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What you should know about “female” cancers

According to the Singapore Cancer Society, 29.1 per cent of cancers diagnosed in women here in 2015 were breast cancer, making it the most common cancer amongst females. PHOTO: ISTOCK
According to the Singapore Cancer Society, 29.1 per cent of cancers diagnosed in women here in 2015 were breast cancer, making it the most common cancer amongst females. PHOTO: ISTOCK

Breast, uterine, ovarian and cervical cancers have different risk factors but they share one thing in common: it pays to detect them early

Cancer has many risk factors: genetic makeup and lifestyle habits are two common ones. 
But for some types of cancers, your gender itself is the main and sometimes only reason why you can be more predisposed to them. These may include breast cancer and cancers related to the reproductive system - ovarian, uterine and cervical cancers. 

According to the Singapore Cancer Society, 29.1 per cent of cancers diagnosed in women here in 2015 were breast cancer, making it the most common cancer amongst females. The disease develops in the milk ducts and glands found in breasts. Malignant cells can spread from these within the organ or tissue and to other parts of the body.

Dr Wong Chiung Ing, senior consultant, medical oncology, at Parkway Cancer Centre, says being a female is an “unmodifiable” risk factor in itself because more than 50 per cent of breast cancer cases are stimulated by the female hormones –  estrogen and progesterone. 

Other unavoidable risk factors include family history and having the BRCA1/BRCA2 genes. The presence of these can also cause breast cancer to occur in men. 

Age plays an important role too as most breast cancer cases in women are diagnosed after the age of 40, with the highest incidence found in those aged from 55 to 59. 

Other factors include having an early and also prolonged exposure to estrogen – think getting your first period before the age of 11 and reaching menopause after the age of 55 – as well as consuming excessive red meat, animal fat and alcohol, leading a sedentary lifestyle and gaining weight. 

Some warning signs of breast cancer include a painless lump, a persistent itch and rash around the nipple, bleeding or unusual discharge from the nipple, and dimpled or thickened and swollen skin over the breast.
But the good news is that more women are surviving the disease with earlier screening and detection, and improved treatment. 

This is why it is important for women 39 years and below to do a monthly breast self-examination. Those aged from 40 to 49 should do this and also go for an annual mammography which detects changes like abnormal densities or calcium deposits in the breasts. If you are 50 or older, continue with your monthly breast self-examination and a mammography every two years.

Sometimes, ultrasound scans are used to differentiate solid masses, which may be cancerous, from fluid-filled cysts, which are usually not cancerous. Magnetic Resonance Imaging (MRI) is also used on younger women with dense breast tissue that makes it harder to screen for suspicious lumps on ultrasound or mammography scans. 
Dr Wong says: “The earlier the cancer diagnosis, the greater the probability of recovery.” 


Dr Wong Chiung Ing, senior consultant, medical oncology, at Parkway Cancer Centre. PHOTO: PARKWAY CANCER CENTRE

What causes other “female” cancers like uterine, ovarian and cervical cancers 

Some “female” cancers that affect the reproductive system, like uterine and ovarian cancers, are sometimes associated with a history of breast cancer. 

Also known as endometrial cancer, uterine cancer is the fourth most common cancer diagnosed in females in Singapore. Uterine cancer occurs when cells grow abnormally in the inner lining of the womb and form tumours. 
Uterine cancer tends to affect women who have never been pregnant, older females, and women with irregular menses or diabetes. Symptoms are seen at an early stage, such as unusual vaginal bleeding and spotting, pain during sexual intercourse and urination, and pelvic pain.

On the contrary, ovarian and cervical cancers do not present red flags in the early stages. 
In ovarian cancer, only when the disease is at an advanced stage does the patient experience warning signs like bloating, abdominal discomfort, constant indigestion and nausea, loss of appetite, back pain and changes in bowel movements. Besides a history of breast cancer, some factors that can increase the risk of having ovarian cancer are endometriosis, early onset of menstruation, late menopause and having children at a later age or not having any children. 

Early cervical cancer also shows no symptoms. Usually, when symptoms such as vaginal bleeding and abnormal discharge, back and pelvic pain, and urination difficulties show up, the cancer is already in an advanced stage.
Cervical cancer is caused by the Human Papilloma Virus (HPV), which is transmitted during sexual intercourse. All women who engage in sexual activity are at a risk of getting cervical cancer – more so if you have multiple sexual partners or if you started having sex at an early age. Other risk factors include smoking, long term use of contraceptives and having given birth to many children.

Cervical cancer usually develops slowly over time and can be detected early with regular check-ups. For women between the ages of 25 and 29 years old who had sexual intercourse, a Pap test should be done every three years. A HPV test should be done every five years for women above 30 years old.  You can also reduce your risk of cervical cancer by getting a HPV vaccination. HPV vaccinations are recommended for females aged nine to 26.The earlier the detection, the higher the chance of recovery.