In the first part of The Mail on Sunday’s comprehensive guide to women’s health last weekend, our esteemed experts provided invaluable information on three significant mid-life concerns. We discussed intimate issues, such as dryness and unusual bleeding, the menopause, and how to identify atypical signs of a heart attack in women. Now, we turn our attention to one of the most dreaded diseases: cancer.
When it comes to female cancers like breast, womb, ovarian, vaginal, and vulval cancer, they are often depicted in movies and television as illnesses that affect young mothers and wives, tragically cutting their lives short. However, this portrayal couldn’t be further from the truth. Half of the 55,000 cases of breast cancer diagnosed each year are in women aged 55 to 75. The majority of gynecological cancers also affect women in their 50s and 60s. Thanks to recent medical advancements, these diseases are no longer the death sentences they once were, as long as they are detected early.
That’s where this guide comes in. In this article, five highly respected female cancer experts from the UK will share what symptoms to look out for and proven methods to reduce your risk. Cancer is still a threat even after NHS screening ends, so don’t hesitate to schedule your own appointments.
Typically, women between the ages of 50 and 70 are invited for NHS breast screenings every three years. These screenings involve a mammogram, a low-dose X-ray. While the process may cause mild discomfort, it saves 1,300 lives from breast cancer each year. However, once women turn 70, they may assume they are no longer at risk since screening invitations cease. This is not the case, as one in three breast cancer cases – 13,500 women – are diagnosed in those over 70. Therefore, women over 70 can still arrange their own mammograms by contacting their local breast cancer screening service. Simply ask your GP practice for the necessary details.
The same principle applies to cervical cancer screenings. Women are typically called for a smear test every three years between the ages of 25 and 49, and every five years between 50 and 64. However, you can request to be tested beyond these age ranges. Cervical cancer, which affects 3,200 women annually, is linked to a common virus called human papillomavirus (HPV), which takes ten to 20 years to develop into cancer. Regular smear tests significantly decrease the chances of developing cervical cancer after the age of 65. While most women under 32 are protected against HPV by a vaccine, older women are not, and 15.4% of cervical cancers are diagnosed in those aged 65 or over. Therefore, if you experience unusual vaginal bleeding, pain during sex, or pain in the lower back or abdomen, make an appointment for a smear test.
The guidelines for examining your breasts have changed. Instead of scheduling monthly or annual checks, experts now recommend feeling your breasts as often as possible to establish what is normal for you. As women age, breast tissue changes, and the skin may wrinkle, making it harder to recognize unusual lumps or changes. Incorporate breast checks into your routine by performing them in the shower or in front of a mirror while getting changed. Look for any lumps, changes in breast shape, puckering or dimpling of the skin, rashes or unusual marks, or nipple discharge. Ensure you lift your breasts and check underneath, spreading the skin between your fingers to make any dimpling more apparent. Remember, most changes are not cancerous, but if you notice anything new, consult your GP.
A breast cancer diagnosis in mid-life may feel overwhelming, often associated with the fear of losing your breasts and enduring grueling chemotherapy and radiotherapy. However, treatments have evolved. Today, only a third of women undergo a full mastectomy. Many can shrink their tumors with drugs and undergo a lumpectomy – the removal of a smaller portion of the breast – followed by radiotherapy. Only a third of women require chemotherapy. Radiotherapy has also become more personalized, with some women receiving treatment within one week and minimal side effects. The National Institute for Health and Care Excellence (NICE) now advises that some women over 65 with low-risk breast cancer have the option to forgo radiotherapy. Recent research suggests that older women tend to have less aggressive, smaller cancers that are less likely to spread. This indicates a potential history of over-treating older women in the past. If radiotherapy is necessary, ask if you qualify for partial-breast radiotherapy, which has fewer side effects than whole-breast radiotherapy. Additionally, there are gentler alternatives to chemotherapy, such as new drugs like palbociclib and ribociclib, known as CDK46 inhibitors, that prevent proteins from encouraging cancer cell growth. Always inquire about eligibility for clinical trials, as advances continually occur.
Approximately 80% of middle-aged women with breast cancer have tumors sensitive to estrogen, a hormone that fuels their growth. This is beneficial for postmenopausal women, as their natural estrogen levels are lower. However, breast cancer patients still need drugs to block the impact of estrogen produced at low levels in fat cells. Some of these drugs, called aromatase inhibitors, can accelerate the aches and pains associated with old age. As a result, a third of women stop taking them due to intolerance, often failing to inform their doctor. This decision puts them at risk of recurrence. Instead, discuss alternative options with your oncologist. One possibility is tamoxifen, equally effective in treating cancer with fewer side effects.
Ovarian cancer cases often remain undetected until they have already spread to surrounding areas, making it the deadliest of all gynecological cancers. The symptoms, such as bloating, abdominal and back pain, decreased appetite, and fatigue, are vague and easily mistaken for signs of less severe conditions. It took Florence Wilks, a 59-year-old campaigner with the charity Ovarian Cancer Action, two years to receive her diagnosis. She experienced fatigue, back pain, and heavy menstrual bleeding, yet her blood tests showed no abnormalities. Florence persisted and requested a pelvic scan, which revealed no issues. However, two years later, when she started experiencing frequent urges to urinate, another scan exposed tumors in both ovaries and throughout her abdomen. Doctors informed her that the cancer was incurable, giving her a prognosis of 12 to 18 months to live. Standard treatment involves surgery, chemotherapy, and an immunotherapy drug called bevacizumab. Recent studies have shown that combining two additional drugs – durvalumab and olaparib – can restrain tumor growth for an additional year compared to the regular treatment regime. Trials are also investigating whether smear tests for cervical cancer could detect tiny cell changes linked to the disease, aiding in early diagnosis. For women with a specific type of ovarian cancer fueled by genes BRCA1 and BRCA2, olaparib alone can improve survival rates. It has been 13 years since Florence’s diagnosis, and she has been taking a daily dose of olaparib for six years, defying expectations.
In conclusion, this guide aims to provide you with crucial information about female cancers and empower you to take control of your health. Cancer is a threat that persists even after NHS screenings, so it is vital to arrange your own appointments. Regular screenings and self-examinations can save lives. Keep abreast of the latest advancements in treatment options and never hesitate to consult your doctor for potential alternatives or clinical trial eligibility. Remember, knowledge is power when it comes to fighting cancer.
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