Cervical Cancer and Breast Cancer
There are more than 200 different types of cancer of which breast cancer remains the most common in the UK. Some 1 in 8 women in the UK will develop breast cancer during their lifetime.
Cervical cancer also remains a major concern. Overall, 2 out of every 100 cancers diagnosed in women (2%) are cervical and it remains the most common cancer in women under 35 years of age.
It’s important to know what the signs are of these cancers as early diagnosis will improve your chances of getting better. It’s also important to take up screening opportunities.
Symptoms:
Cervical Cancer:
- Bleeding between periods.
- Bleeding after or during sex.
- Bleeding past your menopause.
- Some women also get unpleasant smelling vaginal discharge.
- Some women also experience discomfort of pain during sex.
Breast Cancer:
- Lump or thickening area on the breast.
- Change in size or shape of the breast.
- Dimpling of the skin.
- Change in shape of nipple, such as it sinking into the breast.
- Rash on nipple or surrounding area.
- Blood stained discharge from nipple.
- Swelling or lump in your armpit.
What causes cervical cancer?
The cervix has a layer of skin-like cells on its outer surface and it is these cells that sometimes become cancerous. Cancer of these cells is called squamous cell cervical cancer. There are also glandular cells lining the inside of the cervix which produce a mucus. Cancer of these cells is called adenocarcinoma of the cervix.
Human papilloma virus (HPV) is the main cause of cervical cancer. Not all types of HPV cause cancer - some cause genital warts. HPV is contracted via sex. High risk types of HPV can cause changes in the cells covering the cervix making them more likely to become cancerous over time.
Other risk factors for cervical cancer include smoking, having a weakened immune system, taking the contraceptive pill, and having lots of children.
Caught early cervical cancer can usually be prevented. This is because screening picks up pre cancerous cell changes before they have had a chance to develop into cancer.
What causes breast cancer?
While not everything is known about the causes of breast cancer there are many known risk factors. Like most cancers, age is one factor - you are more likely to get breast cancer as you get older.
Genetic factors can also predispose some people to being at risk. If you have a mother or sister with breast cancer or if several members of your family have a particular type of cancer, or a close relative was diagnosed with breast cancer at a young age, then you too may be at risk. If you fall into this category you may be offered genetic testing and yearly mammograms.
Sex hormones play a role in breast cancer. After the menopause women with higher levels of oestrogen and testosterone in their blood have a higher risk of breast cancer than their peers. HRT use and use of the combined contraceptive pill may have an impact.
Being overweight after the menopause increases your risk of breast cancer, as does alcohol intake - the more you drink the higher the risk.
Having children slightly reduces your risk of breast cancer.
How is cervical cancer treated?
Cervical screening can pick up precancerous changes. The nurse takes a small sample of cells from the surface of the cervix during your smear test and these get screened for any changes.
If you have an abnormal smear result you will be called back for further treatment. You may be told you have:
- Borderline changes (where the cells have change but are close to normal). These may not require treatment.
- Mild or slight cell changes (mild dyskaryosis).
- Moderate cell changes (moderate dyskaryosis).
- Severe cell changes (severe dyskaryosis).
Or you may be told you have:
- CIN1 - one third of the thickness of the lining covering the cervix has abnormal cells.
- CIN2 - two thirds has abnormal cells.
- CIN2 - the full thickness of the lining has abnormal cells.
If you have moderate to severe cell changes you will be referred for a colposcopy. This is a magnified examination of your cervix. You may also be offered this if you have mild changes, although often you will be told to come back for a smear test in six months’ time as the changes may have reverted back to normal. You may also be tested for high risk HPV. If treatment is needed this will work to remove or destroy the abnormal cells. There are various treatment options. Laser ablation, cold coagulation and cryotherapy treat just the part of the cervix containing the abnormal cells. Laser therapy (ablation) burns away the abnormal cells, cold coagulation uses a hot probe to burn away the cells, while cryotherapy freezes away the abnormal cells.
Other treatments involve removing the whole area containing the abnormal cells. Diathermy, given under a local anaesthetic, cuts away the tissue containing the cells with an electrical current. LLETZ (large loop excision) works similarly, cone biopsy is where the surgeon removes a cone shaped wedge of tissue from the cervix, while a hysterectomy removes the whole womb (and may only be suggested if you have already had children).
How is breast cancer treated?
Women between 50-70 are invited for mammograms which can help detect early signs of breast cancer. As risk increases with age, this is an offer worth taking up.
There are many different treatments for breast cancer including surgery, chemotherapy, radiotherapy and hormone therapy. Your treatment will depend on the type and stage of your cancer. Early breast cancer means it has not spread beyond the breast or the lymph nodes in the armpit, whereas secondary breast cancer (metastatic breast cancer) means it has spread to other parts. There are also many stages in between.
Likewise treatments will be tailored to you and your cancer. Surgery for example can include the whole breast (mastectomy), only the lump itself or removal of quarter of the breast tissue.
Radiotherapy is treatment that uses radiation to destroy cancer cells, while chemotherapy is the use of anti cancer drugs to destroy cancer cells.
You may need a combination of treatments such as chemotherapy to make a tumour smaller prior to surgery.
Hormone therapy alters the levels of certain hormones in the body but will only work for certain types of breast cancer. While biological therapies change the way cancer cells interact, divide and grow. Once again, this treatment will only work for some types of patients.
Alternative remedies & self-help:
It’s vital to take part in national screening and vaccine programmes in order to protect yourself where possible.
Girls aged 12-13 are now offered an HPV vaccination as part of the NHS childhood vaccination programme. HPV is the major cause of cervical cancer. The vaccine is routinely offered to girls in secondary schools.
While there are no proven ways to prevent cancers, a balanced diet may lower your risk.
Aim for a healthy mix of: fruit and vegetables (at least five 80g portions a day), fibres such as wholegrain bread, rice, potatoes and pasta, some milk and dairy products, some meat, fish, eggs beans and other non-dairy sources of protein and only a small amount of processed foods and items high in fats or sugar.
Alcohol has been linked to an increased risk of breast cancer. Stay within the alcohol limits. The NHS recommends women drink no more than 2-3 units a day.
Obesity has been associated with an increased risk of some cancers. Ideal BMI (body mass index) is 18.5-25. If your BMI is between 25-29 you are ‘overweight’. If your BMI is between 30-40 you are ‘obese’. You can work out your BMI by dividing your weight in kilograms by your height in metres and then dividing the answer by your height again. The best way to lose weight is to combine dieting with exercise. Some 30 minutes of moderate intensity exercise at least five days of the week is ideal.
Smoking is linked to many cancers including an increased risk of cervical cancer. Ask your GP or pharmacist about nicotine replacement therapy and local quit services.