Call Girl Surat Madhuri 7001305949 Independent Escort Service Surat
Prevention of cancer in women
1. 1
Prevention of Cancer in Women
Breast & Cervical
Dr. Vandana Bansal
MS, D.Phil. (Gold Medalist), DGO, FCGP
Senior Gynaecologist & Obstetrician
Gynaecological Endoscopic Surgeon
Infertility & IVF Specialist
DirectorDirector
Arpit Test Tube Baby Centre
Jeevan Jyoti Hospital
2. Importance of Health
• Getting motivated
• Definition of Health
– Health is not merely absence of disease, but it is a
complete physical, mental and spiritual well being
• Disease
– Genetic, Life style, Toxin, Trauma, Infection,
Cancer, Due to Aging
3. Leading Causes of Death for
Women
#1 Heart Disease
#2 Cancer
#3 Stroke
CDC, National Vital Statistics Report, 2007
4. INTRODUCTION
• Cancer is one of the most important cause of
death in women.
• Due to improve cancer screening and
treatment we have a better chances beating
cancer than ever before.
• About 66 % people diagnosed with cancer
between 1966-2002 survived for at 5 years.
• As the science of cancer detection and
treatment continues to advanced even more
people will survive cancer in the future. 4
5. Introduction
• Risk of cancer is known to increase with age.
menopausal women are at higher risk
especially those of female genital tract and breast.
• Hormone therapy can also impact the
development the malignacies
• Screening malignancies of female genital tract and
breast in post menopausal women is a necessity
for there early detection hence better management
good prognosis and better survival.
6. Why you should know about
cancer
• Even if you haven’t been diagnosed
with cancer, its important to know that
there are steps you can take to:
• Reduce your chances of getting cancer
• Detect cancer early
• Make sure you get the treatment you
need.
6
7. • Cancer may regarded as a group of diseases
characterized by an
– Abnormal growth of cells
– Ability to invade tissue and even distant organs
– The eventually death of the affected patient if the
tumor has progressed beyond the stage when it
can be successfully removed
Cancer
8.
9. 5 Most Common Cancer in
Women in India
• Brest
• Cervix
• Oral Cavity
• Lung
• Colorectal (Large Intestine)
9
10. 10
17 Million New Cancer Cases worldwide. 2018
8.8 million (52% male)
8.2 million (48% female)
Male: Female Ratio 10:9.3
It is predicted that there will be 62% increase
in the new cancer cases worldwide by 2040
World Cancer Epidemilogy
11. CANCER IN DEVELOPING COUNTRIES
INCREASING
• Deaths from infectious diseases
• Childhood mortality
• Longevity
• Adoption of Western Life style
– Cigarette Smoking
– Higher consumption of saturated fat
– Consumption of Calorie dense foods
– Physical activity
Survival rates poorer in developing countries (lack
of availability of early detection and treatment
services)
12. What causes cancer
• Genetical or inherited
• Family history
• Gender
• Age
• Smoking, radiation, viruses, cancer-causing
chemicals( carcinogens), lack of exercise,
obesity, and hormones etc.
• Diet and food additives.
• Sexual practices is also a risk factor causing
cancer. 12
13.
14.
15.
16. Risk Factors
Uncontrollable
Being a woman
Getting older
Family
History
Biopsy (Pre-Cancerous
Condition)
1st
period before age 12
Menopause after 55
Positive testing for breast
cancer gene (BRCA1 &
BRCA2)
Controllable
More than 1 alcoholic drink a
day
Obesity after menopause
Weight gain as an adult
Recent use of oral
contraceptives
Never having children
1st
child after age 30
Current/recent use of HRT
Susan G. Komen Breast Cancer Foundation
17. Hereditary Breast Cancer
• About 15% of breast cancers are inheritedAbout 15% of breast cancers are inherited
• Approximately 80% of hereditary breast cancer is caused byApproximately 80% of hereditary breast cancer is caused by
mutations in the BRCA1 or BRCA2 genesmutations in the BRCA1 or BRCA2 genes
• Women who inherit a BRCA mutation have a 50% to 85%Women who inherit a BRCA mutation have a 50% to 85%
chance of developing breast cancer in their lifetimechance of developing breast cancer in their lifetime
• Women with especially strong family history may considerWomen with especially strong family history may consider
preventive surgery to remove breast tissue and/orpreventive surgery to remove breast tissue and/or
chemopreventionchemoprevention
• Several other genetic syndromes can increase breast cancerSeveral other genetic syndromes can increase breast cancer
riskrisk
• Genetic counseling and testing is available for mostGenetic counseling and testing is available for most
syndromessyndromes
• For more information, www.plwc.org/geneticsFor more information, www.plwc.org/genetics
18. Breast Cancer and Early
Detection
• Early diagnosis means a better chance of successfulEarly diagnosis means a better chance of successful
treatmenttreatment
• Mammography is the best tool doctors have toMammography is the best tool doctors have to
screen for breast cancerscreen for breast cancer
• Many organizations recommend that women obtain aMany organizations recommend that women obtain a
mammogram each year, starting atmammogram each year, starting at the age of 40age of 40
• Regular clinical breast examinations and breast self-Regular clinical breast examinations and breast self-
examinations are also recommendedexaminations are also recommended
• Women are encouraged to discuss the frequency ofWomen are encouraged to discuss the frequency of
screening with their doctorsscreening with their doctors
19. Some
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.
Warning Signs of Breast Cancer
Centers for Disease Control
20.
21. Methods of Screening for
Breast Cancer
• Self Brest ExaminationSelf Brest Examination
• Clinical Brest ExaminationClinical Brest Examination
• mammographymammography
• UltrasoundUltrasound
• Magnetic Resonance imaging (MRI) scanMagnetic Resonance imaging (MRI) scan
30. 30
80% of the new cases
occur in the developing
countries
Most frequent cause of
death from cancer in
Women from developing
Countries
CERVICAL CANCER
32. Cervical cancer
• There is a significant rise in the pre-
cancerous lesions like CIN in teenage
and younger women.
• 35% to 50% of invasive cancers are
now diagnosed while they are still at the
stage I level of the disease..
32
33. Who is at risk for cervical
cancer?
• Multiparty
• Low socioeconomic status
• Age of the first coitus
• Multiple sexual partners
• Genital tract infection
HSV infection
Vulval Warts
• Other infection like
CMV
Chlamydia Trachomatis
Trichomonal Vaginalis
• Smoking
• Contraception
34. What causes cervicalWhat causes cervical
cancer???cancer???
The main cause for cervical cancer is aThe main cause for cervical cancer is a
virus called (HPV)humanvirus called (HPV)human
papillomavirus….papillomavirus….
•HPV is sexually transmittedHPV is sexually transmitted
•The HPV detected today could have been acquired yearsThe HPV detected today could have been acquired years
agoago
•There are many different types of HPVThere are many different types of HPV
Low-risk types can cause wartsLow-risk types can cause warts
High-risk types can cause pre cancer andHigh-risk types can cause pre cancer and
cancer of the cervixcancer of the cervix
34
35. The symptoms of cervical cancer
Unusual discharge from the vagina.
Abnormal vaginal bleeding (between periods, during
sex or after menopause.
Anemia because of abnormal vaginal bleeding.
Ongoing pelvic, leg, or back pain.
Urinary problems because of blockage of a kidney or
ureter.
Bleeding from the rectum or bladder.
Weight loss.
35
36.
37. 37
Screening methods available
• VISUAL INSPECTION: VIA and VILLI (subjective
visual inspection with acetic acid &lugol’s iodine
• Cytology : Pap Smear, LBC (Liquid based cytology)
• HPV DNA Test: High Risk HPV DNA Test / HPV
Typing
• Follow up with colposcopy or directed biopsy or treat
with ablative methods or excisional methods
38.
39.
40. PREVENTIVE MEASURES
• Delaying first sexual intercourse until the late teens or older
• Avoidance of early marriage.
• Get regular Pap tests and follow up, if necessary
• Limiting the number of sex partners
• Restriction of Number of Children
• Maintain Genital Hygiene
• Avoiding sexual intercourse with people who are obviously
infected with genital warts or show other symptoms
• Use condoms consistently and correctly during sexual activity
• Quitting smoking
• Vaccination
41. HPV Vaccine
ACOG Recommendations
Three Shots Over Six MonthsThree Shots Over Six Months
Male and FemalesMale and Females
Ages 11-12Ages 11-12
Up to 9-26Up to 9-26
42. Cervical cancer cure rate by
Stages
42
When detected at an early stage, the 5-year
survival rate for women with invasive
cervical cancer is 92%. About 45% of
women with cervical cancer are diagnosed
at an early stage. If cervical cancer has
spread to surrounding tissues or organs
and/or the regional lymph nodes, the 5-year
survival rate is 56%.
Hint: #1 weighs less than a can of soda, it’s about the size of a fist, and operates about 100,000 times a day.
The Risk of developing cancer may be depend upon who you are, where you have been exposed and how do you live (lifestyle). Cancer is not contagious. So you need not worry about spreading or catching from someone else.
Discuss prevention: BSE and getting CBE’s
Hand out BSE card
**Further information on the risk factors can be found on the Susan G Komen website
A risk factor is something that can increase your chance of getting a disease, such as cancer. Some factors are more likely to cause cervical cancer than others.
The most important risk factor is not getting regular Pap tests and treated, when needed.
Also, as mentioned earlier, having persistent HPV infection increases your risk of cervical cancer.
Women smokers are more likely to get cervical precancer and cancer.
Over the last five decades, large scale organized cytology based screening programs have shown substantial reduction in incidence and mortality of cervical cancer in developed countries. However, implementing such screening programs in low resource settings has its own challenges. Poor health care infrastructure, sub-optimal performance of cytology, absence of quality assurance measures and inadequate resources to support multiple visits for screen test evaluation, Colposcopy and treatment are the key barriers in replicating cytology based screening models of developed countries. To overcome these limitations, alternative screening technologies like visual screening has been extensively evaluated in low resource set-ups.
You can usually prevent cervical cancer with routine Pap tests. Make sure you follow up with more testing if your doctor tells you to.
You can lower your risk for cervical cancer by having fewer sex partners over the course of your lifetime. The longer you wait to have sex, the more likely you are to have fewer sex partners. Having a partner who has had no or few prior sex partners can also lower your risk.
If you already smoke, talk to your doctor about programs to help you stop.
Good nutrition can help make your immune system stronger. Some research suggests that folic acid can reduce your risk of cervical cancer. Folic acid can be found in foods such as uncooked spinach; romaine lettuce; rice; lentils; and, certain cereals.
The effect of condoms in preventing HPV infection is not known. However, the use of condoms has been associated with a lower rate of cervical cancer. People who are sexually active should use condoms. When condoms are used consistently and correctly, they help prevent HIV (the virus that causes AIDS) and lower the risk of other STDs.
Important points:
Vaccination recommended for all females 9-26 years old.
Vaccine is most effective if administered before sexual activity
ACOG supports vaccination at 13-15 years of age during first visit to GYN
The vaccine can be given to women with previous CIN, abnormal cytology or genital warts, but it is not intended to treat these patients. Patients with these conditions should undergo the appropriate evaluation and treatment.
Women with suppressed immune systems can be vaccinated, although protection may be less than that of women with normal immune function.
Pap screening recommendations remain the same. The vaccine is a preventive tool and is not a substitute for cancer screening.
Reference: Human Papillomavirus Vaccination. ACOG Committee Opinion No. 344. 2006; 108: 699-705.