Prevent and detect cancer

During October every Thursday is #VitalThursday and the first consultation includes pap smears and physical exams at no additional cost. Dr. Carlos Cortés, Creafam’s oncological surgeon, explains to us everything about the 3 main types of cancer that affect women: Breast, cervical and thyroid. Detecting cancer early is the best way to combat it.

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How are you, good afternoon, how are you? We are in October and this is the month of the fight against cancer and that is why this time we want to talk to you about the three main types of cancer that affect women. Remember: Knowledge is Success.

Breast cancer

The three main types of cancer in women are breast cancer, cervical-uterine cancer and thyroid cancer and about breast cancer, well, this breast cancer is the main cancer that affects women in Mexico and global level. Breast cancer increases its risk throughout life and it is estimated that it may affect 1 in 8 women. Risk factors have been identified that you can see here and the main ones are these: That the patient has a family member who has had cancer and if she has had two or more direct relatives, the risk increases. Being over 45 years old, from this age the risk of breast cancer increases and as age advances the risk becomes greater.

Some nurses associate breast cancer with obesity, hypertension and diabetes. We will also frequently hear these factors related not only to breast cancer but to other types of cancer and other diseases. The lack of physical activity and something very important, not having had children, that is, women who do not have children have a greater risk of suffering from breast cancer and those who have had but did not breastfeed also have a greater risk of suffering from it. . These risk factors that we see here such as obesity, diabetes and hypertension, in addition to being associated with a lack of physical activity, have been found associated with other diseases like this one that we are suffering from worldwide, which is COVID.

It is also associated with other types of cancer: Endometrial cancer, ovarian cancer, kidney cancer, whatever cancer you imagine these three factors are directly or indirectly associated with. Fortunately, some details have been identified to prevent it or identify it in time, one is self-examination and this implies that being at home we could be aware of the appearance of some lumps or alterations in the skin, depressions or bulges, fluid leaking from the nipple. mainly if that liquid looks like blood or is red.

If, in addition to changes in the color of the skin of the breast, we find an increase in temperature, the altered texture with respect to the rest of the breast, these are alarming data that would force us to seek medical attention and we also have very effective studies every time. They help us to detect alterations in the breast or alterations suspicious of cancer in time, such as mammography, breast ultrasound and, of course, a medical physical examination. Mammography is recommended to be performed from the age of 40 in Mexico; however, with some identified risk factors it could be performed from the age of 35. Ultrasound in all women under this age, that is, less than 35 or 40 years old, it is indicated that an ultrasound be performed mainly if they identified any alteration such as those we mentioned previously, and during the physical examination, well, that physical examination that Our trusted doctor can help us, together with the review of the studies, identify breast cancer early and in a timely manner.

How to perform self-examination

Some patients have asked us regarding self-examination: How to do it correctly? And I want to show you on this occasion with this model, one of the techniques that we can recommend so that you can carry out this self-exploration. Placing your arm on the side to be checked, place the three central fingers of your hand and, moving from top to bottom, apply moderate pressure on the tissue, on the gland in order to identify if a nodule, lump or lump is palpable. some irregularity, in this way, we start at the top in the external part and continue with the internal part from top to bottom and in this model you can see three other types of review or exploration, that is, circular movements can be made from the center from the breast to the external or peripheral area they can make their movements from top to bottom as we previously showed, from bottom to top making movements like zig-zag or from the periphery to the center.

I recommend that you do it following the hands of the clock from 12 to the center and then one, two and so on until you check the entire breast by palpating. This review that we suggest be carried out at home, it is important to start carrying it out from the age of 18. And when to carry out this self-examination? The ideal time we suggest is one week before or seven days after your period starts because it is the time when the breasts are less sensitive and there is less discomfort when pressing the gland. Once we detect a small nodule in the breast or a nodule appears in the ultrasound or mammogram we had, the best time to go for a check-up is as soon as possible. What do I mean? That we don’t have to wait for this nodule to start growing.

In the previous slide you saw that the survival rate of this breast cancer can be as high as 97% and this clarified that it depends on some factors, the most important of which is detecting it very early and the use of mammography and ultrasound. Combined with a review by a health professional, it has helped us detect cases of breast cancer in very early stages, that is, very small tumors that are barely developing and with this they can allow timely, less aggressive treatment and then achieve a good chance of cure. It is important that I tell you that fortunately the majority of your nodules are going to be benign, that is, 8 out of 10 are going to be benign, but it means that it is important that we do not sit back and wait to see what happens with that nodule because it may be growing and It is a cancer, therefore, it is better to go for a check-up as soon as possible to be sure that it is a benign cyst, a fibroadenoma, and not a cancer.

Regarding the leakage of liquid through the nipple, it is very common for this to happen, however, the color of that liquid can indicate a disease that is happening within the gland.

Human papillomavirus and cervical cancer

Regarding the risk factors for cervical cancer, this is very important: Smoking is not only associated with a higher frequency of cervical cancer, it is associated with many types of cancer. All tissues that come into contact with cigarette smoke will be exposed to chemicals that can generate cancer over time; skin cancer, oral cancer, esophageal cancer, stomach cancer, lung cancer, cervical cancer, breast cancer and so on, the list can be very long, as long as we want to imagine it, and of course with other respiratory diseases such as the COVID that we are experiencing in the last almost 2 years, so if you can avoid smoking, it would be better. Other important risk factors are sexual infections, sexually transmitted infections that occur throughout our lives can

If we have a predisposition, it will degenerate into cervical cancer. With respect to these sexual or sexually transmitted infections, all are considered: Those generated by viruses, bacteria, parasites and even fungi, however, the most frequent and very important is the viral cause, that is, infections caused by human papillomavirus (HPV). This virus is very common, so that almost 100% of the population can have contact with this virus once we start our sexual life. Fortunately, not all cases of human papillomavirus infections will end in cervical cancer, fortunately, but of the cases that are identified and studied with cervical cancer, 96% are associated with HPV or human papillomavirus.

This means that if we try to avoid infection or fight it in time, we could reduce the frequency of this cervical cancer. On the slide it says multiple pregnancies. What does this mean? It means that the greater the number of pregnancies, the greater the possibility of damage to the cervix, triggering cervical cancer over time. This is becoming less and less common because women are having fewer and fewer children, that is, 30 or more years ago. 40 years because our grandmothers, for example, had many children, they had 3, 4 or more children, this was associated with a greater number of cases of cervical cancer.

Currently, women usually have 1 or 2, that is, they have fewer and fewer children and this reduces the risk of having cervical cancer. Other factors that we discuss here are nutritional deficiencies, when we do not eat well, of course our defenses are not maintained at 100% and these are also responsible for repairing the damage that our tissues suffer as we are exposed to sexual infections, smoke. cigarette and it is not a direct exposure but the damage caused internally by tobacco chemicals.

Early onset of sexual life means that there is an age where our tissues are not completely mature, the cervix effectively finishes maturing in adulthood, that is, after 18 years of age, starting sexual life before this age exposes us to changes. severe symptoms in the cervix and a greater possibility of suffering from cervical cancer, so it is advisable not to start a sexual life during adolescence, that is, not before starting our adult life and finally having multiple sexual partners. Having many sexual partners exposes us to a greater risk of suffering from human papillomavirus infections and therefore a greater possibility of suffering from cervical cancer. I want to emphasize that although these risk factors have been identified, it does not mean that we need to have all or some of them to be exposed to the possibility of suffering from cervical cancer, in reality the only condition is having started a sexual life. See, these are the tools we have to identify it in time and prevent cervical cancer, such as the use of the human papillomavirus vaccine. We currently have a couple of these vaccines available in Mexico that are very effective in preventing cervical infection. human papillomavirus and reduce the risk of suffering from cervical cancer later in life.

The use of condoms limits contact with this virus, so we reduce human papillomavirus infection and the association with cervical cancer, a very important factor that seems simple is not smoking, that would be a point to emphasize. If someone smokes and wants to reduce the risk of suffering from cervical cancer, it would be better to stop doing so. We can make a diagnosis very early using these three tools: 1. A cervical-vaginal cytology pap smear is the simplest method that can be used. It is recommended that This procedure begins to be performed once we have an active sexual life and at least once a year, the pap smear can be complemented with a colposcopy, this study that is performed in the office and helps the Pap smear a lot because we do a review with a microscope with direct vision of the cervix to detect alterations that indicate a possible indication of cervical cancer. There is a molecular test that has been used for many years in the world and in Mexico as well, which are molecular tests to detect human papillomavirus, and there are two tests to date, one of them is hybrid capture, it is available in many laboratories and the other is a PCR for human papillomavirus, they have heard in the last 18 months of the PCR test, a test that is applied to detect many types of the virus, HPV is no exception, with these three tests we could be practically 100% certain of detecting a case that has a high risk of developing into cervical cancer. If we find a premalignant or precursor lesion, it does not automatically turn into cancer; it has been studied that three and a half years, up to five years, and in other countries in the world up to seven years, pass for that lesion to become an invasive cancer, so which gives us enough time to provide treatment, perform follow-up studies, and prevent a preventable problem from turning into an advanced disease.

Thyroid cancer

We want to talk to you about thyroid cancer, it is less common, certainly less common than cervical cancer and breast cancer. Even though it is less common, some types of thyroid cancer can be associated with other problems, other tumors. These are the 4 main types, the first two are the most common, 8 out of 10 cases of thyroid cancer are called papillary or follicular. The important thing about these two types is that with surgery more than 80% of cases can be cured, fortunately. These last two types of thyroid cancer, called anaplastic and medullary thyroid cancer, are very aggressive and can be associated with other types of tumors that manifest some time after the initial treatment.

Due to the location of the thyroid, we can give some signs, such as noticing some growth, some bulge in the neck can be associated with changes in the voice, some recent change such as a hoarse voice, a voice that begins to be a little more dull, in itself alterations in our our voice, independent of what happens when we get sick with our throat, for example. There may also be some difficulty passing food, difficulty swallowing is what it is called and there is another piece of information that we did not write down here but it is the sensation that something is in the way of my neck, that is, the sensation that I have something strange that It makes me uncomfortable, because it can make it difficult for me to pass saliva and food, and sometimes if this increases a lot, the pain can be seen.

It is important then, given these signs, to do two exams, one is the physical exam, a physical examination of the neck that can be performed on all our patients during a general examination and an ultrasound of the neck, this ultrasound of the neck will give us very good details. about how our thyroid is, if there is any alteration, if there is a nodule or tumor that is causing us these discomforts. We have been talking about two things that are different: Prevention and detection. How can we prevent some types of cancer? We have commented: A healthy life, healthy eating, exercising and something different is detection.

“In prevention we participate directly as patients and in detection, because the only way to do it is to go to a consultation, that is why at Creafam every Thursday during October is Vital Thursday and during these days we are including in the consultation a breast examination, examination of the neck to detect thyroid disorders and a pap smear, so that in a single consultation we can initially detect the three main types of cancer that affect women”

Dr. Carlos A. Cortés
Dr. Carlos A. Cortés
Oncologist Surgeon

Subspecialty in Oncological Surgery.
Oncology Hospital National Medical Center “Siglo XXI”

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