Of women-specific cancers, genetic alterations, and preventions

The increase in cancer burden is because of our increasing life span. Cancer results from genetic alterations. The longer we live, genetic alterations accumulate, and our risk of cancers increases. Top 2 common cancers which lead to premature deaths in women in our country are Breast cancer and Carcinoma uterine cervix.

Breast cancer: Is a leading cause of premature deaths among women. Is a lifestyle-related disease. Incidence is on the rise,(expected to rise to 35 per 100,000 women by 2026), due to urbanization and unhealthy dietary habits - increased consumption of high caloric diet, processed meat, excess use of tobacco and alcohol consumption, low fruit and vegetable intake, and lack of exercise correlate with increased cancer risk.

Common risk factors: Older age, Dense breasts, Early Menarche & late Menopause, (uninterrupted exposure of breast tissue to estrogen hormone), late marriage, the first child after 35 years of age, having fewer or no children, the declining trend of breastfeeding, family history of breast cancer, excess consumption of alcohol, high fat & low fiber diet, obesity.

Warning signs: Lump or thickening in the breast, often painless, Discharge or bleeding from the nipples, Change in size or contours of breast, inversion or retraction of the nipple, Change in color or appearance of areola, Redness or pitting of the skin over the breast, like the skin of an orange.

Recommended Screening tests for breast cancer: Clinical breast examination starting at the age of 20 years up to 39 years, once in 03 years and in women more than 40 years, both clinical breast examination and Mammography once a year.

Carcinoma Uterine Cervix: It is the third most common cancer in Indian Women. Every 8 minutes, one woman dies of cervical cancer. Leading cause of premature deaths among women in India. The peak age of occurrence is 55 – 59 years. It is the most preventable cancer. Survival depends on the stage at diagnosis. Regular check-ups are crucial for early detection. Prevalence is on the declining trend and this can be attributed to Screening and vaccination against the human papillomavirus.

Common risk factors: Early age at first sexual contact, multiple sex partners, Human Papilloma Virus infection, Multiple Pregnancies, poor genital hygiene &low immunity, use of oral Contraceptive pills and smoking.

Warning signs: Abnormal intermenstrual bleeding, heavy bleeding during menstruation, post Menopausal bleeding, pelvic pain, post-coital bleeding.

Recommended Screening tests for uterine cervical cancer: Pap smear examination starting at the age of 21 years up to 29 years, once in 03 years and in women 30 years and above, both Pap smear examination and human papillomavirus DNA testing once 05 years. Regular Pap Screening decreases deaths due to Cervical Cancer by 80 percent.

Vaccination protects against the incidence of cancer uterine cervix. Recommended doses are 3 at an interval of 0,2and 6 months.The HPV vaccine protects against the 16, 18, 31, and 33 types of human papillomavirus that most often cause cervical cancers.HPV vaccination is recommended for preteens starting at age 9 to 11 years. HPV vaccine also is recommended for everyone up to 26 years, if they are not vaccinated already. Some adults between the age group of 27 and 45 years may decide to get the HPV vaccine after speaking to their doctor.

Two third of the cancers are detected at late stages when treatment is not cost-effective and the possible causes are lack of knowledge or awareness about the risk factors, early warning signs, nonpractice of cancer screening, and lack of treatment facilities Adopting a healthy and active lifestyle is important to avoid cancers.

Oral cancers: India accounts for more than 50 percent of the world's oral cancer. With 16 percent contribution to the world population, India happens to be the global capital for oral cancers. Oral cancers account for 30 percent of all cancers in India.

Common risk factors: Excess usage of tobacco in the form of Cigarettes, beedi & chewing pan, gutka, khaini and increased consumption of Alcohol and chronic persistent Human Papillomavirus infection, People with weak immunity & Poor personal hygiene, Sharp teeth, or ill fitting dentures.

Warning signs: Chronic persistent painless non-healing ulcers, Change in speech - Hoarseness of voice, decreased mouth opening – Trismus, persistent painless White or Red Patches on the cheeks and tongue. A thorough history and careful examination of the entire inner cavity of the mouth which includes the roof of the mouth, back of the throat, and inside of cheeks and lips is important.