Here’s a guide to understanding – and preventing – some of the most common health afflictions for women.
- Dr Chia Yin Nin, gynaecologist and gynaecologic oncologist, Gleneagles Hospital Singapore
- Dr Bertha Woon, general and breast surgeon, Gleneagles Hospital Singapore
- Dr James Tan Siah Heng, neurosurgeon, Gleneagles Hospital Singapore
- Dr Daniel Yeo, cardiologist, Gleneagles Hospital Singapore
1. Ovarian Cancer
Ovarian cancer is an umbrella term for the different types of cancer arising from the cells of the ovary. The majority of these cancers arise from the epithelium (or outer lining) of the ovary, while others form in the fallopian tubes or even within the ovary itself. The seventh most common cancer in women worldwide, ovarian cancer is on the rise in Singapore. According to the Singapore Cancer Registry, the age-standardised incidence rate of newly diagnosed ovarian cancer cases in females has almost doubled over the last 40 years.
“While around 5 per cent of ovarian cancer cases are hereditary – caused by a mutated gene called BRCA – the major causes of the disease are still unknown,” says Dr Chia Yin Nin, gynaecologist and gynaecologic oncologist at Gleneagles Hospital Singapore. “However, ovarian cancer is associated with a higher number of ovulatory cycles. Women who have no or few children, are sub-fertile or have undergone fertility treatment, or suffer from endometriosis are at a higher risk of developing ovarian cancer.”
“Ovarian cancer is a silent killer that is often asymptomatic in the early stages,” says Dr Chia. However, some symptoms you can watch out for include abdominal pain and swelling, bloating, fatigue and changes in bladder and bowel movements.
To lower your risk of ovarian cancer, Dr Chia advises reducing the number of ovulatory cycles you go through. This can be achieved by having more children, breastfeeding or taking oral contraceptives. “Oral contraceptives are currently the best form of prevention against this deadly cancer. They can halve your risk if taken continuously for three to five years,” she advises. “For those with the BRCA gene, I would recommend surgically removing the ovaries upon completion of childbearing as a means of prevention,” she adds.
2. Cervical Cancer
According to the Singapore Cancer Registry, cervical cancer is the tenth most common cancer affecting women in Singapore. The cancer starts from the cells of the cervix, which is the narrow part of the lower uterus, connecting to the vagina.“Cervical cancer is caused by the human papillomavirus (HPV), which is transmitted sexually. In fact, one in two sexually active women will acquire this virus in their lifetime. While most infections are transient, the virus sometimes persists in the body, giving rise to an increased risk of cervical cancer,” says Dr Chia.
Women who started their sexual activity early, or have multiple sexual partners, are at higher risk of the disease, shares Dr Chia. Also, smokers have lower levels of immunity, making them more susceptible to the disease.
Cervical cancer is often asymptomatic in its early stages. But as the cancer develops, there may be symptoms like irregular vaginal bleeding, abnormal vaginal discharge, pain during sex, or pelvic or back pain.
“The good news is that in today’s context, cervical cancer is highly preventable,” says Dr Chia. Pap smears – whereby cells from the cervix are collected for testing – are an established method of screening for cervical cancer. If you are aged between 25 and 69, you should be going for a pap smear once every three years. Moreover, there are vaccines that can safeguard against two common strains of HPV. “However, these vaccines are not 100 per cent protective, so you will still need to continue with your pap smears even after being vaccinated,” advises Dr Chia.
3. Breast Cancer
Essentially, breast cancer refers to a malignant tumour that develops from the cells of the breast. These tumours often begin in the lobules or ducts of the breast, but they can also occur in its fatty and connective tissues. “Breast cancer is the most common cancer affecting women in Singapore. Its incidence has nearly tripled in the past 50 years, from 22.6 to 63.4 for every 100,000 women,” shares Dr Bertha Woon, general and breast surgeon at Gleneagles Hospital Singapore.
“Having a family history of breast cancer definitely increases your risk of the disease, especially if the patient in question is a first- or second-degree relative,” says Dr Woon. Women who have undergone hormone replacement therapy are also more likely to develop breast cancer. “Breast cancer is also associated with longer exposure to estrogen. Women with early periods or late menopause are therefore more likely to develop breast cancer, as are women who were aged above 30 at the time of their first live birth,” continues Dr Woon.
Broadly speaking, common symptoms include changes in the feel or appearance of the breast or nipple, says Dr Woon. You should also be concerned if you experience abnormal or blood-stained nipple discharge. “Although breast cancer is the most common cancer among women in Singapore, survival rates are excellent due to improvements in treatment and care. Early detection is therefore key, so be sure to conduct self-examinations regularly,” she recommends.
Leading a healthy lifestyle can mitigate your risk of breast cancer, advises Dr Woon. So make sure you eat a variety of fruit and vegetables, exercise regularly, don’t smoke, drink in moderation, get enough sleep and minimise stress factors.
“Stroke refers to a medical emergency where there is a disruption of blood supply to the brain, resulting in cell damage and cell death,” says Dr James Tan Siah Heng, a neurosurgeon at Gleneagles Hospital Singapore. According to Dr Tan, the most common form of stroke is an ischemic stroke, where a blood vessel supplying the brain is blocked or narrowed, starving the brain of oxygen. Less common is a hemorrhagic stroke, whereby a blood vessel bursts or leaks. This causes blood to accumulate in the area, which creates swelling and pressure, and damages cells and tissues in the brain.
“It is estimated that your risk of a stroke doubles for every decade after the age of 55,” shares Dr Tan. “Women are also more susceptible to strokes than men, due to factors like birth control, pregnancy and gestational diabetes.” Moreover, medical conditions such as heart disease, blood disorders and hypertension are major causes of stroke, says Dr Tan. Lifestyle changes play a part as well. “Smoking, alcohol consumption and a lack of physical activity can contribute towards stroke risk. In fact, smokers are twice as likely to suffer a stroke,” adds Dr Tan.
Warning signs include numbness or weakness in the face, arm or leg (usually on one side of the body), problems with vision and speech, dizziness and a sudden, severe headache.
Lifestyle changes are key. “Stop smoking and try to reduce your alcohol intake. You should be having just one to two glasses of wine a day, or its equivalent. Also, try to aim for 150 minutes of moderate exercise a week,” advises Dr Tan. Be sure to monitor medical conditions like hypertension and heart disease that predispose you to a stroke.
5. Heart Disease
Heart disease is the leading cause of death from disease of a single organ in Singapore, says Dr Daniel Yeo, a cardiologist at Gleneagles Hospital Singapore. The disease, which claims 3,500 to 4,000 lives here every year, refers to any type of disorder affecting the heart, such as angina, coronary artery disease, heart attack and heart failure.
“Women are less susceptible to the disease than men, due to the protective effects of female hormones. However, once they reach the perimenopausal and menopausal stage, the risk of heart disease increases markedly,” says Dr Yeo. Also, female smokers who have high blood pressure, high cholesterol, diabetes or obesity are at a higher risk of developing heart disease, he adds. Genetics also play an important role. “Those with a strong family history of heart disease are more predisposed to the dreaded illness,” notes Dr Yeo.
Many types of heart disease are asymptomatic in their early stages. But signs like extreme pain or discomfort in the central or left side of the chest (which might extend to the jaw) may suggest an imminent heart attack. Other symptoms may include nausea, jaw or arm ache, sweating and dizziness.
“Leading a healthy lifestyle can go a long way in preventing heart disease,” advises Dr Yeo. Aim for a balanced diet and engage in moderate exercise at least thrice a week. “Moderate alcohol consumption is also acceptable, but you should not be having more than one standard drink a day, three times a week,” he recommends.
“If you have existing medical conditions such as high blood pressure, diabetes or high cholesterol, you should have them well under control to prevent heart-related complications. Don’t be afraid to discuss your medication needs with your heart specialist,” urges Dr Yeo.
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By Delle Chan, Simply Her, April 2015