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

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

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

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

29. CERVICAL CANCER

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

31. 31

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

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

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%.

43. Dietary and Lifestyle
Changes to Help Prevent
Cancer

47. Exercise Helps in Every Way

49. Benefits of Vitamins and
Phytonutrients

50. Infertility Treatments in
Cancer Patients
• IVF
• Ovarian Tissue Freezing
• Egg Freezing
50

52. Questions
Thank You!!Thank You!!