Women and the so-called men's cancers
Increasingly, women are becoming prone to lung cancer, lymphoma, colorectal and stomach cancer - just like men.
Mon, Mar 17, 2008
SingHealth
LYMPHOMA
Lymphoma is a cancer of the lymphocytes, a type of white cell normally found throughout the body especially in the lymph glands and bone marrow. Practically every organ in the body has these cells, which are part of our immune system.
Fact
In Singapore, lymphoma ranks 10th among all female cancers for all age groups and is the fourth most frequent cancer in females aged 15 to 34.
Men/women ratio
Figures from the Singapore Cancer Registry 2004 showed a total of 1170 new lymphoma cases seen from 1998 to 2002 of which there were 470 (41 per cent) women and 700 (59 per cent) men.
This ratio was seen in Chinese and Indians. However the ratio for Malays showed a higher proportion of men to women [67 (35%) women to 124 (65%) men]. The reasons for this are not known at present.
Most common age group
The incidence for newly diagnosed lymphoma rises most significantly from the sixth decade and peaks in the seventh decade for women and men.
Contributory factors
Although there are links of lymphoma with abnormal immune systems such as severe combined immunodeficiency or viral infections such as HIV, these only account for a small percentage of lymphoma cases.
The results of these investigations have been mixed and have not provided consistent significant positive associations.
Studies of occupational and environmental factors, lifestyle and personal factors, family history and genetic factors, and personal medical history have not yet identified a specific agent or chemical consistently associated with lymphoma.
Prognosis
The good news is that lymphoma is potentially curable or when treated appropriately can be associated with a long survival term.
The factors determining survival include type of lymphoma, extent of disease (stage), age, fitness level, level of a tumour marker called lactate dehydrogenase (LDH) and the number of organs affected by the lymphoma.
COLORECTAL AND STOMACH CANCER
Colorectal cancer affects the colon and rectum, while stomach cancer (also called gastric cancer) can develop in any part of the stomach. It is possible for both cancers to spread to other organs.
Fact
Both these cancers are more common in men than women.
Most common age group
60 years old and above for colon cancer, 50 to 70 years old for stomach cancer.
Contributory factors
Increasing age, genetic factors including family history of colon cancer, obesity, increased red meat intake, reduced levels of exercise, and inflammatory bowel disease all contribute to an increased risk of colon cancer.
Decreased intake of vegetables, fruit and fibre is another risk factor.
The risk factors for stomach cancer are smoking, infection by the microorganism helicobacter pylori in the stomach, genetic factors including family history, having blood group A, and a medical condition called pernicious anaemia.
It is possible as well that consumption of salted, cured, pickled and smoked foods increase the risk of stomach cancer.
Prognosis
If colon cancer is diagnosed at Stage I, 93 per cent of patients could survive after the crucial five years. At Stage IV, it is eight per cent only.The five-year relative survival rate for stomach cancer at Stage I is 56-66 per cent; at Stage IV, it is three per cent.
LUNG CANCER
There are essentially two main types of lung cancer: non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). Each type grows and spreads in different ways and is treated differently. NSCLC is the more common type and is the type more commonly seen among women and non-smokers.
Fact
Lung cancer is the third most frequent cancer and the most common cause of cancer deaths among women in Singapore.
Men/women ratio
About 30 per cent of lung cancer cases are women and 70 per cent are men.
Most common age group
The most common age group is the elderly group above 65 years old.
Contributory factors
Smoking, both active and passive, is the most important risk factor for lung cancer. Other known factors include exposure to asbestos, radon, arsenic, chromium and nickel.
Prognosis
With clinical Stage I lung cancer (meaning the cancer is small and confined to a lobe of the lung), the five-year survival rate is about 50 per cent.
At clinical stage II (which can include cancer that may have spread to the nearby lymph nodes), patients have a five-year survival rate of about 30 pet cent. For both stage I and II, post operative chemotherapy has been shown to improve survival.
At stages IIIA, 1MB, and IV disease (more widespread and also reaching other parts of the body*, the five-year survival rate is about 1 7 per cent, 5 per cent and 1 per cent respectively.
Systemic treatment with chemotherapy and newer targeted therapies can improve the survival of these patients with advanced disease.
| Facing up to the number 1 killer |
| The incidence of colon cancer is rising. Colon cancer is the most common cancer in Singapore among men and women. It is the fourth most common worldwide. However, there are new treatments and this is an exciting time for the field of cancer therapy. New chemotherapy drugs are available and survival rates of patients have improved. There are also"smart"drugs which target specific "Achilles heels" in colon cancer cells that also make a difference to the survival rates. Because the number of treatments have increased, including various combinations of these new agents with traditional chemotherapies, it is important to have a good and clear discussion with a cancer specialist about the best treatments available for colon cancer, and the best approach overall to combat this disease. |
Contributed by Dr Miriam Tao, Dr Toh Han Chong, and Dr Toh Chee Keong, Consultant, National Cancer Centre Singapore
This article was first published in SingHealth's AllWoman! magazine. For more stories on women's health, visit www.singhealth.com.sg