Gynecologic Cancers
Gynecologic cancer is any cancer that starts in a woman's reproductive organs. Cancer is always named for the part of the body where it starts. The five gynecologic cancers begin in different places within a woman's pelvis, which is the area below the stomach and in between the hip bones.
Each gynecologic cancer is unique, with different signs and symptoms, different risk factors (things that may increase your chance of getting a disease), and different prevention strategies. All women are at risk for gynecologic cancers, and risk increases with age. When gynecologic cancers are found early, treatment is most effective.
Cervical Cancer
Cancer is a disease in which cells in the body grow out of control. Cancer is always named for the part of the body where it starts, even if it spreads to other body parts later. When cancer starts in the cervix, it is called cervical cancer. The cervix is the lower, narrow end of the uterus. Also known as the womb, the uterus is where a baby grows when a woman is pregnant. The cervix connects the upper part of the uterus to the vagina (birth canal).
Early on, cervical cancer usually does not cause signs and symptoms. Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex.
Cervical cancer is highly preventable in most Western countries because screening tests and a vaccine to prevent HPV infections are available. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.
All women are at risk for cervical cancer. It occurs most often in women aged 30 years and older. It is important to get tested for cervical cancer because 6 of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years.
The human papillomavirus (HPV), a common virus that can be passed from one person to another during sex, is the main cause of cervical cancer and also causes many vaginal and vulvar cancers. At least half of sexually active people will have HPV at some point in their lives. Keep in mind, many people will have an HPV infection at some time in their lives, but few women will get cervical cancer.
Ovarian Cancer
When cancer starts in the ovaries, it is called ovarian cancer. Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones and produce eggs.
Ovarian cancer causes more deaths than any other cancer of the female reproductive system.† But when ovarian cancer is found in its early stages, treatment is most effective. Ovarian cancer often causes signs and symptoms, so it is important to pay attention to your body and know what is normal for you. Symptoms may be caused by something other than cancer, but the only way to know is to see your doctor, nurse, or other health care professional.
Ovarian cancer often causes signs and symptoms. See your doctor, nurse, or other health care professional if you have any of these signs every day for two weeks or longer and they are not normal for you, especially if they get worse—
• Pain in the pelvic or abdominal area (the area below your stomach and between your hip bones).
• Back pain.
• Being tired all the time.
• Bloating, which is when the area below your stomach swells or feels full.
• A change in your bathroom habits, such as having to pass urine very badly or very often.
• An upset stomach or heartburn.
• Discharge from your vagina that is not normal for you.
Also, see your doctor if you have any bleeding from your vagina that is not normal for you, particularly if you are past menopause. These symptoms may be caused by something other than cancer, but the only way to know is to see your doctor. The earlier ovarian cancer is found and treated, the more likely treatment will be effective.
Uterine Cancer
The uterus is the pear-shaped organ in a woman's pelvis (the area below your stomach and in between your hip bones). The uterus, also called the womb, is where the baby grows when a woman is pregnant. The most common type of uterine cancer is also called endometrial cancer because it forms in the lining of your uterus, called the endometrium. All women are at risk for uterine cancer, but the risk increases with age. Most uterine cancers are found in women who are going through or who have gone through menopause—the time of life when your menstrual periods stop.
The most common sign of uterine cancer is bleeding that is not normal for you because of when it happens or how heavy it is. This could mean bleeding, even a little bit, after you have gone through menopause; periods that are longer than seven days; bleeding between periods; or any other bleeding that is longer or heavier than is normal for you.
Other symptoms, such as pain or pressure in your pelvis, may also occur if you have uterine cancer. If you have any of these symptoms, talk to your doctor, nurse, or other health care professional right away. They may be caused by something other than cancer, but the only way to know is to see your doctor.
Vaginal and Vulvar Cancers
The vagina, also called the birth canal, is the hollow, tube-like channel between the bottom of the uterus and the outside of the body. When cancer starts in the vulva, it is called vulvar cancer. The vulva is the outer part of the female genital organs. It has two folds of skin, called the labia. Vulvar cancer most often occurs on the inner edges of the labia. When vaginal and vulvar cancers are found early, treatment is most effective. Treatment of vulvar cancer, in particular, often leads to a cure. Vaginal and vulvar cancers are very rare. While all women are at risk for these cancers, very few will get them.
Early on, most vaginal cancers do not cause signs and symptoms. But if there are symptoms, they may include—
• Bleeding that is unusual for you because of when it happens or how heavy it is.
• Pain in your pelvis, the area below your stomach and in between your hip bones, especially when you pass urine or have sex.
Many women who have vulvar cancer have signs and symptoms. They may include—
• Itching of the vulva (mostly on the labia) that does not go away.
• Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal for you.
• Skin changes in the vulva, including what looks like a rash or warts.
• A sore on the vulva that does not go away.
It is important for you to pay attention to your body and know what is normal for you. If you have any of these symptoms for more than two weeks, talk to your doctor, nurse, or other health care professional right away. Symptoms may be caused by something other than cancer, but the only way to know is to see your health care professional.
Skin Cancer
Skin cancer is the most common form of cancer in the United States. The two most common types of skin cancer—basal cell and squamous cell carcinomas—are highly curable. However, melanoma, the third most common skin cancer, is more dangerous, especially among young people. About 65%–90% of melanomas are caused by exposure to ultraviolet (UV) light.
Ultraviolet (UV) Light
Ultraviolet (UV) rays are an invisible kind of radiation that come from the sun, tanning beds, and sunlamps. UV rays can penetrate and change skin cells.
The three types of UV rays are ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—
• UVA is the most common kind of sunlight at the earth's surface, and reaches beyond the top layer of human skin. Scientists believe that UVA rays can damage connective tissue and increase a person's risk of skin cancer.
• Most UVB rays are absorbed by the ozone layer, so they are less common at the earth's surface than UVA rays. UVB rays don't reach as far into the skin as UVA rays, but they can still be damaging.
• UVC rays are very dangerous, but they are absorbed by the ozone layer and do not reach the ground.
Too much exposure to UV rays can change skin texture and cause the skin to age prematurely, leading to skin cancer. UV rays also have been linked to eye conditions such as cataracts.
Risk Factors
People with certain risk factors are more likely than others to develop skin cancer. Risk factors vary for different types of skin cancer, but some general risk factors are having-
• A lighter natural skin color.
• Family history of skin cancer.
• A personal history of skin cancer.
• Exposure to the sun through work and play.
• A history of sunburns early in life.
• Skin that burns, freckles, reddens easily, or becomes painful in the sun.
• Blue or green eyes.
• Blond or red hair.
• Certain types and a large number of moles.
Tanning and Burning
When ultraviolet (UV) rays reach the skin's inner layer, the skin makes more melanin. Melanin is the pigment that colors the skin. It moves toward the outer layers of the skin and becomes visible as a tan.
A tan does not indicate good health. Some doctors consider a tan a response to injury, because it appears after the sun's UV rays have killed some skin cells and damaged others.
People burn or tan depending on their skin type, the time of year, and the amount of time they have spent in the sun. The six types of skin, based on how likely it is to tan or burn, are—
• I: Always burns, never tans, sensitive to sun exposure.
• II: Burns easily, tans minimally.
• III: Burns moderately, tans gradually to light brown.
• IV: Burns minimally, always tans well to moderately brown.
• V: Rarely burns, tans profusely to dark.
• VI: Never burns, deeply pigmented, least sensitive.
Although everyone's skin can be damaged by too much sunlight, people with skin types I and II are at the highest risk.
Prevention
Protection from sun exposure is important all year round, not just during the summer or at the beach. Ultraviolet (UV) rays can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand, and snow.
The hours between 10 a.m. and 4 p.m. daylight savings time (9 a.m. to 3 p.m. standard time) are the most hazardous for UV exposure in the continental United States. UV rays are the greatest during the late spring and early summer in North America.
• Use sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection.
• Wear clothing to protect exposed skin.
• Wear a hat with a wide brim to shade the face, head, ears, and neck.
• Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
• Seek shade, especially during midday hours.
Prostate Cancer
The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The job of the prostate is to produce fluid that makes up a part of semen. As men age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow.
Symptoms
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all. Some symptoms of prostate cancer are:
• Difficulty starting urination.
• Weak, or interrupted flow of urine.
• Frequent urination, especially at night.
• Difficulty emptying the bladder completely.
• Pain or burning during urination.
• Blood in the urine or semen.
• Pain in the back, hips, or pelvis that doesn't go away.
• Painful ejaculation.
Risk Factors
Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include:
• Age: The older a man is, the greater his risk for getting prostate cancer.1
• Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.
• Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why.
Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man's risk of developing the disease, either positively or negatively. Some of the factors under study include:
• Vitamins, minerals, and herbal supplements.
• Diets high in animal fat, especially polyunsaturated fat.
• Men's hormone levels.
• Environmental agents (pesticide residues on foods, and industrial and occupational exposures).
Lung Cancer
Lung cancers are cancers that originate in the lungs. Other types of cancers may spread to the lungs from other organs. However, these are not lung cancers because they did not start in the lungs. When cancer cells spread from one organ to another, they are called metastases.
Research has found several risk factors for lung cancer. A "risk factor" is anything that changes risk of getting a disease. Different risk factors change risk by different amounts.
The risk factors for lung cancer include:
• Smoking and secondhand smoke
• Things around us at home or work (such as radon gas).
• Personal traits (such as having a family history of lung cancer).
Symptoms
Different people have different symptoms for lung cancer. Some people don't have any symptoms at all. About 25% of people with lung cancer do not have symptoms from advanced cancer when their lung cancer is found.1 Lung cancer symptoms may include:
• Shortness of breath.
• Coughing that doesn't go away.
• Wheezing.
• Coughing up blood.
• Chest pain.
Other changes that can sometimes occur with lung cancer may include repeated bouts of pneumonia, changes in the shape of the fingertips, and swollen or enlarged lymph nodes (glands) in the upper chest and lower neck.
These symptoms can happen with other illnesses, too. People with symptoms should talk to their doctor, especially if they smoke, but even if they don't. Doctors can help find the cause.
Smoking and Secondhand Smoke
Cigarette smoking causes lung cancer. In fact, smoking tobacco is the major risk factor for lung cancer. In the United States, about 90% of lung cancer deaths in men and almost 80% of lung cancer deaths in women are due to smoking. People who smoke are 10 to 20 times more likely to get lung cancer or die from lung cancer than people who do not smoke. The longer a person smokes and the more cigarettes smoked each day, the more risk goes up.
People who quit smoking have a lower risk of lung cancer than if they had continued to smoke, but their risk is higher than the risk for people who never smoked. As more people quit smoking, lung cancer rates will continue to fall, the percentage of lung cancers that occur in smokers will decrease, and the percentage of lung cancers that occur in people who have quit will rise.
Smoking also causes cancer of the voicebox (larynx), mouth and throat, esophagus, bladder, kidney, pancreas, cervix, and stomach, and causes acute myeloid leukemia.
Using cigars or pipes also increases risk for lung cancer, but not as much as smoking cigarettes.
Smoke from other people's cigarettes (secondhand smoke) causes lung cancer as well. Secondhand smoke contains more than 4,000 chemicals, more than 50 of which cause cancer in people or animals. Every year, about 3,000 nonsmokers die from lung cancer due to secondhand smoke.
Casuses of Lung Cancer at Home and Work
Several things may cause lung cancer in the workplace or even in the home:
• Radon gas causes lung cancer and is sometimes found in people's homes. Radon is an odorless, colorless gas that comes from rocks and dirt and can get trapped in houses and buildings. Radon is the number one cause of lung cancer among non-smokers, according to EPA estimates. Overall, radon is the second leading cause of lung cancer.
• Examples of substances found at some workplaces that increase risk include asbestos, arsenic, and some forms of silica and chromium. For many of these substances, the risk of getting lung cancer is even higher for those who also smoke.
• Other substances may increase lung cancer risk as well.
Family History
Risk of lung cancer may be higher if a person's parents, siblings (brothers or sisters), or children have had lung cancer. This increased risk could come from one or more things. They may share behaviors, like smoking. They may live in the same place where there are carcinogens such as radon. They may have inherited increased risk in their genes.
Diet
Scientists are studying many different foods to see how they may change the risk of getting lung cancer. However, any effect diet may have on lung cancer risk is small compared with the risk from smoking. Eating a lot of fat and cholesterol might increase risk of lung cancer. Drinking a lot of alcohol may raise risk as well. However, it's hard to tell how much of the risk in people who drink is actually due to tobacco smoke, since many people both smoke and drink.
Some foods may actually help prevent lung cancer. Diets high in fruits and vegetables likely decrease cancer risk. Diets high in vitamin C, vitamin E, or selenium also may help protect against lung cancer. The effect of eating foods with carotenoids like beta-carotene on lung cancer risk is uncertain. Carotenoids can be found in carrots, sweet potatoes, and some green vegetables. Eating these foods may lower chances of lung cancer. Taking beta-carotene supplements (pills) is not recommended, however, since it may actually increase risk in some smokers.
Hematologic Cancers
Hematologic cancers are cancers of the blood, bone marrow and lymph nodes. Some more common types of hematologic cancers are listed below.
Leukemia
Leukemia is a cancer of the bone marrow and blood. The two primary types of leukemia are lymphocytic leukemia, which involves an increase of white blood cells called lymphocytes; and myelogenous leukemia (also known as myeloid or myelocytic leukemia), which involves an increase in white blood cells called granulocytes. Leukemia can be acute or chronic. Acute forms of leukemia progress rapidly, whereas chronic forms of leukemia progress slowly, leading to different approaches to diagnosis and treatment.
Scientists do not fully understand all the causes of leukemia, but research has uncovered many associations. For example, chronic exposure to benzene in the workplace and exposure to large doses of radiation have been shown to cause leukemia in some cases. Additionally, cancer-causing chemicals in tobacco may be associated with myeloid leukemia in adults. Family history has also been associated with increased risk of leukemia. Caucasians are more likely than African Americans to develop acute leukemia, but scientists do not know why.
Lymphoma
Lymphoma is a general term for a group of cancers that originate in the lymph system. The two primary types of lymphoma are Hodgkin lymphoma, which spreads in an orderly manner from one group of lymph nodes to another; and non-Hodgkin lymphoma, which spreads through the lymphatic system in a non-orderly manner.
The main causes of lymphoma are unknown. However, research has shown that people infected with the human immunodeficiency virus (HIV) are at much higher risk of developing lymphoma. Other viral agents, such as human T-cell lymphotrophic virus and Epstein Barr virus, also have been linked with certain types of lymphoma. Finally, some studies suggest that specific ingredients in herbicides and pesticides may be associated with lymphoma occurrence, but scientists have not defined the amount of such exposures required to increase the risk of developing lymphoma.
Myeloma
Myeloma is a cancer of the plasma cells. In myeloma, the cells overgrow, forming a mass or tumor that is located in the bone marrow. Bone marrow is the spongy tissue found in the center of the bone, where red cells, white blood cells, and platelets are made.
Age is the most significant risk factor for developing myeloma. People under the age of 45 years rarely develop the disease, while those aged 67 years or older are at greatest risk of developing myeloma. Men are more likely than women to develop myeloma, and myeloma is about twice as common among African Americans as among Caucasians. In rare cases, exposure to radiation may be a risk factor for developing myeloma. Finally, some studies have suggested that workers in petroleum-related industries may be at a higher risk for developing myeloma.
Breast Cancer
Overview
No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age.
Sometimes breast cells become abnormal. These abnormal cells grow, divide, and create new cells that the body does not need and that do not function normally. The extra cells form a mass called a tumor. Some tumors are "benign" or not cancer. These tumors usually stay in one spot in the breast and do not cause big health problems. Other tumors are "malignant" and are cancer. Breast cancer often starts out too small to be felt. As it grows, it can spread throughout the breast or to other parts of the body. This causes serious health problems and can cause death.
There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer. Breast cancer can begin in different parts of the breast, like the ducts or the lobes.
Common kinds of breast cancer are:
Ductal carcinoma. The most common kind of breast cancer. It begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
Lobular carcinoma. In this kind of breast cancer, the cancer cells begin in the lobes, or lobules, of the breast. Lobules are the glands that make milk.
There are several other less common kinds of breast cancer, such as Paget's disease or inflammatory breast cancer.
Symptoms
Symptoms vary from pers on to person. Some individuals do not have any signs or symptoms at all. A person may discover they have breast cancer after a routine mammogram.
Typical breast cancer symptoms include:
• New lump in the breast or underarm (armpit).
• Thickening or swelling of part of the breast.
• Irritation or dimpling of breast skin.
• Redness or flaky skin in the nipple area or the breast.
• Pulling in of the nipple or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Any change in the size or the shape of the breast.
• Pain in any area of the breast.
It is careful to note that any one of the symptoms could indicate a medical condition other than breast cancer.
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The American Cancer Society is a community-based voluntary health organization dedicated to fighting cancer through research, advocacy, education, patient service and rehabilitation.
Charitable organization dedicated to funding research, creating awareness and educating people about cancer. The AICR ‘s Web site provides information on diet, physical activity and cancer prevention.
The National Cancer Institute, a component of the National Institute of Health (NIH), is a federal agency dedicated to conducting and supporting research, programs, training, health dissemination for the cause, diagnosis, treatment and prevention of cancer.
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Cancer Update (Part 1)
Cancer is the second-leading cause of death in this country, closely following heart disease. Although it remains a serious problem, there is some promising research surrounding it underway.
In part one of this two-part interview, our cancer expert Dr. Kevin Cullen discusses some advances in cancer research and treatment, including new methods of targeted cancer therapies and vaccines.
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