Common Cancer Types in Women

Cancer is among the diseases whose incidence is steadily increasing both worldwide and in our country. Every year, millions of people worldwide and approximately 150,000 people in our country are diagnosed with cancer. However, compared with the past, significant progress has been made in the early diagnosis of cancer with modern medicine. Through regular screenings and at least one Check-up per year, cancer can be detected at an early stage, diagnosed and treated. Early diagnosis not only extends the patient's lifespan but also improves quality of life. Therefore, early diagnosis of cancer is of vital importance, as well as its treatment.

At Hisar Hospital Intercontinental, our patients diagnosed with cancer are followed up and treated in our Medical Oncology Unit. In this section, which we have prepared in the belief that knowledge and information are important in the early diagnosis and treatment of cancer, you can find all the details about the most common types of cancer in women, as well as other types of cancer, their symptoms, the importance of early diagnosis and treatment methods.

Most Common Cancer Types in Women

• Breast Cancer

• Cervical Cancer

• Uterine Cancer

• Ovarian Cancer

• Thyroid Cancer

• Skin Cancers

• Laryngeal Cancers

• Pancreatic Cancer

• Stomach Cancer

• Colon Cancer

• Liver Cancer

Breast Cancer

What Is Breast Cancer?

Breast cancer, whose incidence has been increasing especially in recent years, is among the leading cancers in women. Breast cancers, whose mortality is significantly reduced when detected early through effective screening programs, are seen in 1 in every 8 women worldwide and in 1 in every 12 women in Türkiye. Breast cancer occurs when the cells lining the milk glands and ducts in the breast multiply uncontrollably and spread throughout the body; it can spread first to the immediate surroundings and later to the lymph nodes close to the breast. The true cause of breast cancer, in which early diagnosis is very important, is still not fully known, and two-thirds of women who develop breast cancer have no risk factors.

Who Is at Risk?

• Women (The incidence of breast cancer is higher in women than in men),

• Women aged 50-70 years, in the postmenopausal period,

• Those with a family history of breast cancer (Cancer is present in the family of 20-30% of all breast cancer patients. The risk is higher especially for those with cancer in first-degree relatives such as mother, sister or daughter),

• 5-10% of breast cancers occur due to changes in the BRCA1 and BRCA2 genes inherited from the mother or father.

• Patients who have previously had breast cancer (In these patients, the risk of cancer developing in the other breast is 3-4 times higher),

• Patients in whom a benign tumor was detected by a previous biopsy (These patients need to be followed closely, because these tumors also carry a risk of cancer developing later),

• Those who have previously had benign breast diseases (irregular cell development and the presence of abnormal cells in the breast lobules increase the risk of benign breast diseases),

• Those who received radiation therapy, especially to the chest area, in childhood or adolescence,

• Those who started menstruating before age 12 and entered menopause after age 55,

• Women who have never given birth (The risk of breast cancer is higher in these women compared with women who have given birth several times),

• Those who have given birth but did not breastfeed their baby (There are studies showing that prolonged breastfeeding, especially for 1.5-2 years, reduces breast cancer),

• Those who had their first child after age 30,

• Alcohol and cigarette users,

• Those receiving long-term hormone therapy,

• Daughters of families living at a high socioeconomic level (These individuals tend to develop earlier and start menstruating at an early age; due to the diversity of education and employment opportunities, they marry later and have children later),

• People with overweight or obesity are at risk.

What Are the Symptoms?

Breast cancer is not a type of cancer that shows symptoms in its early stages. Therefore, if you have any of the symptoms listed below, please consult your doctor without delay.

• If a swelling has appeared in your breast or armpit for more than two weeks,

• A change in the shape or size of your breast; if asymmetry between the two breasts has recently appeared,

• If you feel a different pain in your breast during your menstrual period,

• Crusting or peeling at the nipple,

• Bloody discharge from the nipple,

• If the skin of the breast has taken on an orange-peel appearance,

• A change in the position of the nipple,

• If the nipple has been pulled inward,

• If there is hardness, swelling or a mass in the armpit, consult a specialist physician without delay.

Breast cancer can be detected early through certain diagnostic methods. These are:

Breast Self-Examination:

1. Lie flat on your back on a level surface and place your left arm under your head. Using your right hand, examine your left breast. Using the index, middle and ring fingers of your hand, make slow, small circular movements. While doing this movement, you need to use the flat parts of your fingers, not the fingertips. Pressing lightly on the top part of your breast, move your fingers around the entire circumference of your breast. Make sure you do not feel any unusual lump, swelling or hardness. Continue the breast examination with circular movements and light pressure until you return to the starting point. Then examine the nipple and armpit area in the same way with circular movements. After you finish the examination of your left breast, place your right arm under your head and examine your right breast with your left hand.

2. Stand in front of a mirror with your arms at your sides and your hands on your hips, standing upright and straight. Now you can carefully examine your breasts both from the front and from the sides. Check for differences in size and shape since your last examination, dimpling or puckering in the breast, and any unusual changes in the appearance and position of the nipples.

3. Perform the examination you did lying on your back while standing, raising your left arm above your head so that your armpit is stretched. In this way, check your armpit and breast again with circular movements.

4. Gently squeeze each nipple between your thumb and index finger. If any kind of inflammatory discharge or fluid comes from your breast, be sure to consult a physician. If you find any suspicious mass or thickening during your breast examination, consult your physician without panicking.

Physician Examination: Even if you have no complaints, if you are between 20 and 40 years old, you should be examined by an experienced general surgeon specializing in breast conditions once every three years; if you are over 40, once a year. During the examination, your doctor may come across benign breast masses. These breast masses are usually softer, have a smooth surface, are round and mobile. Cancerous masses, on the other hand, are harder, have an irregular surface, and are structures that adhere tightly to the tissue and therefore do not move easily.

Imaging Methods

With the capabilities of today's medical technology, breast imaging makes it possible to detect breast cancer at the earliest possible stage. Especially in recent times, breast cancers that cannot be felt by hand but can be detected by imaging methods are encountered more often. Commonly used imaging methods for the diagnosis of breast cancer:

Mammography: Mammography, the basic method in breast cancer diagnosis, is one of the imaging methods that enables the evaluation of breast diseases using low-dose X-rays. With this method, which is accepted as the gold standard, small masses and changes that cannot be detected by examination can be seen. The breast is compressed between two plates and images are taken in different positions. The World Health Organization (WHO) supports every woman having a screening mammogram once a year from the age of 40. It has been observed that breast cancer mortality is reduced by 33% in those who undergo regular screening mammography.

Ultrasonography: It is one of the auxiliary tests to mammography. It performs imaging with the help of ultrasonic sound waves. The reflections of the sound waves are collected by a computer and an image is formed on the screen. It provides information about the internal structure of masses detected on mammography. It also gives preliminary information about distinguishing benign masses from malignant ones. It is one of the preferred methods, especially in young patients, because it provides more information than mammography.

Magnetic Resonance Imaging (MRI): Magnetic resonance imaging, which has started to be widely used today, is considered one of the most sensitive imaging methods for breast cancer when used in the right place and at the right time, due to its ability to combine structural findings with functional findings.

Biopsy: It is the method of taking a sample from a mass suspected of being breast cancer for pathological examination. A tissue sample is taken from the suspicious mass using a fine needle, an automated core needle or surgical technique, and sent for pathological examination.

Early Diagnosis and Treatment

Making a diagnosis at an early stage is life-saving. In the early diagnosis of breast cancer, it will be advantageous for women aged 20-40 to have a physician examination once every three years, and for women over 40 to have a mammogram along with a physician examination once a year.

Surgical Methods Applied in Breast Cancer

When the diagnosis is made at an early stage, the survival rate rises above 90%. Surgery is one of the important treatment methods in breast cancer. The tumor is removed by surgery, and then adjuvant treatments are started in order to prevent the tumor from recurring and spreading to other organs. One of the most important studies on breast cancer is the research aimed at preserving the lymph nodes. In the past, when spread to the lymph nodes of the armpit was seen, the lymph nodes were removed directly even if the spread had not reached the lymph tissue. This caused swelling of the arm, functional impairments and, most importantly, psychological disorders in patients. With the newly developed Sentinel Lymph Node Biopsy, instead of intervening in the entire lymph tissue, only the area where spread has occurred is removed; the patient is spared an unnecessary and exhausting surgical procedure.

Surgeries performed in breast cancer treatment can be grouped under 3 headings:

Radical Mastectomy: The entire breast is removed along with the cancerous tissue; a silicone prosthesis or reconstruction with the patient's own tissues can be performed at the same time or later.

Skin-Sparing Mastectomy: The entire breast tissue is removed, but the breast skin can be preserved. A natural appearance is provided by placing a silicone prosthesis in place of the removed tissue.

Breast-Conserving Surgery: With this type of surgery, the tumor and a certain amount of surrounding breast tissue are removed together and the breast is left in place. Thus, both a natural appearance and the patient's psychological state are preserved. After surgery, radiotherapy is applied for 5-7 weeks in order to prevent the disease from recurring. Breast-conserving surgery is absolutely not performed on pregnant women, on patients with multifocal tumors within one breast, or on those who have previously received radiotherapy to this area.

What Is Cervical Cancer?

It is one of the most common types of cancer in women worldwide. Its biggest difference from other female cancers is that it can be detected at an early stage if regular screening tests are performed, and that the success rate of treatment is high when it is detected early. Cervical cancer is a cancer that develops in the neck of the uterus, called the 'cervix'. The cervix is the lower part of the uterus, an organ of the reproductive system that connects the uterus and the vagina. It consists of two sections. The outer section, described as the ectocervix, is close to the vagina; the inner section, described as the endocervix, is close to the uterus. Most cancers are seen in the area where these two sections meet. Cervical cancer occurs when the cells of the layer lining the uterine cavity (endometrium) undergo change due to external factors and grow in an uncontrolled manner. The endometrial layer is a tissue sensitive to hormones released by the ovaries or taken from outside. If hormonal disorders are not diagnosed and treated, cancer may develop in the inner layer of the uterus as a result of cellular changes over time.

Who Is at Risk?

• Women aged 35-55 years (However, since there is a risk of cancer also in those over 65, PAP Smear testing is recommended to be performed regularly, at least until age 70, in all sexually active women or all women over 18),

• Those who have had an HPV infection (This sexually transmitted infection is very common. It is known that 3 out of every 4 people aged 15-49 have had an HPV infection at some point in their lives. Since this infection is temporary and harmless, a person does not even notice that they have had such an infection. For this reason, people with HPV need to be checked at frequent intervals.),

• Those carrying the HIV virus that causes AIDS (Since the immune system of those carrying this virus is weakened, their risk of developing cervical cancer is higher),

• Those who have had a Chlamydia infection (It is a bacterium that frequently causes infections in the female genital system, does not show symptoms and is transmitted sexually. An increased risk of cervical cancer has been observed in women who have had this infection)

• Those who had sexual intercourse at an early age,

• Women with more than one sexual partner,

• Those who have sexual relations with an uncircumcised male partner,

• Men with more than one sexual partner,

• Not using any method of contraception during sexual intercourse,

• Those who do not pay attention to genital hygiene,

• Smokers (They are at 2 times higher risk than non-smokers),

• Those who do not undergo regular health checks due to low socioeconomic status,

• Those with a family history of cervical cancer (in their mother or sister),

• Those who do not have regular PAP Smear tests,

• People with overweight or obesity are at risk.

What Are the Symptoms?

A significant decrease in the number of women with cervical cancer has begun to be seen with the PAP Smear Test, which is used in screening for cervical cancer, the only gynecologic cancer type that can be prevented each year through regular checks. Changes in the cervix that have not turned into cancer can be detected with the PAP Smear Test. Especially with regular PAP Smear tests performed over the last 50 years, deaths from cancer have decreased by 70%. Although cervical cancer may appear to emerge suddenly, it progresses insidiously, showing some changes that are not given much attention. Symptoms appear when cells turn into cancer and begin to spread to other organs. The best-known symptoms seen in the early stages of cervical cancer are: bloody or yellow, foul-smelling vaginal discharge; painful urination; abnormal vaginal bleeding after sexual intercourse or between menstrual periods; menstrual bleeding that is heavier than normal or lasts longer; and pain during and after sexual intercourse. Depending on the area of spread of the tumor, symptoms such as constipation, bloody urine, leg pain and edema may also occur. Although these symptoms also appear among the symptoms of other diseases, it will be the right choice to consult your doctor immediately.

Early Diagnosis and Treatment

The 5-year survival chance of those who develop cervical cancer is over 70% in the early stage. Since it is a type of cancer that does not show symptoms in its early stage, the rate of it going unnoticed on physical examination is very high. For this reason, action should first be taken based on an abnormal PAP Smear test result. If a risk factor is seen as a result of the PAP Smear test, a biopsy is performed if necessary after an examination with colposcopy (a device that allows the cervix to be viewed in greater detail, magnifying it 6-40 times). The course of the disease and the treatment method to be chosen are determined by the type, location, stage and growth rate of the cancer, the patient's health status, age, and her response to treatment or the response she is expected to give to treatment. Although the main treatment method for the disease is surgery, radiotherapy comes into play at every stage.

Surgical Treatment: It is the most frequently used treatment method. The cervix and small tumors that have not spread beyond the cervix are removed as completely as possible. It is the most commonly used method, especially in the early stage. When surgical treatment is not sufficient, additional treatments may be applied.

Radiotherapy: It is a method used at every stage of cervical cancer. After surgical intervention, radiation treatment is given from outside the body, using high-energy rays directed at the area where the tumor is located.

Chemotherapy: In addition to radiotherapy, low-dose chemotherapy is also frequently applied.

Uterine Cancer

What Is Uterine Cancer?

It is one of the most common types of cancer in women. Its biggest difference from other female cancers is that it can be detected at an early stage and that the success rate of treatment is high. It is a type of cancer that forms in the uterus, the main reproductive organ of women, when the cells of the layer lining the inside of the uterus (endometrium) undergo change due to external factors and grow in an uncontrolled manner. The endometrial layer is a tissue sensitive to hormones released by the ovaries or taken from outside. If hormonal disorders are not diagnosed and treated, cancer may develop in the inner layer of the uterus as a result of cellular changes over time.

Who Is at Risk?

• People over 50 years of age,

• Those who started menstruating before age 12 and entered menopause after age 55 (When menstruation starts at an early age and ends later, the endometrium is exposed to estrogen for longer, so the risk of uterine cancer is high),

• Those who entered menopause late (Giving only the estrogen hormone during menopause treatment in this period increases the risk of uterine cancer. When the progesterone hormone is also given, hormonal balance is ensured and the cancer risk is eliminated),

• Women who have not given birth (Although it is not clear, there are studies suggesting that pregnancy reduces the risk of uterine cancer. Although the estrogen hormone, which poses a risk for uterine cancer, is secreted intensively during pregnancy, progesterone production has the property of preventing the harmful effects of this hormone.),

• Those who experienced menstrual irregularities or delayed periods at a young age (Women with irregular menstruation also carry a risk of uterine cancer because their exposure to estrogen increases. Among the causes of irregular menstruation are obesity and Polycystic Ovary Syndrome. The risk of uterine cancer can also be reduced by treating these diseases),

• Obese patients (Obese patients, who have dense adipose tissue, are also at risk, because adipose tissue secretes estrogen and increases the estrogen level in the body. The risk of this disease in obese women is 3 times higher than in thin women.),

• Diabetic patients,

• Hypertensive patients,

• Those with ovarian tumors,

• Those who have had breast or ovarian cancer are at risk.

What Are the Symptoms?

Since it appears in the postmenopausal period, the chance of early diagnosis of this cancer is very high. The most common symptoms are vaginal bleeding. Any bleeding in the postmenopausal period, prolongation of the menstrual period or bleeding between periods in women who menstruate, non-bloody abnormal discharge, pelvic pain, pain during sexual intercourse and weight loss are among the symptoms. Patients with such complaints should consult a specialist physician without losing time. The patient's history is taken. A pelvic examination is performed, endometrial thickness and structure are evaluated, and a biopsy is taken. After the definitive diagnosis, the patient is referred to a gynecologic oncologist who is a specialist in this field.

Early Diagnosis and Treatment

Uterine cancer is a disease that can be treated immediately when diagnosed early and whose results you can see. In the early stage, the 5-year survival rate of patients is over 90%. For this reason, it is very important to have an examination with a gynecologist every year to protect yourself from uterine cancer. Although the main treatment method is surgery, chemotherapy and radiotherapy can also be applied.

Surgical Treatment: It is the most frequently used treatment method. The uterus, ovaries and fallopian tubes are removed; in addition, regional cleaning and sampling of surrounding tissues are also performed. Additional treatments may be applied when surgical treatment is not sufficient.

Chemotherapy: If, after surgery, the uterine cancer is found to be at an advanced stage and to have spread to other organs, chemotherapy is applied to kill the cancer cells. After treatment, patients are followed up at regular intervals and subjected to certain tests.

Radiotherapy: If there is a risk of the cancer recurring after surgical intervention, radiation therapy is performed following removal of the uterus.

Hormone therapy: If the cancer has spread, high doses of progesterone hormone may be given in order to reduce the spread and stop the growth of the tumor.

Ovarian Cancer

Ovarian cancers, the majority of which occur in the postmenopausal period, are the most difficult to treat among female cancers. This type of cancer, which progresses insidiously and shows symptoms only in advanced stages, can threaten life. This cancer type, seen in about 12 out of every 1,000 women, can reach a cure rate of 90% if caught in the early stage.

The ovaries are a pair of organs located on either side of the uterus. Ovaries, which are about the size of an almond, perform the function of producing eggs and secreting female hormones (estrogen and progesterone). Ovarian cancer forms through uncontrolled division and proliferation of the epithelial cells that are found in the ovarian tissue and form the main structure of the ovary. The most common type of ovarian cancer (in 90% of cases) is epithelial ovarian cancer, which forms in the surface layer of the ovary.

Who Is at Risk?

• Those aged 40 and over (ages 75-79 are the period when it is seen most often),

• Those who have entered menopause,

• Those with genetic factors (Approximately 5-10% of ovarian cancers develop for genetic reasons. For this reason, women who have 2 or more breast, ovarian or uterine cancers among their first-degree relatives are at risk. If there are two or three people with ovarian cancer in the family, the risk is 7%; if the mother or sister has ovarian cancer, the risk is 5%),

• Hormonal treatments given during menopause (treatments predominantly based on estrogen increase the risk of cancer),

• Those who have never been pregnant (They carry a 2 times higher risk compared with those who have given birth),

• Those with frequent and numerous uninterrupted ovulations,

• Those receiving infertility treatment,

• Those following a severe diet and an incorrect nutrition program,

• Those with low serum selenium levels,

• Those using talcum powder in the genital area,

• Those affected by environmental factors (This cancer is seen more often in developed countries),

• Women who have previously had breast cancer are at 2 times higher risk compared with women who have never had it.

What Are the Symptoms?

Two-thirds of ovarian cancers can be diagnosed in an advanced stage. The biggest reason it does not give symptoms is that the cancer grows within the abdominal cavity and does not bother the patient for a long time. In advanced stages, it shows symptoms such as abdominal pain, groin pain, a constant urge to urinate and defecate due to a feeling of pressure in the groin, indigestion, abdominal bloating and weakness. Some patients may also experience gas and digestive disturbances. In the most advanced stage, symptoms such as marked weight loss, loss of appetite, discomfort in the lower abdomen, nausea, fatigue, shortness of breath, a mass in the pelvis, a feeling of downward pressure with the associated frequent urge to urinate, and vaginal bleeding appear. The complaint that most often leads an ovarian cancer patient to see a doctor is excessive abdominal swelling. The cause of this swelling is most often fluid accumulation (ascites) in the abdomen.

Early Diagnosis and Treatment

Early diagnosis is life-saving in this type of cancer as well. Approximately 50% of women diagnosed with ovarian cancer are still alive even after five years. This figure reaches 90% in patients with limited ovarian cancer. This disease, which is seen more frequently in developed countries, does not show symptoms in the early stage and may present with different symptoms in each woman. Furthermore, when ovarian tumors are small, they are very difficult to detect even by examination and rarely give symptoms. The PAP Smear test, which is the screening test for cervical cancer, has no benefit in the early diagnosis of ovarian cancer. Today there is still no test that can be used for screening in women both at risk and not at risk and that gives a definitive result. For this reason, every woman who has reached the age of 18 and has an active sex life should have a gynecological examination once a year and undergo the necessary screening tests. If ovarian cancer gives early symptoms, the chance of diagnosis and treatment increases. In women with a family history of ovarian cancer or who are at risk of developing cancer, evaluation can be made with transvaginal ultrasonography (an ultrasonography method performed with a small device placed inside the vagina) and blood tests. In blood tests, the CA-125 level is measured. In women with ovarian cancer, the level of CA-125 protein in the blood rises. This increase can also be seen in other conditions that are not cancer (such as early pregnancy, heavy cigarette consumption and uterine diseases). When the value is high, imaging methods are used to check whether there is fluid in the abdomen; if fluid accumulation is present, a sample is taken from the fluid or directly from the ovaries and examined. A definitive diagnosis is made by pathological evaluation. If cancer is diagnosed, surgery continues under the gynecologic oncologist, and depending on the area to which the cancer has spread, the uterus, fallopian tubes, ovaries and peritoneum may be removed. In addition, samples are taken from other organs within the body (such as adjacent lymph nodes, intra-abdominal fluid and the diaphragm), and the stage of the disease is determined. A complete diagnosis of the disease is made only by pathological examination of the tissues removed during surgery. After the surgical intervention, the form and program of treatment are determined taking into account the stage of the disease, the patient's age and general health status. After surgical intervention, chemotherapy is used in almost all ovarian cancers. Chemotherapy is generally given on an outpatient basis. Although it varies depending on the drugs used, some side effects such as nausea, vomiting, hair loss, muscle pain, mouth sores, a tendency to infection and weakness may occur. These effects will pass after treatment. Treatment of ovarian cancer requires physicians from many specialties, such as gynecologist, oncologist, radiotherapist, chemotherapist, pathologist, dietitian and psychiatrist, to work together. After the patient's treatment is completed, a physical examination and CA-125 measurement are performed every three months during the first two years; chest X-ray and abdominal tomography are reviewed when deemed necessary. In the following three years, these checks are performed every six months; after the fourth year, they are performed once a year.

Thyroid Cancer

It is a type of cancer formed by excessive multiplication of the cells located in the thyroid gland. It usually presents as a mass or nodule in the neck. The thyroid gland is an organ located in the neck, weighing 20-25 grams, which regulates the metabolism of the entire body with a hormone it produces using iodine. Although its cause is not yet fully known, it is seen less frequently than other cancer types and the course of the disease is quite good. Thyroid cancer is not a single uniform cancer. According to frequency, it is divided into 4 groups: Papillary Cancer, Follicular Cancer, Medullary Cancer and Anaplastic Cancer.

Types of Thyroid Cancer

Papillary Thyroid Cancer: It constitutes 75-80% of thyroid cancers. It generally has a good course. It begins to be seen between the ages of 20 and 50, and its frequency increases between the ages of 30 and 40. This type of cancer, which spreads through the lymph nodes, can spread to the lymph nodes in the neck and to the lungs. It can exist for a long time without showing any symptoms and without causing death. It progresses more rapidly in the elderly than in young people. Spread of the cancer to the lymph nodes in the neck does not carry a poor prognosis in young people; however, in patients over 40 it indicates that the disease will progress rapidly. This type of cancer is encountered in 2% of Türkiye's population.

Follicular Thyroid Cancer: It constitutes 15% of thyroid cancers. It is seen more frequently in the 50s and in women. It is the thyroid cancer type whose diagnosis is the most difficult. It spreads through the vessels and the capsule of the thyroid gland. Spread to other organs such as the lungs, bones, liver and brain is rare but does occur. In those with vascular spread, the cancer progresses more rapidly.

Medullary Thyroid Cancer: It has a tendency to increase the calcium level in the blood and constitutes 6-8% of thyroid cancers. Family members of people with this type of cancer also need to be screened for the disease. Flushing, diarrhea and fatigue may be seen in 30% of patients with medullary cancer. The entire thyroid gland is removed by surgery. If spread is seen in the lymph nodes, they are removed during surgery. Afterwards, the calcitonin level (a hormone secreted by the C cells found in the thyroid gland that acts on the bones) is measured. A high level means that the disease has recurred. Tests such as ultrasound, tomography, MRI, sestamibi scintigraphy, MIBG scintigraphy, DMSA scintigraphy and octreotide scintigraphy are performed to locate the cancerous area.

Anaplastic Thyroid Cancer: It is the least common type of thyroid cancer. The mass in the thyroid develops and grows very rapidly. In cases where it makes breathing difficult, the trachea may need to be removed. Radiotherapy and chemotherapy are applied.

Who Is at Risk?

• Women (seen more frequently than in men),

• Patients with a nodule in the thyroid gland,

• Those who received radiation therapy to the head and neck area in childhood,

• Those exposed to radioactive substances; although its cause is not fully known, it is seen more frequently in people exposed to certain radioactive substances such as uranium (), so those exposed to radioactive substances are at risk.

What Are the Symptoms?

Many patients with thyroid cancer may have no complaints. In most patients, spread to other organs can also be detected at the time of diagnosis. Although the disease does not show many symptoms, symptoms such as swelling in the neck, a feeling of tightness in the throat, pain, difficulty swallowing, difficulty breathing, hoarseness, weight gain, irritability, hair weakness and dry skin are observed.

Early Diagnosis and Treatment

With early diagnosis and treatment, the disease can be completely eliminated. To make a diagnosis, tests are first performed to determine the amount of hormones in the blood. In addition, ultrasonography is performed; if a mass is seen on examination, a biopsy is required for a definitive diagnosis. When a diagnosis is made, the patient is operated on and the thyroid gland is removed surgically, and then a personalized treatment method is started. With the developed technology, it is possible for the patient to return home on the same day after minimally invasive laparoscopic (closed) surgery with only a small scar. Patients with papillary and follicular cancer are exposed to high doses of radioactive iodine in shielded hospital rooms, depending on the degree of spread of the cancer, with the aim of destroying cancer cells remaining elsewhere in the body. Throughout the treatment process, the TSH value is kept under constant control so that the possibility of the cancer recurring can be prevented.

Skin Cancers

Melanoma, a life-threatening skin cancer, is the type with the worst course among skin cancers. It can occur in approximately 1 million people per year; it can form on normal skin without warning, as well as on a pre-existing mole. It is formed by excessive and uncontrolled proliferation of melanocytes, which produce melanin, the pigment that gives color to the skin and enables tanning, and it has the property of spreading.

Who Is at Risk?

• Especially fair-skinned people who are excessively exposed to sunlight (Dark skin does not have a protective effect against this cancer. In people with dark skin, this type of cancer is more commonly seen on the soles of the feet, palms, under the nails or, very rarely, inside the mouth),

• Having a history of skin cancer in the family,

What Are the Symptoms?

It can form on normal skin without warning, as well as on a pre-existing mole. Although this makes early diagnosis more difficult, when symptoms such as peeling, oozing, bleeding, or changes in the color, shape or size of moles on the body, or swelling or raised areas on a mole, appear, it is essential to consult a dermatologist. Dermoscopy is a very important aid used to determine whether moles are skin cancer. A definitive diagnosis of skin cancer can be made by pathological examination of the tissue removed surgically.

Early Diagnosis and Treatment

With early diagnosis of melanoma and the treatment applied, the patient's chance of survival is high. However, if it is not noticed in the early stage, there is a risk of it spreading throughout the whole body, starting from the lymphatic system.

Ways of Prevention

To protect against the disease, it is especially important not to be directly exposed to the sun between 10:00 and 16:00, when the sun is most effective; to prefer light-colored clothing that reflects sunlight; to use multi-factor protective creams; and not to stay in the sun for long periods in order to obtain a tanned skin. In addition, starting from once a month, the whole body should be checked in front of a mirror.

Laryngeal Cancers

One of the cancer types most closely associated with smoking is laryngeal cancer. Approximately 95% of patients with laryngeal cancer are smokers. It occurs when some cells in the larynx area multiply uncontrollably and form a tumor.

Who Is at Risk?

• The risk of laryngeal cancer in smokers is 5-30 times higher than in non-smokers.

• Those who consume excessive alcohol in addition to smoking are particularly more prone to laryngeal cancer than a healthy person.

• Those who prefer an incorrect and poor diet are also at risk.

• Those working in sectors such as woodworking, petroleum and paint industries have a higher probability of developing laryngeal cancer than those working in other sectors.

What Are the Symptoms?

Early-stage symptoms include hoarseness lasting more than two weeks, changes in voice quality, a feeling of something stuck in the throat, and pain in the throat and ears; advanced symptoms include shortness of breath, difficulty swallowing, pain during swallowing and bloody sputum. If the cancer has spread to the lymph nodes in the neck as it progresses, swellings growing on the side of the neck may be seen.

Early Diagnosis and Treatment

For early diagnosis of laryngeal cancer, which manifests with hoarseness and changes in voice quality, if complaints such as hoarseness lasting more than two weeks, a feeling of something stuck in the throat, or pain in the throat and ears are present, be sure to consult an ear, nose and throat specialist. If laryngeal cancer is suspected, the patient is examined, and if an abnormal formation is seen, a biopsy is taken from the suspicious area for a definitive diagnosis. The form of treatment is determined taking into account factors such as the location, size, stage and potential for spread (metastasis) of the tumor, as well as the patient's health status and age. Depending on the location and size of the tumor, surgical intervention, which is the most frequently used and, in many laryngeal cancers, the most effective treatment, can be performed; radiotherapy and chemotherapy can also be applied.

Pancreatic Cancer

The pancreas is an organ located in the very back part of the abdomen, approximately 15 cm long, whose front surface is completely covered by the stomach, the duodenum and the large intestine. Its endocrine secretion produces insulin, which regulates blood sugar, and its exocrine secretion produces pancreatic juice, which regulates the digestion of food in the duodenum. It is one of the most vulnerable organs of the body. It consists of a rich network of lymph vessels and nerves. Pancreatic cancer, which spreads very rapidly to surrounding organs, is the fourth deadliest cancer in the world.

Who Is at Risk?

• Those aged 50 and over,

• Men,

• Those with a family history of pancreatic cancer,

• Smokers,

• Alcohol users,

• Those who are overweight,

• Those who have had gallbladder surgery,

• Those whose diet is heavily based on meat and fatty products, moving far away from healthy eating,

• Those exposed for a very long time to chemicals such as gasoline and insecticides,

• Diabetic patients are at risk.

What Are the Symptoms?

The pancreas is a type of cancer that progresses insidiously; therefore, it may not show symptoms until the final stages of the disease. Alcohol may be seen as the most important cause of the disease. Loss of appetite, weight loss, nausea, jaundice, sudden-onset diabetes, back pain and pain radiating across the abdomen in a belt-like pattern are among the symptoms.

Early Diagnosis and Treatment

Because pancreatic cancer shares similar features with some other diseases, it also reduces the chance of early diagnosis. If cancer starting in the pancreas is noticed before it spreads to the lymph nodes, the 5-year survival chance can rise from 5% to 16%. The examination determines the stage of the pancreatic tumor and whether spread is present. If the tumor is in the head of the pancreas, intervention is not an option because it is not possible to remove only the head part of the pancreas. If the tumor is suitable for surgical removal, the 'Whipple Operation' is preferred because it provides the best quality of life. Surgery is not performed on advanced tumors. Together with chemotherapy, some measures to improve quality of life can be carried out, such as correction of jaundice, provision of nutritional support and reduction of pain:

• Placement of a stent in the bile duct by performing ERCP (an endoscopic method used to diagnose problems such as stones, tumors or chronic inflammation that may cause obstruction or narrowing in the bile ducts or pancreatic duct),

• Draining bile outside the body by performing PTK,

• Inserting a catheter for pain to reduce the sensation of pain,

• Placing a stent in the duodenum in tumors causing obstruction there,

• Concurrent chemoradiotherapy in locally advanced pancreatic cancer; chemotherapy in metastatic cases.

Stomach Cancer

Stomach cancer, one of the most common types of cancer in our country, ranks second among the cancers seen in women, after breast cancer. While the number of people with this cancer is decreasing worldwide, it is increasing in Türkiye. Tumors that develop in the mucosal layer, particularly on the lesser curvature of the stomach located in the upper left area of the abdomen, cause this cancer. This cancer, which is seen most often in the Black Sea and Eastern Anatolia regions in Türkiye, is seen in the world in Far Eastern countries such as Japan and China as well as in Northern European countries. Unhealthy eating habits (excessive consumption of salty foods, consumption of raw meat, eating burnt meat, insufficient consumption of vegetables and fruits, etc.) play an important role in the development of stomach cancer.

Who Is at Risk?

• Men, who have stomach cancer at twice the rate of women,

• Those over 50 years of age (today the age of developing stomach cancer has dropped to 30),

• Those working with asbestos and rubber,

• Coal miners,

• Those working in tire and petrochemical production,

• Those engaged in fishing,

• Those who consume large amounts of heavily smoked, salted, additive-containing or fried foods,

• Those who consume processed meats containing nitrites and nitrates, such as sucuk, salami and sausages,

• Those who consume large amounts of red meat,

• Those who started smoking, particularly at a young age (they carry twice the risk compared with non-smokers),

• Those who have previously had stomach surgery (the first 20 years after stomach surgery is the period of highest risk),

• Those who have had a Helicobacter infection (the risk of developing stomach cancer is 4 times higher than in a healthy person),

• Those with polyps in the stomach,

• Those who consume poor-quality drinking water,

• Those with pernicious anemia based on vitamin B12 deficiency,

• Those with atrophic gastritis,

• Those with a family history of stomach cancer,

• Heavy smokers,

• Those with blood group A (Although the reason is not fully known, they carry a higher risk than people with other blood groups),

• Patients with overweight and obesity are at risk.

What Are the Symptoms?

Stomach cancer is also one of the diseases that progresses insidiously. It usually gives symptoms in the advanced stages of the disease. For this reason, individuals at risk can only have their disease diagnosed through endoscopic examination. In people with stomach cancer, symptoms may appear as a result of serious nutritional problems or as a result of the tumor spreading extensively. These symptoms are generally pain in the stomach area, a feeling of heaviness in the stomach, loss of appetite, marked weight loss, abdominal pain, bloating and discomfort after meals, nausea, vomiting, fatigue, and bleeding in the stomach or intestine, which usually proceeds covertly.

Early Diagnosis and Treatment

Stomach cancer usually presents with complaints of indigestion. However, at this stage, both the patient and the doctor must take this complaint seriously, and gastroscopy must be performed on the patient to investigate the possibility of stomach cancer. The most important step in the diagnosis of this cancer is gastroscopy and biopsy. The most effective treatment method for stomach cancer is surgery. However, for this surgery to be effective, the disease must be noticed and intervened in during its early stages. After surgery, chemotherapy or radiotherapy can be applied depending on the type of cancer.

Ways of Prevention

• Early diagnosis is very important in cancer. Do not neglect your regular check-ups.

• Eat plenty of fresh fruits and vegetables (tomatoes, carrots, potatoes).

• If you smoke or use alcohol, be sure to quit.

• Stay away from overly spicy foods.

• Hot and cold drinks and artificial foods can lead to stomach cancer.

• Reduce the use of animal fats.

• Exercise regularly.

Colon Cancer

Colon cancer, a disease that affects approximately 1 million people worldwide every year, is steadily increasing in Türkiye. It is a disease in which poor diet plays an important role; it is seen more frequently in men than in women. It is a type of cancer caused by polyps that develop in the large intestine, called the colon. Colon cancer, which is seen more frequently particularly in Western countries, ranks 3rd in frequency worldwide. Although its cause is not precisely known, environmental and genetic factors are involved in the development of colon cancer. Colon cancer may arise from the base of a polyp developing in the colon, as well as from the mucosa forming the inner surface.

What Are the Symptoms?

It is a disease that progresses insidiously and does not show symptoms for many years. In advanced stages, it presents with a palpable mass in the abdomen, blood in the stool, loss of appetite, easy fatigue, changes in bowel habits in the form of diarrhea or constipation, stools becoming thin like a pencil, the feeling of being unable to fully empty the bowels, pallor due to occult blood loss, mucus in the stool, and weight loss.

Who Is at Risk?

• Those with colon cancer in their family,

• Those who have polyps in their intestine,

• Those who have previously had breast, uterine and ovarian cancer,

• Those who have had Gardner Syndrome and Familial Polyposis,

• Those with Ulcerative Colitis and Crohn's Disease,

• Those aged 50 and over,

• Those on a Western-type diet,

• Those who consume more animal fats and red meat,

• Those who consume excessive cigarettes and alcohol,

• Those who live a life away from exercise,

• Obese patients are at risk.

Early Diagnosis and Treatment

Since the disease progresses insidiously, the process of noticing it may be delayed; however, if it is diagnosed early through regular screening tests, the likelihood of overcoming this disease with treatment increases. In particular, people with a family history of colon cancer need to have the following tests done regularly.

• Annual testing for blood in the stool; if the occult blood test is positive, colonoscopy (imaging of the entire large intestine),

• Endoscopy of the rectum and the last 50 cm of the large intestine every five years (rectosigmoidoscopy),

• Colonoscopy every ten years (people with colon cancer in their family history need to have this test every year under physician supervision)

In our country, colon cancers cannot be detected at the initial stage because doctors are not consulted when symptoms appear. The main treatment for colon cancer in all stages is surgery. The tumor-containing area is removed by surgical methods, and the upper and lower ends of the removed part of the intestine are joined together. However, the type of surgical treatment varies depending on the location, size and stage of the tumor and the problems it has caused for the patient (if the tumor is located close to the anus, the anus is removed entirely because this area is short, and the colon is attached to the abdominal wall). After surgery, treatment continues with chemotherapy according to the stage of the disease. Radiotherapy is not used in this disease.

Ways of Prevention

Nutrition with high-fiber foods protects against colon cancer. Since there is a direct relationship between fatty foods and colon cancer, it is necessary to consume low-fat foods, to stay as far away as possible from red meat and fatty foods, and to exercise regularly. Another way to protect against colon cancer is to have regular check-ups. With these check-ups, it is possible to prevent the disease and make an early diagnosis. In recent years, studies have found that consuming calcium-rich foods and nonsteroidal anti-inflammatory drugs also contribute protective effects.

Liver Cancer

Liver cancer is abnormal growth of the cells in the liver. The liver has very important tasks, such as removing harmful substances from the body, producing bile, which enables the digestion of fats, storing sugar and producing proteins. Due to its importance in the body and its cellular structure, it is among the highest-risk and most common types of cancer. Cirrhosis (caused by alcohol) and Hepatitis B and C infections play an important role in its development. In patients who have developed cirrhosis for any reason, the annual risk of developing HCC is 3-5%. In addition, aflatoxin found in moldy foods (especially grains) is also an important cause of the disease.

Types of Liver Cancer

There are two types of liver cancer: primary and secondary. If the cancer started within the liver and spreads from there, it is described as primary; if it started in another organ and later spread to the liver, it is described as secondary. The most common organs where secondary liver cancer begins are the lungs, breast and large intestine. The most common primary liver cancer types are:

Hepatocellular Carcinoma: It frequently occurs in association with cirrhosis and Hepatitis B or C infections. In addition, all diseases that cause cirrhosis also predispose to HCC. It is the most common type of primary liver cancer, at 75%. It is most common between the ages of 40 and 60 and is seen 5 times more often in men than in women. It presents with enlargement of the liver, fluid accumulation in the abdomen (this fluid may also be bloody), severe pain in the abdominal area, weakness, loss of appetite, weight loss and a feeling of a mass in the abdomen. However, a definitive diagnosis can be made by performing a liver biopsy.

Cholangiocarcinoma: It is a rarely seen type of cancer arising from the cells of the bile ducts. The disease, which presents with abdominal pain, weakness, fever and weight loss, is generally seen between the ages of 50 and 70. It is definitively diagnosed by ultrasound, CT, elevated ALP and biopsy.

Who Is at Risk?

• Those who consume alcohol,

• Patients with Hepatitis B and Hepatitis C,

• Patients with chronic liver disease,

• Those with a family history of liver cancer are at risk.

What Are the Symptoms?

Liver cancer is an insidious disease. For this reason, it does not give symptoms in the early stage. When it is diagnosed, the disease has usually reached advanced stages. As the cancer grows, it reveals itself with widespread and marked pain on the right side of the abdomen. In the advanced stage, this severe abdominal pain may be accompanied by symptoms such as loss of appetite, weakness, marked weight loss, jaundice of the skin, fluid collecting in the abdomen, abdominal swelling and easy fatigue. Because it has almost the same symptoms as cirrhosis, if it is not examined carefully, the patient may be diagnosed with cirrhosis. At this point, it is very important to consult a specialist physician.

Early Diagnosis and Treatment

Although the chance of early diagnosis in liver cancer is very low, through regular check-ups you can detect the disease before it reaches advanced stages. The diagnosis of the disease can be made with ultrasonography, computed tomography and magnetic resonance imaging. Alpha-fetoprotein testing is also performed. The main treatment for this disease is surgical removal of the tumor. In patients with adequate liver function, the entire mass can be removed surgically (if the tumor is confined within the liver); if the patient is not suitable for surgery, chemoembolization (a treatment aimed at limiting the growth of the mass by administering drugs into the hepatic artery) is applied. Chemotherapy, which is applied in other cancer types, is not an effective method used in liver cancers.