Cancer Evaluation

Screening tests are a vital part of health care. They can pick up cancer in its earliest stages, long before any symptoms develop.

Mammogram for Breast Cancer

Women not at high risk should get a mammogram done every year beginning from age 40 and older and continue to do so as long as they are in good health.  (American Cancer Society guidelines). 

Women in their 20s and 30s should have a clinical breast exam (CBE) done as part of a regular check-up by a doctor, preferably every 3 years. Women should know how their breasts normally look and feel and report any changes to their doctor right away.b

Breast self-exam (BSE) is an option for women starting in their 20s. Talk to your doctor about the benefits and limitations of BSE.
Some women at high risk for breast cancer – because of their family history, a genetic tendency, or certain other factors, should be screened with an MRI along with mammograms.

Pap Smear for Cervical Cancer

The cervix (or neck of the uterus) is the lower, narrow portion of the uterus where it joins with the top end of the vagina.

Cervical cancer develops if the cells of the cervix become abnormal and grow out of control. If abnormal cells are caught early, which they often are through the cervical screening program, cancer can often be prevented or treated early.

Potentially pre-cancerous changes in the cervix can be detected by a Pap smear. In this test epithelial cells are scraped from the surface of the cervix and examined under a microscope. Most cervical cancers occur in women who have never had a Pap smear, or not had one within the last five years.

If abnormal cells do develop into cervical cancer, you may have abnormal vaginal bleeding, for example, between periods or after sex, smelly vaginal discharge or vaginal bleeding after menopause. These symptoms are not always due to cervical cancer, but if you have them, you should visit your doctor.

HPV Vaccines (Cervical Cancer vaccine)

Ninety-nine out of 100 cervical cancers are associated with some type of human papilloma virus (HPV). HPV infection spreads through sexual contact. Most women's bodies are able to fight this infection. But sometimes the virus leads to cancer.

HPV vaccines offer the best protection to girls and boys who receive all three vaccine doses and have time to develop an immune response before being sexually active with another person. HPV vaccination is recommended for girls and boys at age 11 or 12 years.

HPV vaccines are given as a series of three injections over 6 months to protect against HPV infection. There are three HPV vaccines (Cervarix, Gardasil, and Gardasil 9). Girls and young women should get any of these HPV vaccines to prevent cervical cancer.

The cervical cancer vaccine is not recommended for pregnant women or people who are moderately or severely ill. Tell your doctor if you have any severe allergies, including an allergy to yeast or latex. Also, if you've had a life-threatening allergic reaction to any component of the vaccine or to a previous dose of the vaccine, you should not get the vaccine.

Should you get the cervical cancer vaccine if you're already sexually active?

  • The vaccines don't treat HPV infection and only protect you from specific strains of HPV to which you haven't been exposed.
  • The HPV vaccine does not protect against all types of HPV that are associated with cervical changes and cancer and therefore, the vaccines do not provide complete protection against the disease. It is thought that the vaccines will prevent at least seven out of 10 of the most common type of cervical cancer.
  • It is important to have routine cervical screening (Pap smear) even if you have had the HPV vaccine
Pelvic Exam for Gynecologic Cancers

It is important as a woman that you should have a regular pelvic examination. It is one of the first steps in diagnosing several conditions such as ovarian or uterine cancer or sexually transmitted diseases. How often a woman needs a pelvic exam varies depending on her risk factors for certain conditions and previous examination findings. A pelvic exam is often accompanied with a Pap smear test.

Ovarian Cancer Screening

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. There is no way to know definitely if you will get ovarian cancer. There are some factors that may put you at higher risk for ovarian cancer, such as:

  • Your age: Ovarian cancer can occur at any age but is most common in women at the age 50 to 60 years.
  • Having close family members such as your mother, sister, aunt or grandmother who have had ovarian cancer.
  • A small percentage of ovarian cancers are caused by an inherited gene mutation.
  • If you have had breast, uterine, colorectal (colon) cervical cancer or melanoma earlier, you are at increased risk
  • Women who take estrogen by itself (without progesterone) for 10 or more years may have an increased risk of ovarian cancer.
  • If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
  • If you have never been pregnant or have had difficulty getting pregnant, your risk increases.
  • Smoking increases your risk.
  • Women with Polycystic Ovary Syndrome are at increased risk of developing ovarian cancer

There are currently no tests available to detect ovarian cancer early. But there are some tests that might be used in women who have a high risk of ovarian cancer.

You should see your Gynaec right away if you have any of the following symptoms that persists over a period of time. These are ongoing abdominal swelling or unexplained digestive problems (including gas, loss of appetite, and bloating), unexplained abdominal pain or a feeling of needing to urinate all the time and pelvic, back or leg pain that persists despite treatment.

Endometrial Cancer Screening

The uterus (womb) is part of the female reproductive system where your baby grows during pregnancy. The lining of the uterus is called the endometrium and is shed each month as part of your monthly menstrual cycle. Most cancers of the uterus develop in the lining and is called endometrial cancer. Cancer of the uterus is also called uterine cancer. Endometrial cancer is rare in women under the age of 45. Most cases are found in women aged 55 and over.

What are the risk factors for endometrial cancer?

Hormone factors: A woman's hormone balance plays a part in the development of most endometrial cancers. The balance of the two main types of female hormones -- estrogen and progesterone changes during a woman's menstrual cycle each month.  A shift in the balance of these hormones toward more estrogen, increases a woman's risk for developing endometrial cancer. After menopause, a small amount of estrogen is still made in fat tissue. Female hormones may be taken as hormone therapy to treat symptoms of menopause.

Women who take progesterone along with estrogen to treat menopausal symptoms do not have an increased risk of endometrial cancer. (But taking this combination increases a woman's chance of developing breast cancer and also increases the risk of serious blood clots). If you are taking (or plan to take) hormones after menopause, it is important to discuss the potential risks (including cancer, blood clots, heart attacks, and stroke) with your doctor.

If you have any abnormal bleeding or discharge from the vagina you should see your doctor right away.

Total number of menstrual cycles: Having more menstrual cycles during a woman's lifetime raises her risk of endometrial cancer. Starting menstrual periods before age 12 and/or going through menopause later in life raises the risk.

Pregnancy: Having many pregnancies protects against endometrial cancer. Women who have never been pregnant have a higher risk, especially if they were also infertile (unable to become pregnant).

Obesity: Having more fat tissue can increase a woman's estrogen levels, which increases her endometrial cancer risk. In comparison with women who maintain a healthy weight, endometrial cancer is twice as common in overweight women, and more than three times as common in obese women.

Polycystic ovarian syndrome: Women with a condition called polycystic ovarian syndrome (PCOS) have abnormal hormone levels, such as higher androgen (male hormones) and estrogen levels and lower levels of progesterone. The increase in estrogen relative to progesterone can increase a woman's chance of getting endometrial cancer.

Age: The risk of endometrial cancer increases as a woman gets older.

Diet and exercise: A high-fat diet can increase the risk of several cancers, including endometrial cancer. Because fatty foods are also high-calorie foods, a high-fat diet can lead to obesity, which is a well-known endometrial cancer risk factor.Physical activity lowers the risk of endometrial cancer.

Diabetes: Endometrial cancer may be as much as 4 times more common in women with diabetes. This may be linked to the fact that diabetes is more common in people who are overweight, but even people with diabetes who are not overweight have a higher risk of endometrial cancer.

Family history: Endometrial cancer tends to run in some families. Some of these families also have an inherited tendency to develop colon cancer. This disorder is called hereditary nonpolyposis colon cancer (HNPCC). This disorder may be caused by a defect in some genes. An abnormal type of these genes reduces the body's ability to repair damage to its DNA or regulate cell growth and results in a very high risk of colon cancer, as well as a high risk of endometrial cancer. Women with this syndrome have a 40% to 60% risk of developing endometrial cancer. The risk of ovarian cancer is also increased. Some families have a high rate of only endometrial cancer.

Breast or ovarian cancer: Women who have had breast cancer or ovarian cancer may have an increased risk of developing endometrial cancer. Some of the dietary, hormonal, and reproductive risk factors for breast and ovarian cancer also increase endometrial cancer risk.