Cancer
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Cervical cancer begins in the cells of the cervix – which connects the lower part of the uterus to the vagina – the birth canal.
Are Gynaecological Cancers (Ovarian, Breast & Uterine) Hereditary?
Gynaecological cancer: Hereditary (inherited) gynaecological cancers can genetically predispose women to an increased risk of being diagnosed with gynaecological cancers. There are many risk factors that contribute to the development of gynaecological cancers in women. Among those gene mutations constitute around 5 to 10 per cent risk. For instance, BRCA1 and BRCA2 gene mutations are the most common. They are responsible for ovarian and breast cancers in women who have mutated BRCA1 and BRCA2 genes. There is an almost 50 per cent chance of a woman passing the mutated BRCA genes to her offspring.
Another less common hereditary gynaecological cancer syndrome is Lynch syndrome. It increases the risk of getting several different types of both gynaecological and non-gynaecological cancers in women.
Lynch syndrome
MSH2 and MLH1 genes mutation or mismatched sequence in these genes cause Lynch syndrome. This type of gene mutation is present in around 1 in 1000 women who carry this gene. Endometrial cancer risk is very high in women who have Lynch syndrome. In the general population, there is an increased risk of around 40-60 per cent in women who have Lynch syndrome.
The risk of getting ovarian cancer in women, in general, is relatively low – that is around 1.5 per cent. However, the risk is very high in women with Lynch syndrome. The overall risk of getting ovarian cancer in women with Lynch syndrome is around 10 per cent. In addition, a woman with Lynch syndrome is also at an increased risk of developing breast and ovarian cancer. A woman’s risk of developing non-gynaecological cancers such as liver, stomach, small bowel and urinary tract and pancreatic cancers also increases if she has Lynch syndrome.
What is the probability of Getting Hereditary Gynaecological Cancer?
BRCA gene mutation is possible in both men and women with around a 50% chance of both the genders passing it to their offspring. For instance, for women who have inherited BRCA2 mutated genes, then her lifetime risk of getting gynaecological cancer is around 20 per cent. Similarly, women who have inherited BRCA1 mutated genes have up to 40% lifetime risk of getting gynaecological cancer.
BRCA gene mutations are rare (uncommon). About one in a thousand women have one of the two BRCA gene mutations. However, the risk varies depending on the ethnicity and different regions of the world. For instance, the percentage of risk varies among American, Asian and Jewish populations with Ashkenazi Jewish women having a very high risk of BRCA1 and BRCA2 gene mutations.
The following family history criteria may indicate a hereditary gynaecological cancer syndrome:
- Any close relative in the family was diagnosed with breast cancer before age 45.
- Any of the close relatives – such as sister, daughter, granddaughter, mother, grandmother, niece or aunt has or had ovarian or breast cancer.
- Anyone or two of the close relatives from either maternal or paternal family side has or had ovarian or breast cancer before the age of 50 years.
Bottom Line
The genetic material of a woman (genes present in her DNA) and her family history determine whether she is at increased risk of developing gynaecological cancer. For instance, if a woman’s close family members – such as her sister or mother have had ovarian or breast cancer, then her risk of developing hereditary cancer increases. Furthermore, women at inherent risk of developing hereditary cancers typically have gynaecological cancers at a younger age than sporadic cancers. In general, the diagnosis of gynaecological cancer in a woman at a relatively younger age may indicate a genetic issue causing cancer.
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Fallopian Tube Cancer – Symptoms & Risk Factors
Fallopian tube cancer symptoms | Dr. Geetha Nagasree
Fallopian tube cancer develops in the cells of the fallopian tubes that connect ovaries to the uterus. Cancer can develop in one or both tubes. The cells grow uncontrollably and abnormally forming a mass called a tumor. Cancer of the fallopian tube per se is very rare. In most cases, fallopian tube cancer may result from cancer spreading from other organs such as ovaries, uterus, endometrium, or colon.
Fallopian tube cancer Symptoms
Women with fallopian tube cancer may or may not experience symptoms. In most cases, fallopian tube cancer symptoms are often non-specific ( meaning symptoms can mimic the symptoms of other gynecological conditions that are not cancer). Symptoms of fallopian tube cancer may include:
- A pelvic mass or lump
- Pelvic pain
- Heavy vaginal bleeding especially after menopause
- Irregular periods
- Abdominal bloating, gas, constipation
- Abdominal pressure
- Clear white, tinged or blood discharge
- Sudden or frequent urge to urinate
Causes of fallopian tube cancer
The exact or specific cause of this type of cancer is still unknown. However, genetic, environmental, and other factors could play a role in the development of this type of cancer.
What are the risk factors for fallopian tube cancer?
Some factors may increase the risk of a woman developing fallopian tube cancer including age ( above 50 years), ethnic background – European, American, North American, and Jewish origin);
Nulliparity
Starting menstruation early in life
Weight (obesity)
Inherited genetic mutations and conditions
A family history of breast and ovarian cancer
Diagnosis of Fallopian Tube Cancer
If a surgical oncologist or a lady oncologist ( an oncologist specializing in the diagnosis and treatment of gynecological cancer) suspects fallopian tube cancer, she may suggest a few diagnostic tests. After a thorough gynecological examination, the doctors may order tumor marker tests such as CA-125, and imaging tests such as CT, MRI scans, and transvaginal ultrasound scans. On receiving an indication of cancer, the doctor performs a biopsy to confirm the diagnosis of fallopian tube cancer.
Bottom Line
The signs and symptoms associated with gynecological cancers such as ovarian or fallopian tube cancer can also be due to other conditions. Therefore, many women tend to ignore such symptoms assuming them to be due to less serious health conditions such as indigestion or stomach upset. For this reason, both ovarian and fallopian tube cancers often go unnoticed and get detected in the advanced stages. Therefore, if signs and symptoms get worse and do not improve with treatment and care, then check with your gynecologist who specializes in the diagnosis and treatment of gynecological cancer for an accurate diagnosis and early treatment.
Regarding the treatment of fallopian tube cancer, meet Dr. Geetha Nagasree for surgical removal of affected fallopian tubes and advanced chemotherapy options.
Surgeries for Advanced and Recurrent Ovarian Cancers
Ovarian Cancer Surgery | Dr. Geetha Nagasree
Ovarian cancer can be persistent, refractory or recurring. Some patients who have been tested positive and got treated may face this problem. In some cases, following initial treatment cancer can recur. Oncologist, therefore, recommend surgery, chemotherapy and radiation therapy. Some patients respond well to systemic treatment with chemotherapy, radiation therapy and treatment with poly ADP-ribose polymerase inhibitors or other precision medicines.
Ovarian cancer tends to recur in patients who have been treated for advanced epithelial ovarian cancer.
Those who experiences continued or progressive growth of cancer during treatment are said to have REFRACTORY CANCER.
The Role of Surgery
Ovarian cancer surgery: The prognosis is poor for such patients. For the treatment of advanced and recurrent ovarian cancer, surgery plays a role. It is especially helpful prior to beginning chemotherapy. In general, the treatment may involve surgery, chemotherapy and radiation therapy. Additional surgery to remove recurrent cancer combined with systemic therapy appears to further improve survival when compared to treatment with systemic therapy alone.
Systemic Therapy
Surgery is the baseline or the first line treatment for any type of ovarian cancer. In addition, if the cancer has spread to other tissues and organs of the body, systemic therapy is recommended. It involves used of precision cancer medicines, target therapies and chemotherapy. Furthermore, a combination of therapies involving a combination therapy or immunotherapy is suggested. All these treatments – to a large extent – depend on the effectiveness of the surgical treatment, the duration for which chemotherapy is administered and how far has the cancer recurred.
Selection of Chemotherapeutic agents
For the effective treatment, oncologist recommend chemotherapeutic assays. The assays may help in the selection of the best chemotherapeutic agents. Tumour samples or ascitic fluid is sent to laboratory for assay. Expert pathologist culture tumour cells in media that contains a wide range of chemotherapeutic agents. Next, they select agents that have good efficacy and potential against some stubborn cancerous cells. It is also helpful in avoiding chemical agents that are associated with extreme drug resistance.
Bottom Line
Ovarian cancer surgery often offer relief to patients if they have recurrent ovarian cancer. In general patients with recurrent, persistent or refractory ovarian cancer can benefit from treatments that involves surgery and salvage therapy (a second line systemic therapy). However, treatment options largely depend on the type, nature and the behaviour of the cancer. Based on the whether the cancer is recurrent, persistent or refractory, treatment options differ.
In most of the primary ovarian cancer patients, surgery is the backbone of multimodal therapies. In almost all the cases, the effectiveness of all types of cancer treatments – to a large extent – depends on the success of the surgery and the post-surgical outcome. Despite grading and several other tumour factors – surgical outcome is the single most important prognostic tool for halting the progression and recurrence and improving survival.
Dr. Geetha Nagasree has more than 20 years of extensive experiences in performing advanced and complicated ovarian cancer surgeries. For the most effective treatment of ovarian cancer – meet her once for a one-to-one discussion.
Breast Cancer – What Precautions You Must Take to Prevent it?
How to Prevent Breast Cancer
A majority of the women have this question in their minds – Can a Lump in the Breast Be a Warning Sign of Breast Cancer?
A very straightforward answer to this question is no. A lump in the breast does not always mean breast cancer. But you have to look out for other signs as well if you notice a lump in your breast.
What you should do if you have the above signs and symptoms and a lump in your breast?
If you have a lump in your breast associated with changes in breast size & shape, redness, pain, swelling or darkening of breast, nipple retraction, and discharge other than milk, then consult a gynecologist for a clinical breast examination and diagnosis.
What are the early warning signs of breast cancer?
Does breast cancer always come with warning signs?
Breast cancer doesn’t always come with warning signs. In many cases, it goes on growing silently without causing any warning signs and symptoms. The majority of women don’t experience any signs and symptoms of breast cancer in the initial stages. Furthermore, breast cancer incidences are rising in women as young as 25 years age. The silent spread of breast cancer is resulting in late detection – mostly in the third and fourth stages. This trend is rampant in India. Late diagnosis is leading to ineffective treatment and poor survival rates.
Then, how to catch breast cancer even if it doesn’t show any warning signs?
In absence of warning signs and symptoms, many women tend to ignore their breasts. The reason for this is the fact that they don’t know how to do breast-self-examination. When they don’t do breast self-examination, they remain unaware of the potential changes happening to their breasts. Thus, they miss noticing breast cancer in the early stage.
Therefore, women must consult their gynaeconcologist and learn how to do breast self-examination. If they find something abnormal then they should go for clinical breast examination (examination by a gynaeconcologist) followed by breast cancer screening. Being a woman, if you follow this protocol, you would be in a position to catch breast cancer in the early stage itself – wherein the effective treatment is possible.
What is breast cancer screening?
Breast cancer screening begins once you become aware of breast cancer. In the above paragraphs, you have learned how to do breast self-examination. If you notice any abnormality, then immediately consult your gynaeconcologist or a lady breast cancer specialist. Once she detects any abnormality, she will order a mammogram and other breast cancer screening tests including MRI if needed. For women with a strong family history of breast and ovarian cancer, breast cancer screening begins early and may involve MRI and genetic testing.
Breast cancers have the highest cure rates if diagnosed in the early stages. Simple tests like mammograms done at appropriate times can detect breast cancers early for a potential cure. Breast cancers are known to occur in close family members, develop at an early age, and tend to be aggressive. These cancers can be predicted and prevented with a high degree of accuracy based on genetic screening.
Breast cancer screening is important because many women do not experience symptoms in the early stages of breast cancer.
Dr. Geetha Nagasree has more than 20 years of experience in the prevention, diagnosis, and treatment of breast cancer. If you want more information on How to prevent breast cancer by stopping it in its track then meet her for a personal discussion.
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