Updated 20 September 2013

Here’s the good news

This article celebrates developments that could make the lives of women a lot easier.

We’re not here to bang the same old drums about antioxidants, coffee, anaesthetics and HRT. Instead, we’re celebrating developments that could make your life a lot easier.

Here are four reasons you should be glad you live now and not 50 years ago.

Genetic testing for hereditary breast cancer

The problem. Eleven percent of women develop breast cancer. Between five and ten percent of breast cancers are the result of inherited changes of two genes, called BRCA1 and BRCA2. If diagnosed and treated early, breast cancer is curable in about 70% of cases, according to Professor Justus Apffelstaedt, of the University of Stellenbosch.

Previous treatment. In the past, once the lump was discovered, it was already well established and may have metastasised. Treatment usually consisted of surgery, radiation therapy, chemotherapy – the most difficult – and hormone therapy. Radical mastectomy (removal of 95% of the breast tissue) was a fairly standard procedure.

The good news. It is now possible to do a test which can help cancer specialists find out whether a particular patient will benefit from chemotherapy. This means that no patient will go through chemotherapy unnecessarily and it is estimated this will reduce chemotherapy patients by about a third.

Now Researchers say they've moved even closer to working out the genetic profile that raises a woman's chance for breast cancer.

A set of studies published yesterday in the journals Nature and Nature Genetics identified four new breast cancer susceptibility genes, as well as several genetic markers, that are associated with the risk for the disease and that deserve further investigation.

The findings may be the most important genetic discoveries relating to breast cancer genetics since the identification of BRCA1 and BRCA 2 in 1994, experts say.

The treatment of uterine fibroids

The problem. Three in every four women have fibroids in the uterus. These are non-cancerous and seldom cause problems, but they can make their presence felt by causing heavy menstrual bleeding, prolonged periods, pain in the pelvis, urinary incontinence and constipation, and more.

Previous treatment. In the past, a total hysterectomy was often advised. This involved major surgery and a recovery period of at least six weeks.

The good news. There are several much less dramatic and equally effective procedures that can now be done to destroy or remove uterine fibroids – and most women are up and about within three to four days after the procedure. These include:

  • a myomectomy, which destroys the fibroids but leaves the uterus in place if you still want to have children. Surgeons can also use electric current to destroy the fibroids and to shrink the blood vessels that feed them;
  • endometrial ablation, in which the lining of the uterus is removed, but the uterus itself is left intact. This means the end of periods, but not necessarily the start of menopause; and
  • focused ultrasound surgery, involving the destruction of fibroids by high-frequency, high-energy sound waves. This treatment is non-invasive and preserves the uterus.

The vaccine for human papilloma virus (HPV)

The problem. Cancer of the cervix affects one in every 34 South African women. It is most often associated with the human papilloma virus (HPV) which is most often sexually transmitted. Regular Pap smears can usually pick up cervical cancer in its early stages, but once the disease has progressed to a certain stage, cervical cancer may be fatal.

Previous treatment. Once advanced, the cancer was treated with surgery, radiation therapy and chemotherapy. All three could be temporarily debilitating and have long-term negative effects.

The good news. There is now a vaccine against HPV. It is recommended for use in girls and women between the ages of nine and 26 years. As HPV is sexually transmitted, it is recommended that women who have become sexually active before the age of 18, and women who have had many partners, should be immunised.

Cervical cancer screening tests

The problem. Cervical cancer is the most common cause of cancer death among South African women. Cervical cancer can be detected by means of a Pap smear and in developed countries this poses no problem. But in developing countries and especially in rural areas, resources and facilities are limited, with the result that the majority of women are never screened.

Previous treatment. Regular Pap smears (about every two years) were recommended to all sexually active women.

The good news. Two universities, the University of Columbia and the University of Cape Town, have been involved in investigating alternative screening methods. They have been taking a look at a so-called “screen and treat” approach, using either visual inspection of the cervix with acetic acid, or HPV DNA testing followed by immediate cryotherapy treatment (the freezing of abnormal cells or skin lesions) for women who test positive. Professor Lynette Denny won South Africa's 2003 Woman of the Year in Science and Technology Award for her work in this field.


Photo: Mammogram from Shutterstock


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