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By Dr David Delvin

 

Index:    

Introduction

Breast Cancer

Symptoms - Breast Cancer

Screening - Breast Cancer

Ovary Cancer

Screening - Ovary Cancer

Womb Cancer

Cervical Cancer

Screening - Cervical Cancer

Immunisation

Symptoms - Cervical Cancer

Non-female Cancers

Questions & Answers

 

 

Introduction 

The word ‘cancer’ is one that makes a lot of people shiver with fear. But it’s best to know the facts about ‘the Big C’ – because of the simple fact that so many of us are going to get it!

And the majority of cancers occur in the retirement age group. That’s why it’s so important for people in this group to be well informed. By being properly informed, you give yourself the best chance of AVOIDING cancer – or, if you get it, of DEFEATING it.

In this article I’m going to deal with WOMEN’S cancers. And in my next piece, I’ll be dealing with cancer as it affects MEN.

But today is for women. So ladies: do please read on! This feature could save your life. Remember: EARLY treatment will usually produce CURE.

In this article, I’m going to be dealing with the really common cancers which affect the ‘female’ parts of the body.

These are:

·        The breast

·        The ovary

·        The womb

·        The cervix

However, there are cancers which commonly affect BOTH sexes – things like lung cancer and bowel cancer. I’ll explain about them at the end of this feature.

But now … on to the cancers which ONLY affect women.

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BREAST CANCER

Cancer of the breast is terribly common. Unless you’ve been living on a desert island, you must know someone who has had it.

There were over 40,000 cases in Britain last year. Indeed, latest statistics show that a staggering one in NINE British women will get it at some stage of their lives.

To put it another way, when you were at school, were you ever in a class of (say) 27 girls?  Well, about three of them will get breast cancer. These are rather alarming odds, aren’t they?

What’s important to grasp is that the peak age group for breast cancer is the RETIREMENT age group. A lot of people have the idea that breast cancer is commonest in young women, but that’s simply not true. The very highest rates occur between 50 and 64.

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SYMPTOMS The most common symptom is simply a LUMP in the breast. But other possible symptoms are:

·        Bleeding from the nipple;

·        Brown discharge from the nipple;

·        Recent ‘in-turning’ of the nipple;

·        Puckering of the skin of the breast

How can you protect yourself against breast cancer? Well, it’s vital to ‘keep an eye’ on your breasts throughout your life. If you ever think that there’s something wrong, please see a doctor rapidly -- and have that breast checked.

Until quite recent years, it was official advice that every woman should use her hands to check her own breasts MONTHLY for lumps and other abnormalities. Then one day, the Department of Health suddenly decided that this wasn’t necessary.  Instead, they suggested that women should simply be ‘breast aware'.

This came as quite a shock to the breast cancer charities, who for years had been advising women to examine their breasts each month. And it’s noteworthy that the Americans have continued to advise ‘do-it-yourself’ monthly checks of the breast.

Personally, I would suggest that there’s a great deal to be said for checking your own breasts about once a month. If you think you feel a lump – or any other abnormality -- you should have it examined by your GP within a couple of days. And if she believes there’s anything wrong, she will arrange an urgent referral to your local Breast Unit.

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SCREENING  What about screening (mammography)?

Well, this is an x-ray examination of the breast, and it has been shown that carrying it out in women aged over 49 WILL reduce the death rate from breast carcinoma.

So, in 1988 regular three-yearly screening was introduced for women aged 50 to 64. It was decided that ladies OVER the age 64 could have regular screening too – IF they asked for it.

This wasn’t really very satisfactory, because the fact is that many breast cancers develop long after age 64.

So in 2001, it was decided that regular mammograms would now be offered to everyone in the 50 to 70 age group – and that over-70s could have it if they wanted it.

Frankly, my advice to you is that from age 50 onwards, you should DEFINITELY have the three-yearly screening – and continue with it for the rest of your life.

Remember: as with all these cancers, the earlier you get diagnosed, the better the chance of cure. Thank heavens, breast cancer death rates are falling.

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OVARY CANCER

Unfortunately, ovarian cancer is quite common – far commoner than the much better-known cervical cancer. There are about 7,000 cases a year in the UK at the moment. Roughly one woman in every 48 gets ovary cancer.

It’s important to appreciate that this is mainly a disease of post-menopausal women. So anyone who is in the ‘retirement age group’ is to some extent at risk. The highest incidence of all is in people aged 70 to 75.

Regrettably, the symptoms of cancer of the ovaries are usually pretty vague, making it difficult to diagnose. But common ones are:

  • Pain in the lowest part of your abdomen;
  • Bloating in the same area;
  • Irregular vaginal bleeding;
  • Constipation;
  • Persistent urinary problems.

If you get symptoms like those, you should go to your doctor and ask for a gynaecological check-up.

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SCREENING What about screening? Unfortunately, in the case of ovarian cancer this is difficult. At the moment, there is NO formal ‘ovary screening’ service in this country.

Some women who can afford it have regular private ultrasound screening of their ovaries, at a cost of about £150 to £200 a time.

There is also a test which measures the levels of a chemical called CA125 in the woman’s blood. (CA 125 is produced by most ovarian tumours) However, the results are very difficult to assess, and at present doctors are NOT recommending that all post-menopausal woman should have this test.

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CANCER OF THE WOMB (ENDOMETRIAL CANCER)

A lot of people confuse womb cancer with cancer of the cervix, but in reality they’re two different diseases.

Womb cancer actually occurs in the LINING of the womb – which is the tissue which is shed during periods. The womb lining is called the ‘endometrium’ – which is why this is often known as ‘endometrial cancer.’

Womb cancer is nearly as common as ovary cancer; there were nearly 6,000 cases in the UK last year. About one woman in every 50 will get it.

The chief symptom is unexplained BLEEDING from the womb. In particular, any woman who starts bleeding AFTER her menopause needs an urgent check-up to make sure that she hasn’t got womb cancer.

If you’ve passed the menopause and suddenly notice renewed bleeding, never fall into the trap of thinking ‘Oh, my periods have started again.’ It could be something more serious – like endometrial cancer.  

Screening for endometrial (womb) cancer isn’t easy, and there’s no formal programme of screening in the UK at present.   Do NOT make the mistake of thinking that cervical screening (see below) will protect you against it – it can’t. So all you can do is to look out for any symptom of womb cancer – especially postmenopausal bleeding.

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CANCER OF THE CERVIX (CERVICAL CANCER)

Despite all the publicity about it, cervical cancer is actually much less common than the other three ‘female cancers.’

It only occurs in women who have had sex. It’s commoner in smokers, and in women whose partners are manual workers. It is also commoner in the North of England than the South.

There were only 2,800 cases in the UK last year. The great majority of these women survived, and in fact deaths from cervix cancer are now down to about 1,000 a year.

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SCREENING The reason for this is Britain’s excellent cervical screening programme. As I’m sure you’re aware, every woman who has ever had intercourse should have regular cervical smears throughout her life. (Don’t stop just because you’re 50 or 60!)

The INTERVAL between smear tests varies a bit in different parts of the country, and is to some extent dependent on your past gynae history. But most women need a smear every three to five years.

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IMMUNISATION  In March 2006, it was announced that a vaccine against cervical cancer ‘could be available within 12 months.’  However, this immunization will only give protection against certain types of cervix cancer. My guess is that its main value will be in teenagers.  At the moment, I can’t see that it will really be much use to women in the retirement age group – who should continue to rely on the protection given by smear testing.

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SYMPTOMS  What about symptoms? Well, if you have regular screening tests, you’ll probably never get any symptoms – because the condition will be ‘picked up’ so early.

However, the classic symptoms of cancer of the cervix include:

  • Bleeding from the vagina after the menopause;
  • Bleeding between periods;
  • Bleeding after sex.

 (But all these symptoms can also have less serious causes.)

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NON  ‘FEMALE’  CANCERS

Now what about cancers which affect women – but which AREN’T specifically female?

The really common ones are:

  • Lung cancer;
  • Bowel cancer.

I will be dealing with these conditions in full next time. But for the moment, here are a few useful tips:

  • Lung cancer is very rare in non-smokers. though there are occasional tragic exceptions --  like poor Dana Reeve, the widow of Christopher Reeve;
  • Symptoms of lung cancer are often very vague, but the commonest is a cough that just won’t clear up;
  • Bowel cancer  is just about as common as lung cancer in women;
  • It is commonest in the retirement age group;
  • Possible symptoms include bleeding from the back passage, black motions, tummy pain, weight loss, and unexplained change in bowel habits.

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Q  Unusually for a woman of 55, I am still a virgin. Can I assume that I am totally safe from any kind of gynaecological cancer?

A  No. You’re almost totally safe from cancer of the cervix, but you are at much the same risk as anybody else of getting other gynae cancers. So if you get any worrying symptoms, do have a check up.

Q  Is it true that RADON gas increases your chances of cancer?

A  Yes. There are a few parts of the UK where radon gas seeps out of the ground and gets into people’s home. Because the gas is radioactive, it increases the risk of lung and other cancers.

Your local authority will know if you are in a ‘high radon’ area. If you are, it may be possible for the council to pay for adjustments to your house, in order to protect you and your family.

Q  I am 65, and have taken antidepressants for about 15 years. Whenever I get an infection – for instance, a urinary tract one – and have to take penicillin, I find that my depression and anxiety get worse. Also, I feel extremely tired.

Why?

A  Antibiotics do tend to have a sedative effect, and lots of people feel rather exhausted while taking them. Some do feel depressed.

However, there are plenty of other ‘ABs’  apart from penicillin, so I think that next time you get a urinary tract infection (UTI), you should ask your doctor to put you on something different.

One other point: I am perturbed by the fact that you are getting so many UTIs at the age of 65. As I expect you know, they are often sparked off by sexual activity. Also, they may be linked to a drop in female hormone production, after the menopause. For more information, borrow one of Dame Angela Kilmartin’s famous books on UTIs from your library.

Q  Should the elderly take special precautions re ‘bird ’flu’ and other pandemics – or are they just at the same risk as younger people?

A  Good question. Elderly people ARE at more risk from ordinary ’flu, and from bird ’flu and from other infections.  That’s why the Government runs influenza jab campaigns every year which target the over-65s.

At the time of writing (early March 2006) we don’t yet know whether the avian influenza is going to come here and attack human beings. But it will almost certainly attack British BIRDS. If that happens, the best things to do are:

·        to keep away from dead birds;

·        to avoid any contact with bird DROPPINGS.                

Q  Should I get vaccinated against avian influenza?

A  At present, there is NO vaccine available against bird ’flu.  Some of the less well-informed members of the Press keep going on about a ‘vaccine,’ but they’ve got all muddled up with the anti-influenza drug called Tamiflu, which is a tablet.

This is NOT a vaccine, but it will be dished out by the authorities if bird ’flu starts attacking humans.

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© 2006, Dr David Delvin/Retirement Matters Ltd. All rights reserved.

 

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