Gynecological Cancer Awareness

September is gynecological cancer awareness month. In 2017, more than 107,000 new cases of gynecologic cancers were diagnosed in American women. Of those, an estimated 31,600 women lost their fight with a gynecologic cancer.

Every woman is at risk for developing a gynecologic cancer. Risk tends to increase with age, and there is always a heightened possibility of cancer due to family history or race. Lifestyle choices such as chronic smoking and obesity can impact one’s risk for developing a gynecologic cancer; for instance, there is a correlation between higher rates of uterine/endometrial cancers in obese women.

“The biggest takeaway for women is to stay mindful of their bodies, report any symptoms that appear even remotely irregular and make sure they have their screenings conducted on a yearly basis. These actions can ultimately save their life,” said Warner Huh, M.D., senior medical officer of UAB Cancer Service Line and director of the UAB Division of Gynecologic Oncology. Screening can result in early detection, when a cancer is more likely to be treated successfully.

“Most people who get a gynecologic cancer don’t have obvious risk factors,” Huh said. “With these types of cancers, what women can control is being screened regularly and seeking medical advice if something doesn’t seem right with their bodies.”

The infographic below explains the symptoms of the top five most common gynecologic cancers. If you have questions, ask your doctor or visit www.uabmedicine.org/WomensCancers.com.

 

 

Prostate Cancer—Prevention, Risk Factors and Treatment

It wouldn’t be right not to talk about prostate cancer, a disease that only affects men, especially during November while it’s Men’s Health Awareness Month. 

In 2016, more than 180,890 men will be diagnosed with prostate cancer, the second leading cause of cancer death in men. Next to skin cancer, prostate cancer is the most common cancer in American men.  

“Men’s health and prostate cancer are topics that many tend to shy away from, but they need to be discussed more openly,” said Soroush Rais-Bahrami, M.D., assistant professor in the University of Alabama atBirmingham Department of Urology and founding member of the UAB Program forPersonalized Prostate Cancer Care. “One out of eight men will be diagnosed with prostate cancer in his life.”

The prostate is a reproductive gland in men located between the bladder and the penis. The fluid from the prostate is discharged into the urethra at the time of ejaculation as part of the semen to nourish and stabilize sperm for reproductive purposes.

Prevention

Men should begin screening for prostate cancer at age 50. This can be done during their annual exam with a discussion about prostate cancer risks factors. A blood test can be done to measure a biomarker called prostate-specific antigen (PSA) to identify a man’s risk of prostate cancer, along with a digital rectal exam. Once a blood test shows signs of higher PSA levels, a tissue biopsy is required to help determine the grade and stage of the prostate cancer.

“Many men do not know their family history of prostate cancer because men tend not to talk about their health concerns, even with children and other family members,” Rais-Bahrami said. “It is important to discuss family history due to the significantly higher risk for men with a first-degree relative who has been diagnosed with prostate cancer.”

Signs and Symptoms

Symptoms of prostate cancer are rare, and many men show no symptoms before being diagnosed. In advanced stages, symptoms may affect quality of life and may show in one of the following ways:      

• Problems urinating or the need to urinate more frequently, especially at night
• Blood in the urine or semen
• Trouble getting an erection
• Pain in the hips, back (spine), chest (ribs), or other areas the cancer may have spread
• Weakness or numbness in the legs or feet

Most of these symptoms are more likely to be caused by something else, but it is still important to discuss with a doctor, especially to determine risk factors.

Risk Factors

Some risk factors are controllable and others are not. According to the American Cancer Society, the following are some risk factors for prostate cancer:

Age: The chance of having prostate cancer increases rapidly after the age of 50. About 6 in 10 cases are in men over the age of 65.

Race: Prostate cancer occurs more often in African American men. African American men are also twice as likely to die from prostate cancer than white men.

Family History: Having a father or brother with prostate cancer more than doubles a man’s risk of developing it. The risk is much higher for men who have several relatives with prostate cancer.

Other risk factors may include: diet, obesity, smoking, inflammation, and some sexually transmitted infections.

Treatment

“Treatment is based on the patient’s overall health and what works best in treating the patient to ultimately cure the cancer and help the patient preserve an excellent quality of life,” Rais-Bahrami said.

In the earliest stages of low-grade prostate cancer, and with the consultation of a physician, men can opt for active surveillance, which is when the doctor does not prescribe immediate treatment, but watches the cancer cells closely to postpone treatment with curative intent, perhaps for years. Other treatment options include: 

• Surgery, which includes removing the entire prostate gland and occasionally regional lymph node tissues
• Radiation therapy, or beams of radiation focused on the prostate
• Hormone therapy, which reduces levels of male hormones to stop them from affecting prostate cancer cells
• High-intensity, focused ultrasound therapy, or high-energy sound waves that destroy cancer cells
• Cryosurgery, or the use of extreme cold temperatures to freeze and kill cancer cells

“Prostate cancer is a treatable disease and can be cured if caught in early stages,” Rais-Bahrami said. “This is why it is important to receive routine screenings and have early detection when present.”

To help with personalized care of patients, UAB offers magnetic resonance imaging and ultrasound fusion-guided biopsy. The image fusion allows doctors to target a direct tissue sampling of an individual based on imaging areas of concern that can be tested for prostate cancer.

Current Research

New research for prostate cancer is on the horizon, including the ongoing search for better biomarkers that indicate the presence of prostate cancer. At UAB, prostate cancer research is focused on advanced imaging and biomarker development, and hopes of defining the best way toward focal therapy of prostate cancer. UAB has become one of two beta sites in the United States to receive the iSR’obotTM Mona Lisa machine. This machine helps surgeons diagnose prostate cancer in earlier stages with imaging guidance and provides precise location mapping to help with targeting cancer cells for treatment.

Breast Cancer—Early Detection and Screening

October is breast cancer awareness month but women need to be aware of breast health all year long.

“Despite the magnificent strides in breast cancer research, women still need to adhere to screening guidelines recommended for their age group, especially if they have
a family history of breast cancer,” says Catherine Parker, M.D., a fellowship trained breast cancer surgeon at the University of Alabama at Birmingham.

According to the American Cancer Society, there will be 252,710 new cases of invasive breast cancer among U.S. women in 2017. And finding breast cancer early is one of the most important strategies to prevent death from the disease. When breast cancer is found early, it is small and has not spread, making it easier to treat successfully.

“The good news is that we’re living in a time when women are surviving the disease. In fact, the population of survivors is expected to grow,” says Parker. “However, we still need to be vigilant and take measures to protect ourselves.”

The ACS recommends that women who are at average risk for breast cancer start getting mammograms yearly at age 45 but have the choice to start having annual mammograms at age 40. Women 55 and older should switch to mammograms every 2 years, or continue yearly screening.

“Mammograms do not detect every breast cancer. Women at every age should be familiar with how their breasts normally look and feel, as well as be familiar with signs and symptoms of breast cancer,” says Parker. Although there are differing opinions about the benefits of self-breast exams, it is important for patients to know the proper technique, what to look for, and what is their normal; for example, has one breast always been smaller or has one nipple always turned inward; therefore, self-breast awareness should begin in late teens and early 20’s.

The most common symptom of breast cancer is a new lump or mass in the breast. A painless, hard mass that has uneven edges is more likely to be cancer, but breast cancers can be tender, soft, or rounded. For this reason, it is important to have any new breast mass, lump, or change in breast checked by a health care professional.

Other possible symptoms of breast cancer include:
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling of the skin
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• Nipple discharge (other than breast milk)

For women who have a family history of breast cancer, the UAB Breast Health Center offers comprehensive guidance on risk assessment, genetic testing, screenings, and prevention strategies. Furthermore, the Center takes a multidisciplinary approach to cancer care. When patients are diagnosed with breast cancer they are immediately assigned a team of specially trained breast cancer experts (a medical oncologist, radiologist and surgeon) who are able to give them individualized recommendations regarding their diagnosis, treatment, surgery, and recovery. The clinic is also able to offer first and second opinions for any problems related to the breast.

“The program is also able to offer screening and clinical management for women who have an increased risk of both ovarian cancer and breast cancer,” says Parker.


For more information about early detection and screening, click here.