Cancers are a menace. It is one of the leading causes of death in the world. Both men and women get cancers in organs they both have, like the stomach, brain, liver etc. In addition to these, women get cancers in breast, cervix, uterus and ovaries far more frequently than in other organs.
Breast cancer is the most common malignancy in women. It is also the leading cause of cancer related deaths in women. Early breast cancer is asymptomatic. It usually presents as a breast lump. Change in size and shape of the breast, skin dimpling, skin discoloration, nipple inversion, nipple destruction, nipple discharge lymph nodes in axilla may suggest the presence of a malignant breast tumour. Abnormal mammogram may be the first sign of breast cancer. Clinical examination may show a hard, irregular, immobile lump with associated skin changes and axillary lymph nodes. Breast cancer may spread to the other breast, bones, brain, liver and lungs. Needle biopsy of the lesion gives a histological diagnosis. Open excision biopsy removes the whole lesion. Wide local excision cures local disease. Advanced cancer may need mastectomy with axillary lymph node clearance. Post-surgical radiotherapy improves survival in advanced breast cancer.
Cervical cancer is the third commonest cancer. The risk increases from 35 years of age. Sri Lanka has a comprehensive screening program for cervical cancer. All women above 35 years of age should undergo a pap smear to detect cervical cancer or any pre-cancerous lesion. Recommendation is to investigate any and all abnormalities detected in the pap smears and repeat the smear. Human papillomavirus increases the risk of cervical cancer. Positive HPV test necessitates close follow up.
Abnormal vaginal bleeding, watery vaginal discharge, foul smelling discharge and painful urination are a few known symptoms of cervical cancer. Cervical cancer spreads along the pelvic tissue planes, to lung, liver, brain etc. Spread along lymphatic system occurs more than blood spread. Imaging studies like computer tomography and magnetic resonance imaging shows the extent of the spread. Hysterectomy cures early cancer confined to the cervix. Advanced cancer needs surgical debulking, radiotherapy and chemotherapy.
Endometrial cancer is the ninth commonest cancer in women. Polycystic ovarian syndrome, obesity, granulose cell tumours, hormone replacement therapy and anovulation increase the risk of endometrial cancer by increasing unopposed action of oestrogen. Drugs like Tamoxifen increase the risk while oral contraceptive pills reduce risk. Endometrial cancer spreads to lung, liver, brain and bone. Endometrial cancer presents with irregular menstrual bleeding. Endometrial biopsy is the first step. But endometrial biopsy may miss highly localized lesions. Dilatation and curettage provides a better sample. Hysterectomy is enough for localized cancer. Post-surgical chemotherapy and radiotherapy improve survival in advanced disease.
There are numerous types of ovarian tumours. Many are benign. Some may mistake a benign ovarian lesion for an ovarian cancer. Epithelial type is the commonest out of various histological types. Talcum powder on perineum, genetic susceptibility and incessant ovulation increase the risk of ovarian cancer. ( Benign means that the tumour does not spread to other sites. Benign tumours are well circumscribed, slow growing and localized lesions. Malignant means that the tumour invades surrounding tissues.)
Some cancers may get very large before giving rise to significant symptoms. Ultra sound scans done for other conditions often detect ovarian malignancies. Surgical excision, chemotherapy and radiotherapy are the main treatment modalities.
By: Dr T. M. S. Sameera B. Madugalle MBBS (COL)
ඔබට ඇති වෛද්ය ගැටළු අසන්න මෙහි ක්ලික් කරන්න, Ask a Doctor | වෛද්යවරයාගෙන් අසන්න
මෙම ලිපිය ඔබට ප්රයෝජනවත් වුනානම් හෝ ඔබේ මිතුරියකට ප්රයෝජනවත් වේ යයි සිතනවානම්, කරුණාකර පහත ඇති "recommend" ක්ලික් කිරීමෙන් එය බෙදා හදා ගැනීමට අමතක කරන්න එපා. තවද, මෙම ලිපිය පිළිබඳව ඔබේ අදහස්, යෝජනා සහ අනෙකුත් මවුවරුන්/කාන්තාවන් හට ප්රයෝජනවත් වන ඔබේ අත්දැකීම් පහත ලියා තැබීමටද අප ආරාධනා කරමු. ස්තුතියි!
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