A woman’s overall health may affect her risks of contracting several diseases. Smoking and heavy drinking, obesity, a sedentary or active lifestyle, practicing safe sex, knowing her family medical history, and avoiding abusive relationships can play key roles in her overall health.
Cancer is the second leading cause of death in the United States, exceeded only by heart disease. We’ll discuss heart disease, stroke, diabetes, and obesity in a separate article in this issue. One of every five deaths in the United States is due to cancer. Let that figure set in. What are the cancers that most affect women?
Skin Cancer is the leading type of cancer affecting women in the United States. About 97,610 new melanomas will be diagnosed in the United States this year. Of them, 39, 490 will occur in women, an estimated 2,590 women will die. Melanoma is twenty times more common in White people than in Black people. Melanoma has become one of the most common cancers in young adults, especially young women. Risk factors for developing melanoma include ultraviolet light exposure, moles, fair skin, freckling, and light hair, family history of melanoma, personal history of melanoma or other skin cancers, having a weakened immune system, being older, being male, and Xeroderma pigmentosum – a rare inherited condition that affects skin cell’s ability to repair damage to their DNA. Early-stage melanoma is often treated with surgery. More advanced causes may require immunotherapy, targeted therapy drugs, chemotherapy, and radiation. Melanoma cannot be completely prevented, but there are certain steps you can take to minimize your risk - limit your exposure to UV rays, wear a shirt and hat, use a good sunscreen, and reapply often, wear sunglasses to protect your eyes and the skin around them, avoid tanning beds and sunlamps, and above all protect your children from the sun. Know the hours when UV rays will be the strongest and stay indoors during that time. Protect your immune system and watch for abnormal moles. Have a skin check during your wellness visits.
Breast Cancer
Your greatest risk of developing breast cancer is having breasts. Period. We are all at risk and even if we eat well, exercise, maintain a healthy weight, don’t smoke or drink, get adequate rest/sleep, we are still at risk. Do monthly self-exams, never skip your wellness checks, and get your mammograms starting at age 40 or younger if you have a family history of breast cancer.
I know this is our women’s health issue, but protecting our partners, fathers, brothers, and friends from a delayed breast cancer diagnosis is important. Men have 1% of the breast tissue women have, but that 1% can develop breast cancer. Men also need to perform monthly breast self-examinations. According to the American Cancer Society, 2,800 men will be diagnosed with breast cancer this year. That is 1% of the cases that will be diagnosed. Of those cases, 530 men will die of breast cancer this year. Why? Because men and their doctors may initially dismiss a lump or breast soreness as a pulled muscle or a fat deposit because most of the time that’s exactly what it is. When it’s not, breast cancer can spread and worsen survival rates the longer it remains undetected.
Female breast cancer has now surpassed lung cancer as the most commonly diagnosed cancer in the world. In 2020, an estimated 2,261,419 new cases of breast cancer were diagnosed in women across the world.
More women in the United States are diagnosed with breast cancer than any other type of cancer, besides skin cancer. The disease accounts for 1 in 3 of new female cancers annually.
In 2023, approximately 297,790 women in the United States will be diagnosed with invasive breast cancer, and 55,720 women will be diagnosed with non-invasive (in situ) breast cancer. Since the mid-2000s, invasive breast cancer in women has increased by approximately half a percent each year. Likely causes for this include an increase in excess body weight in women overall, a drop in fertility rates, and rising age for first births. A woman’s chances of being diagnosed with breast cancer are 1 in 8. That encompasses approximately 13% of the female population of the United states. The chance that a woman will die from breast cancer is 1 in 39 or about 2.5%.
Currently, there are more than 3.8 million women who are living with or beyond breast cancer in the United States. That’s roughly the same number as last year. It should be higher. When caught early in its localized state, the five-year survival rate is 99%. Reoccurrence rates are highest during the first few years after treatment and decrease over time.
It is estimated that 43,700 deaths (43,170 women and 530 men) from breast cancer will occur in the United States in 2023. Worldwide, female breast cancer is the fifth leading cause of death. In 2020, an estimated 684,996 women across the world died from breast cancer.
Lung Cancer is the third leading type of cancer affecting women in the United States behind skin cancer and breast cancer. About 120,790 new cases of lung cancer in women will be diagnosed in 2023 as compared to 117,550 in men. About 59,910 women will die in 2023 from lung cancer. It’s the number one cause of cancer deaths in the United States. On a happier note, those levels are dropping because more people are quitting or not starting smoking.
Most people diagnosed with lung cancer are over 65 years old. One in 17 women will develop lung cancer in her lifetime. Lung cancer rates for women have risen 84% over the past 42 years while they have declined by 36% among men. Why? More women started smoking during that period. There are also environmental factors contributing to lung cancer rates. Risk factors include tobacco smoke, exposure to asbestos, family history, secondhand smoke, exposure to radon, exposure to cancer-causing agents in the workplace or home, diesel exhaust, arsenic in drinking water, previous radiation therapy to the lungs, air pollution all may play important roles in the development of lung cancer. Factors such as smoking marijuana, secondhand smoke from marijuana, talc and talcum powder, e-cigarettes are currently being evaluated as possible cancer-causing agents. Because marijuana is still illegal in many parts of the United States and the world, many patients with lung cancer do not admit to smoking it, so the data may be skewed. Treatment for lung cancer may include surgical removal of part or all of one lung, radiation, chemotherapy, targeted therapy, and immunotherapy.
Some people with earlier-stage lung cancers are reaching “cured status – no evidence of cancer for five full years after treatment.”
Women’s Reproductive Health
Uterine Fibroid Tumors are the most common noncancerous tumors in women of childbearing age. These tumors are made of muscle cells and other tissue that grow in or around the wall of the uterus. The cause of fibroids is unknown, but the risk of developing them are higher for African American women and women who are overweight. Symptoms include painful periods, bleeding in between periods, lower back pain, feeling full in the lower abdomen, painful intercourse, infertility, early labor, and multiple miscarriages.
Some women have no symptoms, so yearly exams are important for your reproductive health.
Endometriosis is a condition in which tissue similar to the tissue lining the inside of your uterus grows outside of the uterus on your ovaries, fallopian tubes, and/or the tissue lining your pelvis. In rare instances, endometrial-like tissue migrates beyond the area where pelvic organs are located. This tissue thickens, breaks down, and bleeds with each menstrual cycle, but unlike the tissue lining the uterus, it has no way to exit the body and becomes trapped creating a painful and unhealthy situation. Cysts on the ovaries may form. If the endometrial-like tissue becomes irritated, scar tissue may form and cause pelvic tissues to stick to each other. In addition to painful periods, women may experience pain during intercourse, and while urinating, or having bowel movements.
Endometriosis can worsen with time and may be confused with pelvic inflammatory disease (PID), Ovarian cysts or Irritable Bowel Syndrome (IBS). It can affect a woman’s ability to get pregnant and carry a child to term. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Doctors often advise women with endometriosis not to delay having children because of the progression of their condition.
Ovarian cancer occurs at higher rates than expected for women with endometriosis, but researchers are unsure why. Another rare form of cancer, endometriosis-associated adenocarcinoma can develop later in life in women who have had endometriosis.
Early detection and treatment are important for women with endometriosis. If you have problems with painful periods, excessive bleeding, pain during intercourse, pain with bowel movements or urination, infertility, or symptoms such as fatigue, diarrhea, constipation, bloating nausea especially during menstrual periods, see your doctor.
Interstitial Cystitis is a chronic bladder condition which causes chronic pain in the bladder or surrounding pelvic area. The walls of the bladder may become inflamed or irritated causing scarring and stiffening of the bladder. Symptoms may include painful and/or frequent urination, mild to severe abdominal or pelvic discomfort or pressure, tenderness, or lower abdominal pain that increases as the bladder fills or empties.
Polycystic Ovary Syndrome (POCS) occurs when a woman’s ovaries or adrenal glands produce more male hormones such as testosterone than normal. Cysts may develop on the ovaries. Women who are obese are more likely to have PCOS. Women with PCOS are at higher risks of developing diabetes and heart disease. Symptoms include pelvic pain, infertility, excess hair growth on the face, chest, stomach, thumbs, or toes, hair thinning or hair loss, acne, oily skin, or dandruff, and thickened dark brown or black patches of skin.
Gynecological Cancers include cervical cancer, ovarian cancer, peritoneal cancer, Fallopian tube cancer, uterine cancer, vaginal cancer, and vulvar cancer.
Cervical Cancer begins in the cervix, the lower, narrow end of the cervix. The risks of developing cervical cancer can significantly be reduced by PAP smear screening and an HPV vaccine. Risk factors include smoking, increased number of sexual partners, early sexual activity, other sexually transmitted diseases, a weakened immune system, exposure to miscarriage preventing drugs. Reduce your risks by not smoking, having protected sex – using a condom and limiting your number of sexual partners, getting the HPV vaccine, and having regular PAP smears. Each year in the U.S. @ 11,500 new cases are diagnosed and about 4,000 women per year die of cervical cancer. There were @ 604,000 cases diagnosed in 2020 worldwide.
Ovarian Cancer is caused by abnormal cell growth in the tissue covering the ovaries. It is the deadliest reproductive cancer affecting women. In 2020, there were 18,518 new cases of ovarian cancer diagnosed in the U.S. In 2020, 13,438 women died of ovarian cancer. Nine new cases of ovarian cancer were diagnosed for every 100,000 women and six out of every nine of those women will die. There are no early symptoms for this disease. Women with the genetic mutations BRCA 1 and 2 are at higher risk for developing ovarian cancer. Other risk factors include a family history of the disease, being over 50, infertility, and early menopause.
Peritoneal Cancer is a rare cancer the forms in the membrane lining of the abdominal cavity known as the peritoneum. Cancer that has spread to the peritoneal cavity from ovarian cancer, primary colorectal cancer appendiceal cancer, or mesothelioma and pseudomyxoma carcinomatosis are frequently referred to as peritoneal cancers. The risk factors are the same as for ovarian cancer. Symptoms are often vague and non-specific and may include abdominal swelling with pain, frequent urination and a sense of fullness while eating, weight loss, a change in bowel habits, or abnormal vaginal bleeding. Treatments may include surgery, chemotherapy or HIPEC, a heated chemotherapy bath of the affected area as well as targeted therapy, immune therapy, and radiation.
Fallopian Tube Cancer or tubal cancer is a rare cancer that develops in one or both of the fallopian tubes which leads from the ovaries to the uterus. It accounts for only 1-2% of all gynecological cancers and has the same risk factors as ovarian cancer. It is most common in Caucasian women who have never had children. Roughly 1,500 – 2,000 cases of fallopian tube cancer have been reported worldwide. Symptoms include abnormal vaginal bleeding, especially after menopause, pain, or pressure in the abdomen, abnormal pinkish or white vaginal discharge, or a pelvic mass. Treatments may include surgery and chemotherapy.
Uterine Cancer includes two types of cancer: endometrial cancer (most common) and uterine sarcoma (rare). Symptoms include bleeding between periods or after menopause. Endometrial cancer is the most common cancer affecting women’s reproductive systems and people AFAB i(assigned feamle at birth) n the U.S. It mainly develops after menopause and will affect roughly 3% of women and people AFAB during their lifetimes. About 65,00 cases are diagnosed each year. Symptoms include vaginal bleeding between periods before menopause, vaginal bleeding (even slight bleeding) after menopause, lower abdominal pain, thin clear or white vaginal discharge postmenopausal, extremely prolonged, heavy, or frequent vaginal bleeding if you are over 40 years old. Risk factors are age (higher as you get older), a diet high in animal fat, family history, obesity, diabetes, ovarian disease, menstruation, and reproductive history – early menstruation and late menopause, long menstruation span, not getting pregnant, earlier radiation therapy to your pelvis, estrogen replacement therapy, or the use of Tamoxifen – a drug used to treat hormone receptor positive breast cancer. Tests for uterine cancer include a CA-125 assay blood test, CT scans, MRI scans, trans vaginal ultrasound, endometrial biopsy. Hysteroscopy, and D&C (dilation and curettage) – a surgical procedure to remove uterine tissue. Treatments for cervical cancer may include removal of the uterus, chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted therapy.
Vaginal cancer is not common. It is a disease characterized by malignant cancer cells forming in the vagina. Risk factors include older age and having had an HPV infection. Symptoms include pain or abnormal vaginal bleeding. Treatments may include surgery, chemotherapy, and radiation.
Vulvar Cancer is a rare type of cancer that occurs on the outside surface of the female genitalia. The vulva includes the clitoris and the labia. It usually appears as a lump or sore on the vulva that often causes itching. It can occur at any age, but most often occurs in older adults. Treatment usually involves surgery to remove the cancer and a small amount of healthy tissue. Sometime the entire vulva must be removed. Early diagnosis usually involves the least invasive surgical procedure. Risk factors include increasing age, exposure to HPV, smoking, a weakened immune system, previous history of precancerous conditions of the vulva, or having a skin condition involving the vulva. Prevention measures include practicing safe sex and getting the HPV vaccine.
Sexually Transmitted Diseases (STDs) are infections you can get from having sex with infected people. They are caused by bacteria, viruses, or parasites. STDs caused by bacteria or parasites can be treated and cured with antibiotics. Viral infections can be treated but not cured by antiviral medications. Correct usage of latex condoms helps prevent STDs.
HIV/AIDS – HIV is the human immunodeficiency virus. It affects CD4 cells in the body. Over time so many CD4 cells may be destroyed that it compromises your immune system preventing the body from fighting off infections. There is no cure for HIV, but there are now treatments. AIDS, acquired immune deficiency, can develop from HIV causing severe damage to the immune system. Women typically get HIV/AIDS from having unprotected sex with infected men or sharing intravenous needles with infected people. Pregnant women who are infected are at risk of spreading the disease to their children during pregnancy, childbirth, or after birth. Knowing your status can help protect your child from HIV/AIDS.
Sources for this article:
https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html
https://my.clevelandclinic,org
https://www.cdc.gov/cancer/ovarian/index.htm
https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/