Health and well-being

Cancer in women: The big five

According to the 2016 National Cancer Registry (NCR), breast and cervical cancers are the leading cause of death among South African women.

Breast cancer is the most commonly diagnosed cancer, with a lifetime risk of one in 25, while cervical cancer is the second most commonly diagnosed (excluding basal cell carcinoma), with an estimated lifetime risk of one in 35.

The Cancer Association of South Africa (CANSA) encourages women to take care of themselves by knowing their bodies, the signs of cancer and taking up their right to cancer screening to promote early detection.

“Women generally put others first. We want women to realise that they too have the right to prioritise their health. Women need to go for regular cancer screening, as early detection saves lives. Get to know the early warning signs and symptoms of cancer so that you're informed and can seek help if needed,” says Gerda Strauss, CANSA's Head: Service.

According to the National Department of Health's Breast Cancer Control Policy, women are entitled to an annual clinical breast examination and to three free

Pap smears per lifetime, from the age of 30, with a 10-year interval between each Pap smear, at primary healthcare centres.

Dr Manala Makua, CANSA's Chief Director: Women, Maternal and Reproductive Health, urges healthcare professionals to ask women five critical questions that can save lives.“This is what we call the ‘high five'. Please ask the following: Do you perform breast self-examinations regularly? Have you noticed any changes in your breasts? Have you experienced abnormal vaginal bleeding? Have you ever had a Pap smear? Do you have a family history of cancer?”

Breast and cervical cancer

According to CANSA, breast and cervical cancer have been identified as a national priority with increasing incidences occurring.

“Women should do regular monthly breast self-examinations,” says Strauss.

While not all breast lumps indicate cancer, they should be investigated, especially if accompanied by other changes in breasts or the under-arm area, such as lumps, texture changes, thickening, dimpling, changes in shape or size of nipples or breasts, tenderness, discharge, rash or swelling, or one breast suddenly being slightly larger than the other.

“Women should also familiarise themselves with the risk factors and symptoms of early stage cervical changes (although women may only present with symptoms at a later stage in the disease). Cervical cancer can be effectively treated if detected and diagnosed early,” says Strauss.

Cervical cancer symptoms include abnormal bleeding between periods, heavier and longer menstrual period, vaginal discharge, vaginal bleeding or pain during intercourse (after menopause) and increased

urinary frequency.

It is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin-to-skin contact, body fluids and sexual intercourse. Failure to use protection during sexual intercourse, sexually transmitted infections, multiple sexual partners, early sexual debut and use of oral contraceptives increases the risk.

“Let's adopt lifestyle behaviours that can help lower the risk for breast and cervical cancers by being physically active, maintaining a healthy weight, avoiding alcohol and tobacco, eating balanced meals, avoiding sexual activity at an early age and avoid engaging in sexual activities with different partners or risky sexual behaviour, which increases the chances of getting HPV. Women should also avoid exposure to known cancer causing agents,” says Strauss.

The big five

While breast and cervical cancer are the two cancers most affecting women in South Africa, colorectal, uterine and lung cancer also fall within the top five.

Colorectal or colon cancer is the third most common cancer affecting South African women, with one in 127 females at risk of being diagnosed (NCR 2016).

Most colorectal cancers begin as a polyp, a small growth of tissue that starts in the lining and grows into the centre of the colon or rectum. Symptoms include a change in bowel habits (diarrhoea or constipation), rectal bleeding or blood in stools and persistent abdominal discomfort (cramps, gas or pain).

Cancer of the uterus, also as known as uterine cancer or womb cancer, is the fourth most common cancer affecting women in South Africa, with one in 135 women at risk for being diagnosed (NCR 2016).

The most common form of this cancer affects the lining of the uterus, known as the endometrium, and is also referred to as endometrial cancer. A hormone imbalance causes the lining of the uterus to thicken. If the lining builds up and stays that way, cancer cells may start to grow.

Symptoms include abnormal vaginal discharge or bleeding (high volumes between periods), long and heavier than normal menstrual bleeding and pain, or pressure in the pelvic area (especially when urinating or during sexual intercourse).

Lung cancer is the fifth most common cancer in South African women, with a lifetime risk of one in 182 (NCR 2016). Lung cancer does not typically cause symptoms in its earliest stages, but symptoms present when the disease is already advanced.

Symptoms include a chronic cough; a cough that gets worse and does not go away; coughing up blood (even a small amount); shortness of breath or wheezing; constant chest pain (especially when coughing); frequent chest infections; a chest infection that lingers; hoarseness and feeling tired all the time.

If you are experiencing the symptoms described above, visit a doctor for further advice and treatment.