[의학신문·일간보사=유은제 기자]Every year, May 10 is Women’s Health Day and the third week of May is Cervical Cancer Awareness Week. It was established by the Korean Society of Obstetrics and Gynecology to promote women’s health. We would like to find out what are the main gynecological cancers that threaten only women in the faculty of obstetrics and gynecology at Kyung Hee University Hospital.
Fewer ovulations reduce the risk of ovarian cancer
(From left) Minhyung Jeong and Byungsoo Kwon, professors of obstetrics and gynecology at Kyung Hee University Hospital
There are three main types of gynecological cancer. Ovarian cancer, cervical cancer, and endometrial cancer are classified based on where the malignancy occurs (ovary, cervix, and endometrium). There are three reasons to watch out for gynecologic cancer. This is because the initial symptoms are unclear, the risk of recurrence is high, and thorough management and follow-up are required even after full recovery.
Professor Jeong Min-hyung of the Department of Obstetrics and Gynecology of Kyung Hee University Hospital said: “The exact cause of ovarian cancer has not been determined, but early menarche, late menopause and low birth rate are considered to be the main risk factors for the disease”. The fewer the number of ovulations, the lower the risk of developing ovarian cancer. “This means that the incidence of ovarian cancer may increase if you have little experience of pregnancy, early menarche, or late menopause.”
Ovarian cancer is known to have a particularly high genetic probability compared to other gynecological cancers. That is why recently the hereditary mutation of the BRCA gene has been considered one of the main causes. The BRCA 1 and 2 genes are found in approximately 15% of patients with epithelial ovarian cancer, and the chance of transmitting it to children is 50%. In other words, if you have a family history or past history related to ovarian cancer, you are classified as a “high risk group for ovarian cancer.”
Professor Jeong Min-hyung said: “There is no effective screening test for ovarian cancer and there are no particular early signs, so about 70-80% of patients are diagnosed at stage 3-4, which has an impact significant on the survival rate. ” He added: “If you belong to a high-risk group, genetic testing is recommended.” “We strongly recommend it, and if the gene is positive, the risk of ovarian cancer after age 35 increases compared to the general population,” so bilateral oophorectomy should be considered a preventative measure,” he said.
In particular, having a child is known to reduce the incidence of ovarian cancer by approximately 30-40%. Since the incidence of ovarian cancer and fertility are inversely proportional, depending on whether you intend to have children or not, it is recommended to undergo a transvaginal ultrasound every six months or to regularly take oral contraceptives that help suppress ovulation and reduce the number of oocytes. release.
Endometrial cancer must be prevented by maintaining adequate weight.
Endometrial cancer, like ovarian cancer, is one of the gynecological cancers with an increasing incidence. The exact mechanism of its appearance is not known, but it is closely related to exposure to the female hormone, estrogen. The typical symptom is abnormal bleeding.
Professor Kwon Byeong-soo from the Department of Obstetrics and Gynecology at Kyung Hee University Hospital said: “Female hormones include estrogen, which promotes cell proliferation in the endometrium, and progesterone, which suppresses proliferation of the endometrium and induces cellular differentiation”. “If the balance of female hormone secretion is disrupted, exposure to estrogen increases. “Reduced exposure to progesterone can lead to abnormal proliferation, increasing the risk of developing endometrial cancer,” he said.
Typical factors that disrupt the balance of female hormone secretion include obesity, stress and smoking. A certain amount of female hormones is produced in the subcutaneous fat, but when the subcutaneous fat increases due to weight gain, female hormones are produced in excess, which reduces the adequate amount of female hormones secreted by the ovaries, causing an imbalance . Furthermore, stress and smoking can interrupt the secretion cycle by supporting sympathetic nerve activation.
Professor Kwon Byeong-soo said, “Uterine aspiration cell biopsy is used to diagnose endometrial cancer, and if endometrial cancer is confirmed, postmenopausal women are basically subjected to total hysterectomy and salpingo- Bilateral oophorectomy, but in some cases lymph node dissection may be performed. “Women who have received estrogen hormone therapy or antiestrogen therapy, or who have been diagnosed with atypical endometrial hyperplasia, require follow-up for endometrial cancer,” he said.
To prevent endometrial cancer, it is important to minimize exposure to estrogen. Taking oral contraceptives for more than a year can reduce estrogen exposure and reduce the risk of endometrial cancer. Additionally, because fat cells in the body can increase exposure to estrogen, it is important to maintain a healthy weight through adequate physical activity and diet.
Early prevention of “cervical cancer” through screening tests and vaccines
Cervical cancer is a malignant tumor that occurs in the cervix, the entrance to the uterus. It is the only gynecological cancer that can be diagnosed early through a screening test and there is a preventive vaccine for the causative cause. The representative cause is human papillomavirus (HPV) infection through sexual contact, which is found in more than 80–90% of patients. Other risk factors include smoking, decreased immune function, unsanitary environment, and nutrient deficiencies.
Professor Jeong Min-hyeong of the Department of Obstetrics and Gynecology at Kyung Hee Medical Center said: “The number of patients has been steadily decreasing since 1999 with the implementation of cytology, a screening test, every two years nationwide, but the disease occurs due to changes in sexual life patterns, such as an earlier first sexual experience and increased sexual experience. “The age is decreasing,” he said “In particular, unlike other types of cancer, the incidence rate varies by race and income class. Compared to the West, the incidence rate is higher in the South America, Africa and Asia, and is higher in socioeconomically low-income groups than in high-income groups.
The representative symptom of cervical cancer is bleeding, similar to endometrial cancer. As the cancer progresses, vaginal bleeding and discharge increase, leading to weight loss and swelling of the lower extremities.
Early vaccination with the cervical cancer vaccine is essential to prevent infection with “human papilloma virus,” the main cause of cervical cancer. However, since vaccination cannot 100% prevent cervical cancer, screening tests are essential and should be performed periodically.
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