Gynecology
/ Gynecology
FEMALE REPRODUCTIVE SYSTEM CANCERS
As gynecologists, the cancer we most worry about and insist on monitoring and screening for is cervical cancer.
This is because it affects young women, even girls.
The causative agent is HPV (Human Papillomavirus), a sexually transmitted virus. There are nearly 150 types of HPV, the most risky of which are types 16, 18, 31, 33, and 51. Regardless of age, screening is conducted for both cytological screening (smear) and genetic typing (HPV DNA) for women over 30.
Smear and HPV-DNA tests are often confused. DNA testing is a genetic screening test that determines the type of HPV you have. If you have HPV types that carry a high risk of cancer, such as 16, 18, 31, 33, or 51, your pathological screening tests, or Pap smear tests, will be performed more frequently.
Women and girls under 30 who are sexually active should not neglect their screening. HPV DNA testing is performed in private clinics for girls, regardless of age, if they are sexually active. Cervical cancer has now reached childhood. Case reports of cervical cancers in women as young as 17 have been reported at our congresses.
HPV is constantly mutating, and its carcinogenic types are increasing. In addition to cervical cancer in women, it can also cause cancers of the anus, mouth, throat, and vulva and vagina.
Cancers of the anus, mouth, throat, testicle, and penis have also increased rapidly in men in Europe.
As oral and anal sex has become more common, cancers of the mouth (tongue, lips, throat) and anus are on the rise. Wart-causing types of HPV can also cause widespread cauliflower-like warts on the vulva, anus, rectum, mouth, penis, scrotum, and hands.
These warts are treated with cryotherapy, cautery, and laser procedures. Local removal is possible with special preparations. We have patients with cervical cancer who have been diagnosed early and undergone prompt surgery, and who have lived for over 15 years with radiation therapy.
Women should not delay consulting a gynecologist if they experience breakthrough bleeding, notice warts, or experience bleeding after intercourse or brown discharge.
Patients are monitored through a special immune-boosting diet, an information file about HPV, recommended external creams, and treatments.
Clinical information and tests are never shared with anyone, whether patients are married or single.
Early diagnosis, surgery, and proper follow-up are crucial.
You should quickly contact our obstetricians who can dedicate time to your care and provide psychological support. Knowing your condition and not neglecting your follow-up is actually sufficient.
The positive/negative course of diseases is determined by psychological pressures and stress, as well as the doses of foods and drinks that harm our immune systems.
Maintaining health is a significant challenge for today's population.
A life with multiple partners will also bring with it sexually transmitted infections.
Where and with whom you have sex is a determining factor.
Vaccination is a hotly debated topic these days, and we hope to address it in a separate article.
UTERINE CANCER
Uterine cancer is the first disease that comes to mind when vaginal bleeding occurs in older ages, often after menopause. We perform a diagnostic curettage quickly and send samples to pathology.
Women with PCOS should not neglect their regular follow-ups. Women with obesity, high blood pressure, and diabetes are especially at risk of uterine thickening and uterine cancer after the age of 40-50. After the age of 35, gynecological conditions called uterine hyperplasia have also rapidly increased in our country. I'm sure every woman over 35 with a bleeding disorder is asked if there are cancer cells? Is there hyperplasia? A curettage is performed for both diagnostic purposes and to stop excessive bleeding.
Many cases of hyperplasia (uterine thickening) can be detected early and treated by doctors before they progress to cancer.
Women over the age of 50 or 60 who have entered menopause and experience bleeding or brown spotting in later years should consult their gynecologist without delay and expedite the procedure.
My own mother-in-law, who was 65, experienced bleeding for 3-4 days without informing me. My father-in-law informed me, and we had a sample taken the same day, diagnosed with cancer quickly, and performed emergency surgery the next day with Prof. Dr. Metin Çapar. And thankfully, she has been living very healthy for five years.
Thanks to early diagnosis and surgery, she was diagnosed with stage 1 and her treatment progressed well. Women who bleed for months and say they're afraid to go to the doctor, afraid they might say something bad, are diagnosed with Stage 4. Their quality of life decreases, and they spend their lives suffering from the disease and undergoing treatments.
Any woman who experiences bleeding after menopause should immediately consult a gynecologist.
VULVA-VAGENITAL CANCERS
If sores in the external genital area persist despite treatment, a biopsy is performed to screen for cancer. They are less common.
It's the cancer of elderly grandmothers.
However, even in young HPV carriers, cancer should always be a consideration, and we should definitely get a biopsy if there are non-healing vulvar lesions, and we should always consider a biopsy.
BREAST CANCER
Among female genital cancers, early diagnosis is the most easily treatable.
Giving birth and breastfeeding for at least two years can be protective.
General cancer prevention efforts also apply to breast cancer (nutrition, sleep patterns, chemical consumption, alcohol, smoking, stress, medications, etc.).
Screening tests and early diagnosis address genetic risks; screening is crucial if a woman in the family has genital cancer.
Women should regularly examine their breasts and consult a gynecologist for any suspicious lumps.
We screen those under 40 with breast ultrasounds, while those over 40 receive mammograms and follow-up with breast ultrasounds every five years. Because mammograms involve radiation, it's unwise to use them too frequently. Sometimes, women come in and have two mammograms performed, one year apart. The person who requested the scan doesn't know it, nor does they know it shouldn't be. They're even happy to see it during the scans, even after a second one.
Benign cysts and adenomas of the breast are monitored with a breast ultrasound. Biopsies are taken for suspicious lumps. Magnetic resonance imaging (MRI) may be preferred over mammography.
Women should definitely learn how to perform a breast self-examination from training videos and brochures.
Men often refer women to us for examinations after finding suspicious lumps in their breasts. Men's awareness of these differences in sexual intercourse and the possibility of breast cancer coming to their minds is crucial for early diagnosis.
Psychological support for women undergoing breast surgery due to breast cancer will also provide numerous benefits.
They need professional help to avoid feeling inadequate, sexually unattractive, unhappy, and alone.
These women who undergo breast surgery can benefit from plastic surgery's aesthetic breast recommendations.
Female genital cancers are serious conditions that require family counseling, sexual counseling, psychotherapy, and motivational support for psychological, sexual, and reproductive health. We wish all our women a healthy, happy, and peaceful life.
Our love and care will continue for our women and their families.
Op. Dr. Ünzile GİRİŞGİN