Women & Cancer
CANSA places the focus on women reducing their cancer risk during October. However, we encourage women to make their health a priority all year round, by knowing what is normal for their bodies, and to be aware of the symptoms of cancer.
It’s important for women to be empowered with knowledge regarding lowering their cancer and health risk and recognising warning signs. We encourage annual medical check-ups and cancer screening for early detection, as symptoms don’t always present until cancer has spread. Women need to lead a healthy, balanced lifestyle, cutting out lifestyle factors that increase their cancer risk.
Contact your local CANSA Care Centre for health awareness materials and to arrange for screening for breast, cervical or skin cancer, or ask about scheduled screening campaigns by our Mobile Health Clinics, if you live in a remote area.
Women are encouraged to join our Champions of Hope Facebook Group for cancer Survivors & chat to peers who are facing similar challenges.
Find general information regarding cancer, cancer types, treatment, support and risk reduction and information regarding female cancers prevalent in South Africa & other gynecologic cancers below.
Top Five Cancers Affecting SA Women:
According to statistics from the National Cancer Registry (NCR) 2014, the top five cancers affecting women in SA include: breast, cervical, colorectal, uterine and lung cancer.
Both breast and cervical cancer have been identified as a national priority with increasing incidences occurring.
Approximately 19.4 million women aged 15 years and older live at-risk of being diagnosed with breast cancer – the cancer affecting women in South Africa the most. In 2013, deaths from breast cancer and cancers of the female genital tract, accounted for 0.7% and 1% of all deaths in South African respectively.¹
Awareness of the symptoms, and early detection through screening, can help lead to earlier diagnosis, resulting in improved treatment outcomes. Awareness of risk factors, can help women reduce their personal cancer risk.
¹Vorobiof D, Sitas F, Vorobiof G. Breast cancer incidence in South Africa. Journal of Clinical Oncology 2001 (September 15 Supplement); Vol 19, No. 18s: 125s -127s
1. Breast Cancer:
Apart from non-melanoma skin cancer, breast cancer is the most common cancer in women of all races, with a lifetime risk of 1 in 27 in South Africa, according to the 2014 National Cancer Registry (NCR).
The risk for breast cancer increases as women grow older, but many women under the age of 40 are diagnosed with breast cancer. All women are at risk, and in particular women with a family history of breast cancer. Being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals also increases risk.
Melissa Willemse: “When it comes to breast cancer age is not a factor. The first doctor I saw immediately dismissed my question about the painful lump under my arm because I was too young for breast cancer. When I eventually went for a second opinion we found out I had stage 3 Triple negative breast cancer. I was 28 the first time and now at 32 I have just finished treatment for a recurrence. My advice is if you feel something is wrong don’t hesitate to get a second opinion. Cancer doesn’t care how old you are.” (cancer Survivor)
Cynthia Erasmus: “Don’t ignore your body if something feels off, no matter how insignificant, like excessive hair fall, nail discolouration, tiredness – this is your body warning you that something is wrong. I had all of these symptoms before I even felt the lump that changed my life. Looking back now I realize that if I had acted sooner, perhaps I could just have had a lumpectomy instead of a double mastectomy.” (cancer Survivor)
Reduce Risk Through Regular Examinations:
Self Breast Examinations
While not all breast lumps indicate cancer, they should be investigated, especially if accompanied by other changes in breasts or the under arm area, such as lumps, texture changes, thickening, dimpling, changes in shape or size of nipples or breasts, tenderness, discharge, rash or swelling, or one breast suddenly being slightly larger than the other.
Research has shown that a regular Breast Self-Examination (BSE), plays an important role in discovering breast cancer, compared to finding a breast lump by chance.
A BSE should be done once a month, preferably at the same time of day, following a woman’s menstrual cycle.
If you feel or see any change in your breasts or underarms, arrange for a Clinical Breast Examination at your local CANSA Care Centre, primary health care centre or health practitioner.
Clinical Breast Examinations
A Clinical Breast Examination (CBE) is a visual and manual examination of the entire breast, from the collarbone to the bra line, and from the armpit to the breast bone. It is advisable to have a CBE as part of your annual medical check up.
Contact your local CANSA Care Centre, primary health care centre or health practitioner to arrange for a Clinical Breast Examination.
Ask Care Centre staff about Mobile Health Clinic visits scheduled in your community, especially if you live in a remote area.
Should any abormalities be detected you will be referred for further testing by a medical professional.
Mammograms (a special x-ray to detect lumps in the breast), do not prevent breast cancer, but they can save lives by finding breast cancer as early as possible. Finding breast cancers early with mammography has also meant that many more women being treated for breast cancer are able to keep their breasts. When caught early, localised cancers can be removed without resorting to breast removal (mastectomy).
Women from the age of 40 should go for an annual mammogram, for purposes of non-symptomatic breast screening. Women 55 years and older, should have a mammogram every two years – or if they choose, continue with an annual mammogram. Women, who have other risk factors such as mutated BRCA1 /2 gene, should be referred for an annual mammogram. See CANSA Breast Cancer Position Statement (NCR 2014) regarding this.
- Our CANSA Care Centres do not offer mammograms, however, women can be screened at the following Public Hospital Breast Clinics…
- Alternately contact the Radiological Society of SA (RSSA) on 011-794 4395, email: firstname.lastname@example.org or visit www.rssa.co.za, to arrange for a mammogram – the RSSA offers discounted mammograms in October – view participating radiology practices (details will be added by 22nd September)
Portia Ntuli: “Drawing from my own experience as a breast cancer survivor, cancer is not necessarily painful and does not always show symptoms. It was during one of my routine mammography tests that a small tumour was detected. Doing breast exams at home was not enough, because the tumour was so small it could not be felt by hand. Those gyne visits are very important. If detected early, it can be treated successfully. Get up and get yourself tested!” (cancer Survivor)
Many women and men overestimate their exposure to ionizing radiation from mammography. Read Fact Sheet Effective Radiation Received from Routine Mammography.
MammaPrint (Genomic Testing)
The MammaPrint test, made by Agendia, is a genomic test that analyses the activity of certain genes in early-stage breast cancer.
Research suggests the MammaPrint Test may eventually be widely used to help make treatment decisions based on the cancer’s risk of coming back (recurrence) within 10 years after diagnosis. MammaPrint Testing can help some breast cancer patients avoid chemotherapy treatment – read MammaPrint Fact Sheet.
Only a licensed healthcare provider (i.e. surgeon, medical oncologist, radiation oncologist, pathologist) can submit an order request for genomic testing.
Ask a licensed doctor to order the Agendia Breast Cancer Test Suite for breast cancer. Local Agendia Molecular Oncology Specialists can assist with the ordering process. From South Africa, one should contact Agendia Customer Service in The Netherlands at +31 20 462 1500, or alternatively contact email@example.com
Agendia B.V., headquartered in Amsterdam in The Netherlands, provides innovative diagnostic testing for the treatment of cancer patients, which is based on gene expression analysis. For any enquiries, please email firstname.lastname@example.org or phone 021- 9389324.
As long as a woman is in good health and expected to live longer than 10 years, all breast cancer screening should continue.
Symptoms | Risk Factors & Treatment
- Fact Sheet | CANSA Position Statement: Breast Cancer (NCR 2014) (female)
- Fact Sheet: Breast Cancer (NCR 2012) (male)
- Infographic: Breast Cancer | Borskanker
- Leaflet: Your Breast Cancer Risk, Symptoms & Screening: English | Afrikaans
- Bookmark: Know the Signs & How to do a Breast Self-Examination
- Booklet: CANSA Detectives – Women’s Pathways to Breast Cancer Diagnosis & Care
- Fact Sheet: Metastatic Breast Cancer (NCR 2012 n/a)
- Fact Sheet: Breast Cancer, Pregancy & Breastfeeding
- Fact Sheet: Phyllodes Tumours (NCR 2013 n/a)
- Fact Sheet: Herceptin (Trastuzumab)
- Link between Breast Cancer and Malignant Melanoma
- CANSA Caution re Preventative Double Mastectomy
Our Phakamisa Navigation Programme assists ladies with breast cancer and raises awareness in communities. CANSA supports WAND (Women’s Achievement Network for Disability) in helping to reduce the risk of Breast Cancer in disabled women.
CANSA further funds research projects at tertiary institutions regarding breast cancer related to screening, improved management, rehabilitation and improved quality of life.
Warning Signs Breast Cancer
Diagnosis & CANSA Support
If you have been diagnosed with breast cancer, please contact your local CANSA Care Centre so that our staff can offer you and your loved ones care & support, including medical equipment hire, wigs, counselling, support groups, online support groups and resources, as well as CANSA Care Homes where patients receiving treatment far from home can stay during treatment.
Staff can also help guide you through the public health care system.
Read the Buddies for Life online lifestyle publication and find tips for breast cancer Survivors.
CANSA Care Centres offer a variety of breast prostheses at affordable rates for those who had to undergo a mastectomy / lumpectomy and offer advice to help cope with the side effects of cancer treatment.
Lymphoedema is a challenging complication of cancer surgery or radiation therapy and is called secondary lymphoedema (lymphoedema occurring at birth due to dysphasia is called primary oedema). It is a common side effect of treatment for women’s cancers, especially Breast Cancer.
It is the accumulation of fluid due to inactive or damaged lymph glands. Lymphoedema causes: Swelling of a body part and usually occurs in the arms or legs, but can also occur in the face, neck, abdomen or genitals. Read more: Lymphoedema Fact Sheet.
Our specially trained Lymphoedema Therapists offer Complete Decongestive Therapy (CDT) to manage the symptoms – contact your local CANSA Care Centre regarding treatment. Please note that not all Care Centres offer Lymphoedema treatment, but we will be able to assist with regards to referrals in this case.
2. Cervical Cancer:
Cervical cancer is the 2nd most common cancer among South African women. Women have a 1 in 42 lifetime risk of cervical cancer (NCR 2014). It can be successfully treated if detected in the early stages, so it is important that women are aware of symptoms and what is normal for their bodies.
Symptoms include: abnormal bleeding between periods, heavier and longer menstrual period, vaginal discharge, vaginal bleeding or pain during intercourse / after menopause, increased urinary frequency.
Bulelwa Norose: “Before I was diagnosed with cervical cancer, I struggled with menstruating too much, a smelly discharge, pain, a swollen stomach and constipation.” (cancer Survivor)
Cervical cancer is mainly caused by the Human Papilloma Virus (HPV), a common virus spread through skin to skin contact, body fluids and sexual intercourse. Failure to use protection during sexual intercourse, sexually transmitted infections (STIs), multiple sexual partners, early sexual debut, and use of oral contraceptives increases risk.
Women with HIV infection also have a higher risk of developing cervical cancer.
Furthermore, being overweight, inactive, consuming alcohol, poor dietary habits, smoking and exposure to chemicals increases risk.
CANSA funds several cervical cancer research projects at tertiary institutions.
Reduce Risk Through Pap smears
Having regular Pap smears can detect abnormal cells in the cervix (lower part or mouth of the womb), that could develop into cervical cancer. Screening involves taking a swab of the cervical cells. It is uncomfortable, but painless.
When abnormal cells are identified and removed, in many cases it is prior to cancer cells actually developing. Early diagnosis and treatment of pre-cancerous lesions prevents up to 80% of cervical cancers, in high resource countries, where cervical cancer screening is routine.
Contact your local CANSA Care Centre to arrange for a Pap smear, or if you live in a remote area enquire about scheduled CANSA Mobile Health Clinic visits to your area. Your health practitioner can also assist you.
Women making use of public sector screening services are entitled to three free Pap smears per lifetime, starting at the age of 30 years or older, with a 10 year interval between each smear. Find more information in CANSA’s Cervical Cancer Position Statement & Fact Sheet (NCR 2014).
Who should have a Pap smear?
- all women who have been sexually active, should start having Pap smears between ages 18 to 20 years
- every eligible woman should preferably have a Pap smear at least every 3 years
- It is better to have a Pap smear at a less optimal time, than not at all
- Routine cervical screening is not required for women under the age of 18 years, even if they are sexually active
- If a woman is 70 years old and, within the last 5 years, had two normal Pap Smears, she need not continue with Pap smears
Reduce Risk Through Vaccinations
The primary underlying cause of cervical cancer is the Human Papilloma Virus (HPV), which is transmitted through skin to skin contact and is a very common virus infecting most people at some point in their lives.
There are many types of HPV and some of the virus types can infect the cells that could lead to cancer. About 40 types are sexually transmitted through genital contact, while mostly two types (16 + 18) are considered high risk in South Africa.
High risk HPV is estimated to cause: 70% of cervical cancers; 50% of vaginal & vulvar cancers; and 20% of head & neck cancers.
CANSA supports the Department of Health’s HPV School Vaccination Programme to help reduce cervical cancer risk. Persistent infection with HPV may lead to cervical cancer, so all females in the age group of 9 – 26 years (provided they are not sexually active) may be vaccinated – read more… – women who have had the vaccination should continue to be screened for cervical cancer.
Furthermore, CANSA advises delaying sexual debut; reducing the number of sexual partners, and increased condom use. Medical male circumcision helps to reduce Human Immunodeficiency Virus (HIV) acquisition and transmission, and is protective for Human Papilloma Virus (HPV) in males, thus reducing the risk of initial or re-infection of HPV among women.
Human Immunodeficiency Virus (HIV) & Human Papilloma Virus (HPV)
Women living with HIV are at increased risk of developing cervical cancer and experience more rapid progression of the disease.
Symptoms | Risk Factors & Treatment
- Fact Sheet | CANSA Position Statement: Cervical Cancer (NCR 2014)
- Infographic: Cervical Cancer | Servikale Kanker
- Leaflet: ‘Your Cervical Cancer Risk, Symptoms & Screening’: English | Afrikaans
- CANSA Position Statement & Fact Sheet – Pap Smears During Pregnancy
- CANSA Fact Sheet – Human Papilloma Virus Infection & Cancer
- CANSA Position Statement & Fact Sheet Vaccines & Vaccination
- CANSA Fact Sheet – Cervical Dysplasia – condition that can lead to cervical cancer
Diagnosis & Support
If you have been diagnosed with cervical cancer, please contact your local CANSA Care Centre so that our staff can offer you and your loved ones care & support, including medical equipment hire, wigs, counselling, support groups, online support groups and resources, as well as CANSA Care Homes where patients receiving treatment far from home can stay during treatment.
Staff can also help guide you through the public health care system.
3. Colorectal Cancer
Colorectal cancer or colon cancer is the 3rd most common cancer affecting women in SA – 1 in 134 females are at risk of being diagnosed with colorectal cancer (NCR 2014). CANSA continues to appeal to women to get to know their bodies and start looking out for any telling signs and symptoms that may indicate colorectal cancer.
Most colorectal cancers begin as a polyp, a small growth of tissue that starts in the lining & grows into the centre of the colon or rectum. Doctors can remove polyps during the colonoscopy procedure.
A change in bowel habits (diarrhoea/constipation), rectal bleeding or blood in stools, and persistent abdominal discomfort (cramps, gas or pain), are among some of the warning symptoms of colorectal cancer.
Risk factors include: a family history of colorectal cancer; colorectal polyps, consumption of red & processed meats; low fruit & veg intake; low-fibre & high-fat diet; excess body weight; alcohol consumption; insufficient intake of clean, safe water; smoking and physical inactivity.
CANSA advises living a balanced lifestyle to reduce risk of colorectal cancer, and to go for regular colon screening tests such as a colonoscopy, as from the age of 50, every 10 years.
Some CANSA Care Centres | Mobile Health Clinics offer faecal occult blood tests (a sample of stool is collected on the end of an applicator to help detect small quantities of blood). Positive results, although not always an indication of cancer, require a referral to a medical health practitioner.
- Fact Sheet: Colorectal Cancer (NCR 2014)
- Infographic: Women & Colorectal Cancer | Vrouens & Kolorektale Kanker
- Nutritional Guidelines for Colorectal Cancer Patients
4. Uterine Cancer
Cancer of the uterus, also known as endometrial cancer or uterine cancer is the 4th most common cancer affecting women, occurring in the tissue of the endometrium, which is the lining of the uterus. 1 in 195 women are at risk for being diagnosed with uterine cancer (NCR 2014).
CANSA advises that should any of the following warning signs appear, they should be investigated further by a medical practitioner: abnormal vaginal bleeding or discharge; and pain in the pelvis or abdomen, especially when urinating or during sexual intercourse. Early detection is key and leads to better treatment outcomes.
Risk factors include: genetics & family history; inability to fall pregnant; infrequent menstrual cycle or menses starting before the age of 12; oestrogen replacement therapy without the use of progesterone; age; obesity; lack of exercise; smoking; and alcohol use.
5. Lung Cancer
Lung cancer occupies the position of 5th most common cancer and SA women have a lifetime risk of 1 in 205 (NCR 2014).
Statistics reveal that the more a person smokes, the greater the risk of developing lung cancer. It’s also more likely to develop in people who start smoking at a young age.
However, if someone stops smoking, the risk of developing lung cancer falls dramatically and after approximately 15 years, the chance of developing the disease is similar to that of a non-smoker.
Other Gynecologic Cancers:
Gynecologic cancer is an uncontrolled growth and spread of abnormal cells that originate from the reproductive organs.
- Fallopian Tube Cancer (NCR 2012 n/a)
- Gestational Trophoblastic Disease (NCR 2012 n/a)
- Ovarian Cancer (Ovary) NCR 2013 – recognise the symptoms & raise awareness…
- Primary Peritoneal Cancer (PPC) (Peritoneum) (NCR 2011)
- Vaginal & Vulvar Melanoma (NCR 2012 n/a)
- Vaginal Cancer (Vagina) (NCR 2014)
- Vaginal Clear-Cell Adenosarcoma (NCR 2012)
- Vulvar Cancer (Vulva) NCR 2014
- Bowenoid Papulosis – Squamous Cell Carcinoma in situ (genitalia)
How Women can Reduce their Cancer Risk:
Be aware of the importance of the early detection of cancer. This enables more effective treatment and a better chance of recovery.
Acknowledge the importance of:
- a healthy balanced lifestyle
- no tobacco use
- avoiding alcohol
- being SunSmart
- preventative screening
- avoiding known cancer-causing factors
We also encourage women to reduce their risk of female cancers by: Avoiding hormone therapy | using condoms to help prevent sexually transmitted infections such as the Human Papilloma Virus (HPV), which is a high risk factor for cervical cancer | consulting a healthcare professional on the HPV vaccine | consulting a healthcare professional for advice on appropriate screening tests if there is a family history of cancer.
Read online lifestyle publication for cancer Survivors, “Buddies for Life” and “Oncology Buddies”.
Hair Matters: Henna Tattoos, Hair Dye, Scalp Cooling
It is known that cancer and its treatment can weaken the body’s immune system, because it affects the blood cells that protect one’s body against disease and germs.
As a result cancer Survivors have a compromised immune system and their bodies cannot fight infection, foreign substances, allergies, and disease as well as a healthy person’s body can (American Cancer Society).
Any product like henna skin dyes that have the potential to cause any form of infection, irritation and /or allergic reaction, should be totally avoided by individuals diagnosed with cancer, those undergoing cancer treatment, as well as cancer Survivors.
- Position Statement & Fact Sheet Temporary Henna Tattoos
- Fact Sheet Scalp Cooling to Minimise Hair Loss
- Can I Use Hair Dye After Chemo?
Has Cancer Touched Your Life?
Cancer affects one in four South Africans, through diagnosis of family, friends, colleagues or self.
We want you to know that you are not alone and that we would like to support you and your loved ones, regardless of how cancer has touched your life.
Find info & online resources to help you fight cancer and please read more about CANSA’s Holistic Care & Support which is offered at our CANSA Care Centres countrywide.