Ovarian and Cervical cancer

Ovaries and cervix form an important part of the female reproductive organs.

Each woman has two ovaries. They are oval in shape, about four centimetres long and lie on either side of the womb (uterus) against the wall of the pelvis in a region known as the ovarian fossa. They are held in place by ligaments attached to the womb but are not directly attached to the rest of the female reproductive tract, e.g. The Fallopian tubes. Ovaries produce oocytes (eggs) for fertilization and also produce female hormones estrogen and progesterone.

The cervix is the part of the female reproductive system that connects the uterus (womb) to the vagina. It is the lowermost part of the uterus and is made up of strong muscles. The function of the cervix is to allow the flow of menstrual blood from the uterus into the vagina and direct the sperms into the uterus during intercourse.

Cancer refers to any one of a large number of diseases characterized by the development of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer occurring in ovaries is known as ovarian cancer and cancer occurring in the cervix of female reproductive organs is known as cervical cancer.

Risk factors:

A. Ovarian cancer:

1. Age: Most of the cases of ovarian cancer are seen after menopause (cessation of the menstrual cycle). Half of all ovarian cancers are found in women 63 years of age or older.
2. Overweight/Obese BMI: Higher BMI has been linked to a higher risk of developing many cancers.
3. Obstetric history: Women who have their first full-term pregnancy after the age of 35 or women who have never carried a full-term pregnancy have a higher risk of developing ovarian cancer.
4. Hormonal therapy after menopause: Women who continue to use estrogen and progesterone even after menopause are at higher risk of developing cancer compared to women who do not take any hormonal therapy.
5. Family history: Ovarian cancer can run in families. A small percentage of ovarian cancers are caused by gene mutations inherited from parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer.

B. Cervical cancer:

1. Human papillomavirus (HPV) infection: The most important risk factor for cervical cancer is infection with HPV. HPV is common. There are over 100 different types of HPV. Not all of them are linked to cancer. The HPV types, or strains, that are most frequently associated with cervical cancer are HPV16 and HPV18. Starting to have sex at an earlier age or having multiple sexual partners puts a person at higher risk of being infected with high-risk HPV types.
2. Weak immune system: Women with the lowered immune system have a higher risk of developing cervical cancer. A lowered immune system can be caused by immune suppression from corticosteroid medications, organ transplantation, treatments for other types of cancer, or female infected with Human immunodeficiency virus.
3. Herpes: Women who have genital herpes have a higher risk of developing cervical cancer.
4. Smoking: Women who smoke are about twice as likely to develop cervical cancer as women who do not smoke.
5. Oral contraceptives: Research suggests that women using oral contraceptives as birth controls are at higher risk of developing cervical cancer than women who do not use these birth controls.

Symptoms:

A. Ovarian cancer:

• Bloating (retention of gas)
• Pelvic or abdominal (belly) pain
• Trouble eating or feeling full quickly
• Urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often)
• Abdominal (belly) swelling with weight loss
• Fatigue (extreme tiredness)
• Back pain
• Pain during sex
• Constipation
• Changes in a woman’s period, such as heavier bleeding than normal or irregular bleeding

B. Cervical cancer:

• Blood spots or light bleeding between or following periods
• Menstrual bleeding that is longer and heavier than usual
• Bleeding after intercourse, douching, or a pelvic examination
• Increased vaginal discharge
• Pain during sexual intercourse
• Bleeding after menopause
• Unexplained, persistent pelvic and/or back pain

Prevention:

There is no proper way to completely prevent ovarian or cervical cancer. But there are some ways to lower the risk.

A. Ovarian cancer:

1. Taking birth control pills: Women who took birth control pills for 3 or more years are 30% to 50% less likely to develop ovarian cancer. Use of Intrauterine device (IUD) has also been linked to a decreased risk in ovarian cancer.
2. Breastfeeding: The longer a woman breastfeeds, the lower the risk of developing ovarian cancer.
3. Pregnancy: The more full-term pregnancies a woman has had, the lower the risk of ovarian cancer.
4. Surgical procedures: Women who have had a hysterectomy or a tubal ligation may have a lower risk of developing ovarian cancer. A hysterectomy is the removal of the uterus and, sometimes, the cervix. Doctors recommend a bilateral salpingo-oophorectomy, which is the removal of both ovaries and fallopian tubes, for women with a high risk of ovarian cancer. For women with high-risk genetic mutations such as BRCA1 and BRCA2, having the ovaries and fallopian tubes removed after having children is recommended to prevent ovarian cancer as well as possibly reduce the risk of breast cancer. This can reduce ovarian cancer risk by as much as 96%.

B. Cervical cancer:

1. Routine Pap test: Pap test or Papanicolaou test refers to routine screening of cervix for detection of cancerous cells. “Women should have a Pap test at least once every three years, beginning at age 21,” Dewdney says. “Once you turn 30, we recommend pap smears every five years as long as you have HPV testing with your Pap and the results are negative.” According to the American Cancer Society, between 60 and 80 per cent of women in the United States with newly diagnosed invasive cervical cancer have not had a Pap test in the past five years. And, even more alarming, many of these women have never had the exam.
2. Vaccination: Two vaccines, Cervarix and Gardasil, are available to protect against the types of HPV that cause the most cervical cancers are recommended for high-risk females.
3. Practice safe sex: Studies have shown that women who have many sexual partners increase their risk of developing HPV and their risk of cervical cancer. So proper protection methods should be used.
4. Quit smoking: Smoking cigarettes doubles the risk of cervical cancer and must be quit by high-risk females.

References:

1. https://www.yourhormones.info/glands/ovaries/
2. https://www.haad.ae/simplycheck/tabid/71/Default.aspx#:~:text=It%20is%20the%20lower%20most,canal%20is%20normally%20very%20narrow.
3. https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html
4. https://www.cancer.net/cancer-types/cervical-cancer/risk-factors
5. https://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/risk-factors-and-prevention
6. https://www.rush.edu/health-wellness/discover-health/preventing-cervical-cancer