapy. 5 “Prostate Cancer Cells,” National Cancer Institute, www.cancer.gov/cancertopics/wyntk/prostate/page3. 6 “Prostate Cancer,” Centers for Disease Control and Prevention, www.cdc.gov/cancer/prostate/basic_info/symptoms.htm. 7 “Prostate Cancer,” Centers for Disease Control and Prevention, www.cdc.gov/cancer/prostate/basic_info/treatment.htm. BSR | HERproject Serious Illnesses | Reproductive Cancers Health Manual 12