Women's Health

Women & Cancer

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.

Read media release: English | AfrikaansView Infographics | eNewsletter

CANSA Mobile Health Clinics offer screening in remote areas…

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

Slide Show & PDF: English | Afrikaans


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).

Risk factors: 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

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.

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 customerservice@agendia.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 customerservices@gknowmix.com 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

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.

Prostheses

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 Management

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)

Risk factors: 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

Note:

  • 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

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).

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.

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. Should women experience abnormal symptoms, they should request a referral for a colonoscopy to screen for cancer. CANSA recommends a colonoscopy from the age of 50, every 10 years.

Symptoms include: A change in bowel habits (diarrhoea / constipation), rectal bleeding or blood in stools, and persistent abdominal discomfort (cramps, gas or pain).

Mimi Neumann: “My message as a stage 4 colorectal cancer patient is to insist on a colonoscopy if you suffer recurrent irritable bowel symptoms, or if there is a close relative suffering from colon cancer.” (cancer Survivor)

Donna Bessenger: “Don’t ignore simple things like constipation. Monitor your bowel movements. I was healthy and then had constipation. The next thing I knew I had stage 4 rectal cancer.” (cancer Survivor)

Carol Le Cornu: “I had constipation and pain. My initial doctor said I had piles. When I finally went to get a second opinion after one year of misdiagnosis, I was diagnosed with 4th stage colorectal cancer and 3rd stage lymph node cancer.” (cancer Survivor)

Waheebah Mustapha Jordaan: “My bowel movements were normal, but I had severe abdominal pain for two months, before being diagnosed with stage 4 colorectal cancer.” (cancer Survivor)

Heather Richards: “I have colon cancer stage 4. Looking back I had 2 symptoms: a change in colour of stool and excessive tiredness about 3 weeks before diagnosis. No pain at all. I put it down to anxiety and stress.” (cancer Survivor)

Carima Adams: I am a colorectal survivor who was diagnosed at 28, late stage 3. I experienced symptoms but the doctors kept misdiagnosing me. Eventually I went straight to a specialist who picked it up. If you find any blood or mucous in your stools go to a GP or specialist immediately.” (cancer Survivor)

Risk factors: a family history of colorectal cancer; a personal history of inflammatory bowel disease; 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, physical inactivity and exposure to chemicals. CANSA advises living a balanced lifestyle to reduce risk of colorectal cancer.

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.

Diagnosis & Support

If you have been diagnosed with colorectal 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.

A side effect of colorectal cancer may include having a colostomy. CANSA offers professional pre- and post-operative counselling and support groups at our Stoma Clinics and Stoma bags and linen savers can be purchased at reduced prices at most local CANSA Care Centres. CANSA provides stock of the biggest stoma brands and guarantees the lowest prices, professional assistance and speedy delivery.

NB: Where a CANSA Care Centre is not equipped to provide the above-mentioned service, patients will be referred to reliable service providers in their local community.

Staff can also help guide you through the public health care system.


4. Uterine Cancer

Cancer of the uterus, also as known as uterine cancer or womb cancer is the 4th most common cancer affecting women in SA. 1 in 195 women are at risk for being diagnosed with uterine cancer (NCR 2014). The most common form of this cancer affects the lining of the uterus, known as the endometrium and is also referred to as endometrial cancer. A hormone imbalance causes the lining of the uterus to thicken. If the lining builds up and stays that way, cancer cells may start to grow.

Symptoms include: abnormal vaginal discharge or bleeding (high volumes between periods), long and heavier than normal menstrual bleeding, and pain or pressure in the pelvic area (especially when urinating or during sexual intercourse).

Risk factors: Women who are 50 and older, have diabetes, or who have a family history of uterine cancer or endometrial polyps, infrequent menstrual cycle, menses starting before age of 12 yrs, have used oestrogen replacement therapy without the use of progesterone are more at risk. Other risk factors include being overweight, inactive, consuming alcohol, poor dietary habits, and smoking.

Madeleine Beukes: “I had a cyst on my ovary at the time which contributed to a lot of the symptoms and led to finding out that I had uterine cancer. My symptoms included: very painful menstruation cycles; irregular cycles (sometimes for three months on end, with a break of a day or two in between); heavy bleeding during cycles (heavier than I had been used to); spotting or brown discharge in between cycles.

My first gynecologist thought the symptoms I was experiencing could be caused by the contraceptive which I was using at the time. He spotted a growth in my womb, but said it was likely to be a wart and nothing to worry about. After 6 months my symptoms were still present and the pain had become worse, and so did the bleeding, so I consulted a 2nd gynecologist. She was concerned that the cyst had grown and also spotted the growth in my womb. It was removed and later on (after no one contacted me with any results – 5 weeks post op) I made a follow up appointment, and my gynecologist then explained to me that I have a rare type of uterine cancer called adenosarcoma*.

The most important thing I would like to share is that women need to realise the importance of screenings in order to catch these things early. Early detection is key, as it gets caught before it has the chance to spread. Also, trust your body- it tells you when something is wrong. Go for second opinions and follow up on results. The treatment is never pleasant, but it is worth it to prevent many other possible horrors.” (cancer Survivor, 27 yrs at time of diagnosis)

* Adenosarcoma of the uterus is a rare tumor of the uterus that typically originates in the lining of the uterus (endometrium).

Diagnosis & Support

If you have been diagnosed with uterine 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.


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). Lung cancer doesn’t typically cause symptoms in its earliest stages, but symptoms present when the disease is already advanced.

Symptoms include: a chronic cough; a cough that gets worse and does not go away; coughing up blood (even a small amount); shortness of breath or wheezing; constant chest pain (especially when coughing); frequent chest infections; a chest infection that lingers; hoarseness; feeling tired all the time.

Lettie Truter: “Wanneer ‘n aanhoudende kuggie (gedink dat dit die gevolg was van ‘n sinus-drup) later “ontaard” in erge hoesbuie – ook net af en toe – maar daar verskyn ‘n effense bloederigheid in dit wat jy uithoes – gaan onmiddellik dokter toe!” (cancer Survivor) (When a nagging cough – thought it was as a result of a post-nasal drip) later evolves into severe coughing fits – only now and again – but then you cough up a little blood – go to the doctor immediately!)

Risk factors: 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. Being exposed to passive smoking and chemicals can also increase risk.

CANSA can assess your risk with a Smokerlyzer device – carbon monoxide is an invisible, odourless, toxic gas formed during tobacco smoking. The Smokerlyzer device is used to measure the exhaled air of the carbon monoxide levels and guides as an awareness tool to educate and encourage quitting the use of tobacco products, and also to be aware of being exposed to pollution and secondary smoke.

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. In the event of a smoker quitting, health benefits may be experienced immediately…

Join the CANSA Kickbutt online cessation programme to help you quit for good, and find other tips to help you quit…

If you suspect that you have lung cancer, you need to contact your medical practitioner in order that the proper screening tests be performed.

Diagnosis & Support

If you have been diagnosed with lung 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.


Other Gynecologic Cancers:

Gynecologic cancer is an uncontrolled growth and spread of abnormal cells that originate from the reproductive organs.

Related Issues:


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:

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.

Other Matters:

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.


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