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5 cancers that affect SA women

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1. BREAST CANCER
Breast cancer can strike at any time, so take responsibility for your own health, and start by getting to know your breasts.

Who gets it?

  • Breast cancer generally affects women in their 40s and 50s. But Dr Carol-Ann Benn, a specialist surgeon who runs The Netcare Breast Care Centre of Excellence, says she's seeing more and more women with the disease who are still in their 30s… some even in their late 20s.
  • 'Breast cancer is not the same experience at 35 as it is at 55,' says Thea Weeks, director of the National Breast Cancer Patient Advocacy Coalition. 'Although it is a life-altering experience, the reality is that most younger women are dealing with career and fertility issues apart from the treatment concerns.' It is im-portant that the community supports breast cancer survivors of all ages and all walks of life.
  • Most cases occur at random, affecting any woman at any time as a result of the environment's effect on the genes.
  • Genetic causes of the disease only account for 10 percent of cases, where oncogenes (a gene that stimulates hyperactive cell growth) are inherited from the parents and a small number may be as a result of mutations. Some family members can carry over the gene without actually developing the disease.

    Risk factors

  • A family history of breast cancer on either the mother or father's side means that if your mother or sister had it at a young age, your chance of developing it is doubled.
  • A family history of any cancer.
  • Having your first child after age 30.
  • Prolonged oestrogen exposure through either the early onset or late cessation of menstruation. The Pill, though it is generally safe, has been implicated in some studies.
  • Obesity increases breast cancer risk.
  • Alcohol consumption has been shown to increase the risk by 24 percent in young women.

    Diagnosis and treatment
    Diagnosis involves a triple assessment consisting of a clinical examination; a mammography and an ultrasound; and a needle tissue biopsy. The new 3D-mammography breast screening technique looks promising.

    Latest treatment is a multidisciplinary approach involving three lines of attack:

  • Surgery
  • Radiotherapy (DXT)
  • Chemotherapy, used in various combinations

    Dr Benn has the following advice if breast cancer is diagnosed: 'Breast cancer is not flu, and doesn't need to be treated that same day. Taking a day or two to find out what the different treatment options are results in better, more holistic treatment.'

    2. CERVICAL CANCER
    More South African women die of cervical cancer than of breast cancer, largely because it is often symptomless, and preventative care is only now becoming a priority.

    Who gets it?

  • Women in developing countries are more likely to fall prey to cervical cancer.
  • It is the most common cancer affecting black women and the second most common overall.
  • Cancer of the cervix is associated with certain strains of the human papilloma virus (HPV), but there is uncertainty about the link with other sexually transmitted infections.

    Risk factors

  • Having intercourse for the first time at an early age.
  • Number of sexual partners.
  • Parity (the number of children a woman has given birth to) and poor socio-economic conditions.
  • Suppression of the immune system from corticosteroids (any steroid hormone produced by the adrenal cortex that affects carbohydrate, protein, and electrolyte metabolism, gonad func-tion, and immune response).
  • Kidney transplants.
  • Therapy for other cancers and Aids.
  • History of genital warts and herpes simplex virus infection

    Diagnosis and treatment
    A pap smear is the most effective method of diagnosis, and other screening procedures may follow. The key to solving the problem could lie in improving socio-economic conditions, better access to medical facilities and screening. In almost all cases, there are no symptoms, but if persistent vaginal bleeding or discharge and pain leave you uncomfortable, you ought to have yourself checked out.

    A new home testing option, the Sen-C- Test, can be used in addition to the Pap smear to test for HPV, which is associated with cervical cancer. It's been hailed as a breakthrough in self-care, but the manufacturers are clear that it should not be used to avoid regular medical check-ups. But Pro-fessor Lynette Denny, senior specialist in gynaecological oncol-ogy at Groote Schuur Hospital, advises caution: 'My concern is that this test is being introduced prior to there being sufficient education of both the lay and the medical community.'

    Ways to treat it :
    n By undergoing radical surgery and radiation therapy. These have proved effective in the early stage of the disease.

    3. COLORECTAL CANCER
    This is the third most common cancer in South Africa. A diet high in red meat is associated with colorectal cancer. It is food for thought, considering our tendency to gather around the braai on the weekend.

    Who gets it?

  • Colorectal cancer usually affects people older than 40.
  • Rates for colorectal cancer in Western countries are higher than those in China or Africa.
  • People with a history of adenomatous polyps (a growth found within the lining of the colon) as well as polyps of the colon and rectum are at higher risk. As symptoms may not show in the early days, you may not even be aware you have the disease.

    Risk factors
    The exact cause is still a mystery but risk factors include:

  • Sufferers in the family
  • Inflammatory bowel disease, inactivity and constipation
  • A high-fat, low-fibre and (possibly) low-calcium diet
  • Eating large amounts of charcoal-broiled foods

    Diagnosis and treatment
    A physical examination will determine whether you have the disease or not. Other tests that may be needed include a digital rectal examination (DRE); an abdominal exam; a complete blood count (CBC); a barium enema x-ray; a colonoscopy; and a sigmoidoscopy (a small type of camera enabling the physician to observe the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid colon).

    Treatment will be managed according to the stage of disease:
    For localised disease, the primary treatment is surgery. Thereafter chemotheraphy or radiation therapy may be recommended depending on certain factors.

    4. LUNG CANCER
    Sit up and take note if you have a persistent cough, are coughing up blood and are wheezing.

    Who gets it?

  • The second and fourth most common cancer in South Afri-can men and women, respectively, lung cancer can hit you at any age, but the time to be extra vigilant is between the ages of 50 and 69.
  • The numbers affected are increasing in populations that have smoked tobacco for extended periods.
  • There are more than a dozen types of lung cancer on record, but about 90 percent fall into small cell and non-small cell cat-egories. These two forms of cancer, which grow and spread dif- ferently, are also treated differently. The type of lung cancer is based on the size and other characteristics of the cancer cells.

    Risk factors

  • Lung cancer is still predominantly caused by smoking tobacco. Other areas of concern are:
  • Exposure to asbestos
  • Working in a foundry
  • Exposure to radioactive dust
  • Exposure to other inhalable compounds

    Diagnosis and treatment
    In addition to the coughing and other symptoms mentioned above, if the cancer reaches your chest: chest pains, persist-ent hoarseness, drooping eyelids, pain in the arm and armpit, shortness of breath and swelling in the arms or face will give you sleepless nights. Any of the following will be used for diagnosis: a chest x-ray; a computerised tomography also known as a CAT scan; a sputum cytology; and a position emission tomography (PET), a South African-designed diagnostic technique.

    Combating the disease would involve:

  • Surgery
  • Radiotherapy
  • Chemotherapy, or a combination of the three

    5. CANCER OF THE OESOPHAGUS
    Drinking and smoking? Think again…
    Who gets it?

  • It's the third most common cancer in men, and it affects mostly black men.
  • One in 71 men and one in 169 women in South Africa are at risk of developing this cancer in their lifetime.

    Risk factors

  • Poor socio-economic conditions and a diet lacking in vita-mins A and C (or fresh fruit and veggies).

    Diagnosis and treatment
    Oesophagoscopy is the key test because it allows both visualisa-tion and biopsy. Other means of diagnosis include a physical examination; blood tests; cell analysis; barium swallow; and an x-ray of the oesophagus.
    Treatment depends on the patient's needs :

  • Surgery
  • Laser therapy
  • Radiotherapy or combination chemotherapy

    FOR MORE INFO

  • CANSA 0800-22-66-22 or visit www.cansa.co.za
  • Netcare Breast Care Centre of Excellence 0860-233-233 or visit www.breasthealth.co.za
  • The National Breast Cancer Patient Advocacy Coalition (012) 998-6638, 082-826-2026 or e-mail drweeks@mweb.co.za
  • Cancer Patient Advocacy Coalition (012) 998-6638 (tel and fax); 082-826-2026; email drweeks@mweb.co.za
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