Gynecological Cancer and Family Planning. A Prospective Study of a Group of Eighty-Eight Greek Women and Review of Literatures
Abstract
One of the major problems faced by modern women represents the gynecological cancer, comprising uterine, cervical, endometrial, ovarian and breast cancer.
Therefore, gynecological cancer can be also described as cancer of the female reproductive system. Nowadays, cancer consists the primary cause of death worldwide, displacing all coronary diseases and strokes.
Gynecological cancer constitutes around 20% of these cases, whereas mortality rates reach up to 13%. When cancer is diagnosed in women of reproductive age, consult by specialists should be undertaken in order to inform the couple about the alternations in their lives, the options they have and discuss all possible scenarios.
In most cases, gynecological cancer does not only affect the health of the patient as an individual, but also her sexual life, her ability to procreate and her partner’s life, in consequence. Although the treatment of cancer is of primary importance, the attending doctor should also examine the impact of the disease on fertility at the time of diagnosis and the damage caused by possible surgery, chemotherapy or radiotherapy.
In addition, consult of family planning should be offered to all couples, in order to inform them about contraceptive methods suitable for their individual cases as well as hereditary characteristics they might be interested in.
Several studies prove that the use of contraceptive pills increase the incidence of breast and cervical cancer, whereas others support that the incidence depends on the period of use and the chronological gap between contraception and cancer appearance.
Another variable that should be kept in mind is the type of hormonal contraception is used. Progestin-only oral contraceptives’ action is supported by the suppression of ovulation, an inhibiting effect on the midcycle peaks of LH and FSH, an increase in cervical mucus viscosity, a reduction in the number and size of endometrial glands and a reduction in cilia motility in the fallopian tube.
On the other hand, combination oral contraceptives’ dominant mechanism of action is to prevent ovulation, with the combination of the 2 steroids, estrogens and progesterone, which greatly increases their antigonadotrophic and ovulation-inhibitory effects.
The significance of this study lies in the knowledge around complications arising by certain contraceptive methods, as far as around the way cancer patients are informed about family planning and the evaluation for the need of alternations in the existing system.
Keywords:Gynecologic cancer; Family planning; Contraceptive methods
Introduction
Breast cancer represents the most common type of cancer among women worldwide and is referred to as second, after lung cancer. In fact, studies claim that one out of eight women will be diagnosed with breast cancer during her lifetime [1]. The most important risk factor is the existence of a positive family history, especially when this appears in first-degree relatives. The mutations of the tumor suppressor gene BRCA1, which is mounted on chromosome 17 have been implicated in an increased incidence of breast cancer and / or ovarian cancer (breast - ovarian syndrome) [2].
Early menarche, late menopause and advanced age of first pregnancy are factors that increase the risk of developing breast cancer. Nulliparous women or women with a first pregnancy after the age of 35 present 2-3 times greater risk of developing breast cancer, compared to those of childbearing for the first time before the age of 35 [3].
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