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Serious Illnesses |
Reproductive Cancers
Health Manual
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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:
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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.
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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
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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
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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.
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There may be redness or a sore on the breast that does not heal.
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She may have abnormal discharge from a nipple.
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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
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Adapted from “What is Breast Cancer,” BreastCancer.org,
www.breastcancer.org/symptoms/understand_bc/what_is_bc.jsp.
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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
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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
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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.
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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:
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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.
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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.
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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
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lump. It can be mistaken for an infection of the breast. It is very rare in men.
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Adapted from “What Is Breast Cancer in Men?” American Cancer Society www.cancer.org ,
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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
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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.
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Adapted from “Cervical Cancer” Medical.Net,
http://www.medicinenet.com/cervical_cancer/article.htm
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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
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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.
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Adapted from “Sex & Fertility,” Women to Women,
www.womentowomen.com/sexualityandfertility/routinepappelvicexam.aspx.
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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:
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Visible genital warts can be removed with medication or treated by a health
care provider.
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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
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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.
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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:
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Vaginal bleeding that is not normal
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Pain or pressure in the pelvic or abdominal area
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Back pain
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Abdominal bloating
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Feeling full quickly while eating
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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.
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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
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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
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have any symptoms at all. The most common symptoms are the following :
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Difficulty starting to urinate
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Weak or interrupted flow of urine
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Frequent urination, especially at night
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Difficulty emptying the bladder completely
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Pain or burning during urination
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Blood in the urine or semen
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Pain in the back, hips, or pelvis that doesn't go away
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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.
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“Prostate Cancer Cells,” National Cancer Institute,
www.cancer.gov/cancertopics/wyntk/prostate/page3.
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“Prostate Cancer,” Centers for Disease Control and Prevention,
www.cdc.gov/cancer/prostate/basic_info/symptoms.htm.
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“Prostate Cancer,” Centers for Disease Control and Prevention,
www.cdc.gov/cancer/prostate/basic_info/treatment.htm.
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