Common Types of Cancer in Women

Cancer is one of the diseases whose frequency is increasing both worldwide and in our country. Every year, millions of people in the world and approximately 150 thousand 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.

With regular check-ups and at least one check-up per year, cancer can be detected early, diagnosed, and treated.

Early diagnosis increases not only the patient’s life expectancy but also quality of life. Therefore, in addition to cancer treatment, early diagnosis is also of vital importance.

At Hisar Intercontinental Hospital, our Medical Oncology Unit follows and treats patients diagnosed with cancer. In this section, prepared with 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 cancer types, their symptoms, the importance of early diagnosis, and treatment methods.

Common Types of Cancer 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?

It is among the cancers whose incidence has increased in women, especially in recent years. Breast cancers, for which mortality has decreased significantly when effective screening programs allow early diagnosis, are seen in 1 out of every 8 women in the world and 1 out of every 12 women in Turkey. Breast cancer develops as a result of the uncontrolled proliferation of the cells lining the milk glands and ducts in the breast and spreading throughout the body. It may first spread to the surrounding area and then to the lymph nodes near the breast. The exact cause of breast cancer, for which early diagnosis is very important, is still not fully known, and two-thirds of women with breast cancer develop the disease despite having no risk factors.

Who Is at Risk?

• Women (breast cancer is more common in women than in men),

• Women between the ages of 50 and 70 who are postmenopausal,

• Those with a family history of breast cancer (in 20–30% of all breast cancers, there is a family history of cancer. In particular, the risk is higher in those whose first-degree relatives such as mother, sister, or daughter have had cancer),

• 5–10% of breast cancers are caused by changes in the BRCA1 and BRCA2 genes inherited from the mother or father.

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

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

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

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

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

• Women who have never given birth (the risk of breast cancer is higher than in women who have given birth many times),

• Those who have given birth but did not breastfeed their baby (studies show that long-term breastfeeding, especially for 1.5–2 years, reduces breast cancer),

• Those who gave birth to their first child after the age of 30,

• Alcohol and cigarette users,

• Those receiving long-term hormone therapy,

• Daughters of families with a high socioeconomic level (these individuals develop earlier and begin menstruating at an earlier age; due to variety in education and job opportunities, they marry and have children later),

• Those with obesity or weight problems are at risk.

What Are the Symptoms?

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

• If you feel a lump in your breast or armpit for more than two weeks,

• If there is a change in the shape or size of your breast; if there is newly developed asymmetry between the two breasts,

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

• If there is crusting or peeling on the nipple,

• If there is bloody discharge from the nipple,

• If the breast skin has a peau d'orange appearance,

• If there is a change in nipple position,

• If the nipple is pulled inward,

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

There are certain diagnostic methods for the early detection of breast cancer. These are:

Self-Examination: 1. Lie on your back on a flat surface and place your left arm under your head. Use your right hand to examine your left breast. Using the index, middle, and ring fingers of your hand, make small circular motions slowly. While doing this, you should use the flat parts of your fingers, not the fingertips. By pressing lightly on the upper part of your breast, move your fingers around the entire breast. Make sure that you do not feel any unusual lump, swelling, or hardness. Continue your breast examination with circular motions and light pressure until you return to the starting point. Then examine the nipple and armpit area in the same way using circular motions. After finishing 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 resting on your hips. Now you can carefully examine your breasts from both the front and the side. Determine whether there are differences in size and shape since your last examination, dimpling, retraction, or unusual changes in the appearance and position of the nipples.

3. Repeat the examination you performed while lying on your back, but this time stand while raising your left arm above your head so that your armpit is in a tense position. In this way, check your armpit and breast again with circular motions.

4. Gently squeeze the nipples of both breasts between your thumb and index finger. If any inflammatory discharge or fluid comes from your breast, you must consult a physician. If you find any suspicious lump or thickening during your breast examination, do not panic and be sure to consult your doctor.

Doctor’s Examination: Even if you have no complaints, if you are between the ages of 20 and 40, you should have a breast examination by a general surgeon experienced in breast diseases once every three years; if you are over 40, you should be examined once a year. During the examination, your doctor may encounter benign breast masses. These masses are usually softer, with a smooth surface, round, and mobile. Cancerous masses, on the other hand, are harder, irregular in surface, and less mobile because they are more firmly attached to the tissue.

Imaging Methods

With the possibilities of today’s medical technology, it is possible to detect breast cancer at the earliest possible stage through breast imaging. In recent years, breast cancers that cannot be felt by hand but can be detected through imaging methods have become more common. The imaging methods frequently used for the diagnosis of breast cancer are:

Mammography: Mammography, the basic method in breast cancer diagnosis, is one of the imaging methods that allows evaluation of breast diseases using low-dose X-rays. With this method, considered the gold standard, small masses and changes not 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 screening mammography once a year for every woman starting at age 40. It has been observed that the mortality rate from breast cancer decreases by 33% in those who undergo regular screening mammography.

Ultrasonography: This is one of the auxiliary tests for mammography. It performs imaging with the help of ultrasound waves. Reflections of the sound waves are collected by the computer and an image is created on the screen. It provides information about the internal structure of masses detected on mammography. It also gives preliminary information in distinguishing between benign and malignant masses. 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 begun to be used widely today, is considered one of the most sensitive imaging methods for breast cancer because, when used correctly and at the right time, it has the ability to combine structural findings with functional findings.

Biopsy: This is the method of taking a sample from a mass suspected of breast cancer for pathological examination. Tissue samples are taken from the suspicious mass using fine needle, automatic core needle, or surgical techniques and sent for pathological examination.

Early Diagnosis and Treatment

Diagnosis in the early period is life-saving. In the early diagnosis of breast cancer, women between the ages of 20 and 40 having a doctor’s examination every three years, and after the age of 40 having a doctor’s examination once a year and a mammogram, will be beneficial.

Surgical Methods Used in Breast Cancer

With diagnosis made in the early period, the survival rate rises above 90%. One of the important treatment methods in breast cancer is surgery. The tumor is removed by surgery, and then adjunctive treatments are started in order to prevent recurrence and spread to other organs. One of the most important studies regarding breast cancer concerns the preservation of lymph nodes. In the past, when spread to the axillary lymph nodes was observed, the lymph nodes were removed directly even if the lymph tissue itself had not spread. This caused swelling in the arm, functional disorders, and, most importantly, psychological problems in patients. With the newly developed Sentinel Lymph Node Biopsy, the entire lymph tissue is not intervened in; only the part where spread has occurred is removed, protecting the patient from an unnecessary and exhausting surgical procedure.

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

Radical Mastectomy: The entire breast is removed together with the cancerous tissue; a silicone prosthesis or the patient’s own tissue can be used to reconstruct the breast either at the same time or later.

Skin-Sparing Mastectomy: The entire breast tissue is removed, but the breast skin can be preserved. A silicone prosthesis is placed in the removed area to provide a natural appearance.

Breast-Conserving Surgery: In such surgeries, the tumor and a portion of the surrounding breast tissue are removed together and the breast is left in place. In this way, both the natural appearance and the patient’s psychological state are preserved. After surgery, radiotherapy is applied for 5–7 weeks to prevent recurrence of the disease. Breast-conserving surgeries are absolutely not performed in pregnant women, patients with multifocal tumors in one breast, or those who have previously received radiotherapy to this area.

Cervical Cancer

What Is Cervical Cancer?

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

Who Is at Risk?

• Women between the ages of 35 and 55 (however, since there is also a risk of cancer developing over the age of 65, PAP smear testing is recommended regularly for all sexually active women or women over 18 at least until the age of 70),

• Those who have had an HPV infection (this sexually transmitted infection is very common. It is known that 3 out of 4 people aged 15–49 have had an HPV infection at some point in their lives. Since this infection is temporary and harmless, the person may not even realize they have had it. Therefore, people with HPV should be monitored at frequent intervals.)

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

• Those who have had Chlamydia infection (a bacterium that often causes infection in the female genital system but is sexually transmitted without showing symptoms. An increased risk of cervical cancer has been observed in women who have had this infection),

• Those who have sexual intercourse at an early age,

• Women with multiple sexual partners,

• Those who have relations with an uncircumcised male partner,

• The man having multiple sexual partners,

• Not using protection during sexual intercourse,

• Those who do not pay attention to genital hygiene,

• Smokers (they are at twice the risk compared with non-smokers),

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

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

• Those who do not have regular PAP smear tests,

• Those with obesity or weight problems are at risk.

What Are the Symptoms?

With the PAP smear test used in the screening of cervical cancer, which is the only gynecological cancer that can be prevented by regular annual check-ups, a significant decrease in the number of women with cervical cancer has begun to be observed. Precancerous changes in the cervix can be detected with the PAP smear test. Especially in the last 50 years, regular PAP smear tests have reduced cancer deaths by 70%. Cervical cancer may appear to arise suddenly, but it progresses with some subtle changes that are often not taken seriously. When cells transform into cancer and begin to spread to other organs, symptoms appear. The best-known early-stage symptoms of cervical cancer are bloody or yellow, foul-smelling vaginal discharge, painful urination, abnormal vaginal bleeding after sexual intercourse or between menstrual periods, heavier than normal menstrual bleeding, prolonged bleeding, and pain during and after sexual intercourse. Depending on the spread of the tumor, symptoms such as constipation, bloody urine, leg pain, and edema may also occur. Although these symptoms can be seen in other diseases as well, it would still be correct to consult your doctor immediately.

Early Diagnosis and Treatment

Those diagnosed with cervical cancer have a 5-year survival chance above 70% in the early stage. Since it is a type of cancer that does not show symptoms in the early stages, it is very likely to go unnoticed on physical examination. Therefore, first, action should be taken based on an abnormal PAP smear result. If risk factors are seen in the PAP smear result, after examination with colposcopy, which allows a more detailed view of the cervix (an instrument that provides a 6–40 times magnified view of the cervix), a biopsy is taken if necessary. The course of the disease and the treatment method to be chosen are determined by the type of cancer, location, stage, growth rate, patient’s health status, age, and response to treatment. Although the main treatment method is surgery, radiotherapy is used at every stage.

Surgical Treatment: This is the most commonly used treatment method. Small tumors that have not spread outside the cervix and cervix are removed as completely as possible. It is especially the most commonly used method in the early stage. Additional treatments may be applied when surgical treatment is not sufficient.

Radiotherapy: This is a method used at every stage of cervical cancer. After surgical intervention, radiation treatment is administered with high-energy rays delivered directly to the tumor area from outside the body.

Chemotherapy: In addition to radiation therapy, low-dose chemotherapy is often administered.

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 early and the success rate of treatment is high. It is a type of cancer that develops in the uterus, the main reproductive organ of the woman, when cells in the lining of the uterus (endometrium) change due to external factors and grow uncontrollably. The endometrium is a tissue sensitive to hormones secreted by the ovaries or taken from outside. If it is not diagnosed and treated due to hormonal disorders, cancer may develop in the uterine lining over time as a result of cellular changes.

Who Is at Risk?

• Those over the age of 50,

• Those who started menstruating before the age of 12 and entered menopause after the age of 55 (the earlier menstruation starts and the later it ends, the more the endometrium is exposed to estrogen and the higher the risk of uterine cancer),

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

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

• Those who experience menstrual irregularities or delays at young ages (those with irregular menstruation are also at risk of uterine cancer because exposure to estrogen increases. Obesity and Polycystic Ovary Syndrome are among the causes of irregular menstruation. Treating these diseases can also reduce the risk of uterine cancer),

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

• Diabetic patients,

• Patients with hypertension,

• Those with ovarian tumors,

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

What Are the Symptoms?

Because it occurs after menopause, the chance of early diagnosis is very high in this cancer. The most common symptoms are vaginal bleeding. Symptoms such as any bleeding after menopause, prolonged menstruation or bleeding between periods in menstruating women, non-bloody abnormal discharge, pelvic pain, pain during sexual intercourse, and weight loss may occur. A patient with such complaints should consult a specialist without delay. The patient’s history is taken. A pelvic examination is performed, the thickness and structure of the endometrium are evaluated, and a biopsy is done. After a definitive diagnosis, the patient is referred to a gynecologic oncologist specialized in this field.

Early Diagnosis and Treatment

When uterine cancer is diagnosed early, it can be treated immediately and you can see the results. In the early stage, patients have a 5-year survival chance of over 90%. Therefore, to protect against uterine cancer, it is very important to have a gynecological examination every year. Although the main treatment method is surgery, chemotherapy and radiotherapy may also be applied.

Surgical Treatment: This is the most commonly used treatment method. The uterus, ovaries, and tubes are removed; regional cleansing and sampling from surrounding tissues are also performed. Additional treatments may be applied when surgical treatment is not sufficient.

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

Radiotherapy: If there is a risk of recurrence after surgical intervention, radiation treatment is given after removal of the uterus.

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

Ovarian Cancer

The vast majority of ovarian cancers are seen after menopause and are the most difficult female cancers to treat. This cancer type, which progresses insidiously and shows symptoms only in advanced stages, can be life-threatening. This cancer type, seen in approximately 12 out of 1,000 women, can reach a recovery rate of 90% if caught early.

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

Who Is at Risk?

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

• Those who have entered menopause,

• Those with genetic factors (approximately 5–10% of ovarian cancers occur due to genetic causes. Therefore, women with two or more first-degree relatives with breast, ovarian, or endometrial cancer are at risk. If there are two or three people in the family with ovarian cancer, the risk is 7%; if the mother or sister has ovarian cancer, the risk is 5%),

• Hormonal treatments seen during menopause (estrogen-heavy treatments increase cancer risk),

• Those who have never been pregnant (they carry 2 times more risk than those who have given birth),

• People who experience frequent and repeated ovulation without interruption,

• Those undergoing infertility treatment,

• Those who follow severe diets and incorrect nutrition programs,

• Those with low serum selenium levels,

• Those who use talc powder in the genital area,

• Those affected by environmental factors (this cancer is more common in developed countries),

• Women who have previously had breast cancer are at twice the risk compared with those who have not.

What Are the Symptoms?

Two-thirds of ovarian cancers are diagnosed at an advanced stage. The main reason for the lack of symptoms is that the cancer grows within the abdominal cavity and does not disturb the patient for a long time. In the advanced stage, symptoms include abdominal pain, groin pain, constant urge to urinate and defecate due to pressure in the groin, indigestion, abdominal swelling, and weakness. Some patients may also experience gas and digestive problems. In the most advanced stage, pronounced weight loss, loss of appetite, discomfort in the lower abdomen, nausea, fatigue, shortness of breath, a mass in the pelvis, a downward pressure sensation and the related frequent urge to urinate, and vaginal bleeding may be seen. The most obvious complaint that leads an ovarian cancer patient to see a doctor is extreme abdominal swelling. This swelling is often caused by fluid accumulation in the abdomen (ascites).

Early Diagnosis and Treatment

Early diagnosis is life-saving in this cancer type as well. Approximately 50% of women diagnosed with ovarian cancer are still alive five years later. This rate reaches 90% in patients with localized ovarian cancer. This disease, which is more common in developed countries, does not show symptoms early and may present with different symptoms in each woman. In addition, when ovarian tumors are small, they are difficult to detect even by examination and rarely cause 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 no test that can be used for screening in women with or without risk and provide a definite result. Therefore, every woman who has reached the age of 18 and is sexually active 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 cancer, evaluation can be done with transvaginal ultrasonography (an ultrasound 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 the CA-125 protein in the blood increases. This increase can also be seen in other non-cancerous conditions (such as early pregnancy, heavy cigarette consumption, uterine diseases). If the value is found to be high, imaging methods are used to check whether there is fluid in the abdomen; if fluid accumulation is present, the fluid or the ovaries themselves are sampled and examined. A definitive diagnosis is made with pathological evaluation. If cancer is diagnosed, surgery performed by a gynecologic oncologist may continue, and depending on the spread of the cancer, the uterus, tubes, ovaries, and peritoneum may be removed. In addition, samples may be taken from other organs in the body (adjacent lymph nodes, intraperitoneal fluid, and the diaphragm) to determine the stage of the disease. The complete diagnosis of the disease can only be made through pathological examination of the tissues removed during surgery. After the surgical procedure, the treatment type and program are determined by taking into account the stage of the disease, the patient’s age, and general health condition. Chemotherapy is used in almost all ovarian cancers after surgery. Chemotherapy is usually administered on an outpatient basis. Depending on the drugs used, side effects such as nausea, vomiting, hair loss, muscle pain, mouth sores, susceptibility to infection, and weakness may be observed. These effects will pass after treatment. Ovarian cancer treatment requires physicians from many specialties such as gynecologists, oncologists, radiotherapists, chemotherapy specialists, pathologists, dietitians, and psychiatrists to work together. After the patient’s treatment is completed, physical examination and CA-125 measurement are performed every three months for the first two years; if necessary, chest X-rays and abdominal CT scans are reviewed. In the following three years, these checks are done every six months; after the fourth year, once a year.

Thyroid Cancer

It is a type of cancer that occurs as a result of excessive proliferation of the cells in the thyroid gland. It usually presents as a mass or nodule in the neck. The thyroid gland is one of the organs located in the neck, weighing 20–25 grams, and regulating the body’s overall metabolism with the hormone it produces using iodine. Although its exact cause is not yet fully known, it is seen less often than other cancer types and the course of the disease is quite good. Thyroid cancer is not a single type of cancer. According to frequency of occurrence, it is divided into 4 groups: Papillary Cancer, Follicular Cancer, Medullary Cancer, and Anaplastic Cancer.

Types of Thyroid Cancer

Papillary Thyroid Cancer: It accounts for 75–80% of thyroid cancers. It usually has a favorable course. It begins to be seen between the ages of 20 and 50, with an increase in frequency between the ages of 30 and 40. This cancer type, which spreads through the lymph nodes, may spread to the lymph nodes in the neck and the lungs. It may exist for a long time without showing any symptoms and without causing death. In older people, it progresses more rapidly than in younger individuals. Spread to the lymph nodes in the neck does not indicate a bad prognosis in young patients, but in patients over 40 it shows that the disease will progress rapidly. This type of cancer is seen in 2% of the population of Turkey.

Follicular Thyroid Cancer: It accounts for 15% of thyroid cancers. It is seen more frequently in women in their 50s. It is the most difficult thyroid cancer type to diagnose. It spreads to blood vessels and the thyroid capsule. Spread to other organs such as the lungs, bones, liver, and brain is rarely seen. In those with vascular spread, the cancer progresses faster.

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

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

Who Is at Risk?

• Women (it is more common than in men),

• Patients with nodules in the thyroid gland,

• Those who received radiation therapy to the head and neck region during childhood,

• Although the exact reason is not fully known, people exposed to some radioactive substances, especially uranium, are at risk because it is seen more often in such individuals.

What Are the Symptoms?

In most thyroid cancers, there may be no complaint. In many patients, it may be found at diagnosis that the disease has also spread to other organs. Although the disease does not show many symptoms, swelling in the neck, a feeling of discomfort in the throat, pain, difficulty swallowing, difficulty breathing, hoarseness, weight gain, irritability, weakness in the hair, and dry skin may be 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, an ultrasonography examination is done; if a mass is seen on examination, a biopsy is necessary for a definitive diagnosis. Once diagnosed, the patient undergoes surgery and the thyroid gland is removed, after which a personalized treatment method is started. With developing technology, laparoscopic (closed) surgeries make it possible for the patient to go home the same day with minimal incision scarring. Patients with papillary and follicular cancer are exposed to high-dose radioactive iodine in shielded hospital rooms depending on the spread of the cancer, with the aim of killing cancer cells remaining elsewhere in the body. With the treatment process, keeping the patient’s TSH value continuously under control can prevent the possibility of recurrence.

Skin Cancers

The life-threatening skin cancer melanoma is the type with the worst course among skin cancers. It can occur in approximately 1 million people per year; it may form without warning on normal skin or on an existing mole. It is caused by the excessive and uncontrolled proliferation of melanocytes, which produce melanin, the pigment that gives skin its color and helps it tan, and it has the ability to spread.

Who Is at Risk?

• Fair-skinned people who are especially overexposed to sunlight (dark skin does not have a protective effect against cancer. In dark-skinned people, this cancer type is more commonly seen on the sole of the foot, palms, under the nails, or very rarely inside the mouth),

• Having a family history of skin cancer,

What Are the Symptoms?

It may occur on normal skin without warning, or it may occur on an existing mole. Although this makes early diagnosis difficult, when symptoms such as peeling, leakage, bleeding, or color, shape, or size changes in moles on the body, or swelling/bulging on the mole are seen, a dermatologist should definitely be consulted. Dermatoscopy is a very important aid used to understand whether moles are skin cancer. A definitive diagnosis of skin cancer can be made by pathological examination of the surgically removed tissue.

Early Diagnosis and Treatment

With early diagnosis of melanoma and the treatment to be applied, the patient’s chance of survival is high. However, if not detected early, there is a risk of spreading throughout the body starting from the lymphatic system.

Ways of Protection

To protect against the disease, it is important not to be exposed to direct sunlight especially between 10:00 and 16:00, to prefer light-colored clothing that reflects sunlight, to use high-factor protective creams, and not to sunbathe for long periods in order to achieve a tanned skin tone. In addition, the entire body should be checked in front of a mirror once a month, starting from the face.

Laryngeal Cancers

Another cancer type associated with smoking is laryngeal cancer. Approximately 95% of patients with laryngeal cancer are smokers. It develops as a result of uncontrolled proliferation of some cells in the laryngeal area and turning into a tumor.

Who Is at Risk?

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

• Those who consume excessive alcohol together with smoking are more likely to develop laryngeal cancer than a healthy person.

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

• Those working in sectors such as woodwork, oil, and paint industries have a higher likelihood 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 progressed and spread to the lymph nodes in the neck, enlarging swellings may be seen on the side of the neck.

Early Diagnosis and Treatment

In laryngeal cancer, which manifests itself through hoarseness and changes in voice quality, if there are complaints such as hoarseness lasting more than two weeks, a feeling of something stuck in the throat, and pain in the throat and ears, you should definitely 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 treatment method is determined taking into account factors such as the location and size of the tumor, stage, possibility of spread (metastasis), the person’s health status, and age. Depending on the location and size of the tumor, surgery, which is the most commonly used and the most effective treatment in many laryngeal cancers, can be performed, and radiotherapy and chemotherapy can also be applied.

Pancreatic Cancer

The pancreas is an organ located in the back part of the abdomen, about 15 cm long, with its front surface completely covered by the stomach, duodenum, and large intestine. Its internal secretion produces insulin to regulate blood sugar; its external secretion produces pancreatic juice to regulate 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 and nerves. Pancreatic cancer spreads very quickly to the surrounding organs; it 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,

• Overweight individuals,

• Those who have had gallbladder surgery,

• Those who follow an unhealthy diet with a predominance of meat and fatty foods,

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

• Diabetic patients are at risk.

What Are the Symptoms?

Pancreatic cancer is a cancer type that progresses insidiously; therefore, it may not show symptoms until the final stages of the disease. Alcohol can be considered the most important cause of the disease. Loss of appetite, weight loss, nausea, jaundice, sudden-onset diabetes, back pain, and belt-like abdominal pain are among the symptoms.

Early Diagnosis and Treatment

Since pancreatic cancer shows similarities with some diseases, the chance of early diagnosis is also reduced. If cancer starting in the pancreas is detected before it spreads to the lymph nodes, the chance of surviving for 5 years can increase from 5% to 16%. Through examination, the stage of the pancreatic tumor and whether there is spread are checked. If the tumor is in the head of the pancreas, intervention is not possible because the head of the pancreas cannot be removed on its own. 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 in advanced-stage tumors. With chemotherapy, some measures may be taken to improve quality of life, such as correcting jaundice, providing nutritional support, and reducing pain:

• Stent placement 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 and pancreatic duct),

• PTK to drain bile externally

• Placement of a catheter for pain relief to reduce pain sensation

• Stent placement in the part that causes obstruction in the duodenum,

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

Stomach Cancer

Stomach cancer, one of the most common cancers in our country, ranks second among cancer types seen in women after breast cancer. While the number of people diagnosed with this cancer is decreasing worldwide, it is increasing in Turkey. Tumors developing in the mucosal lining, especially on the lesser curvature of the stomach located in the upper left part of the abdomen, cause cancer. This cancer is seen mostly in the Black Sea and Eastern Anatolia regions in Turkey; worldwide, it is seen in Far Eastern countries such as Japan and China as well as in Northern European countries. Unhealthy dietary habits play an important role in the development of stomach cancer (excessive consumption of salty foods, raw meat consumption, eating burnt meat, inadequate intake of vegetables and fruits, etc.).

Who Is at Risk?

• Men, in whom stomach cancer is seen twice as often as in women,

• Those over 50 years of age (today, the age at which stomach cancer appears 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 excessive smoked, salted, additive-containing, or fried foods,

• Those who consume processed meats with nitrite and nitrate such as sausage, salami, and hot dogs,

• Those who consume large amounts of red meat,

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

• Those who have previously undergone 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 due to vitamin B12 deficiency,

• Those with atrophic gastritis,

• Those with a family history of stomach cancer,

• Heavy smokers,

• People with blood group A (although the exact reason is not known, they carry a higher risk than those with other blood groups),

• Those with obesity are at risk.

What Are the Symptoms?

Stomach cancer is also one of the insidious diseases. It usually shows symptoms in advanced stages of the disease. Therefore, only people at risk can be diagnosed through endoscopic examination. Symptoms may appear in people with severe nutritional problems or when the tumor has spread significantly. These symptoms generally include pain in the stomach area, a feeling of heaviness in the stomach, loss of appetite, marked weight loss, abdominal pain, bloating and discomfort after eating, nausea, vomiting, fatigue, and bleeding in the stomach or intestines, which is usually occult.

Early Diagnosis and Treatment

Stomach cancer usually presents with complaints of indigestion. However, during this period, both the patient and the doctor should take this complaint seriously and the patient should definitely undergo gastroscopy to investigate the possibility of stomach cancer. The most important step in diagnosing this cancer is gastroscopy and biopsy. The most effective treatment method for stomach cancer is surgery. However, for this surgery to be effective, it must be detected in the early stages and treated. After surgery, chemotherapy or radiotherapy can be applied depending on the form of the cancer.

Ways of Protection

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

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

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

• Avoid excessively spicy foods.

• Hot and cold drinks and artificial foods may cause stomach cancer.

• Reduce the use of animal fat.

• Exercise regularly.

Colon Cancer

Colon cancer, one of the diseases affecting approximately 1 million people every year worldwide, is increasing in Turkey. The disease, in which improper nutrition plays an important role, is more common in men than in women. It is a cancer type caused by polyps developing in the large intestine called the colon. Colon cancer, which is especially common in Western countries, ranks third in terms of frequency worldwide. The exact cause is unknown, but environmental and genetic factors are involved in its development. Colon cancer may arise from the polyp bed in the colon or from the mucosa forming the inner surface.

What Are the Symptoms?

The disease progresses insidiously and shows no symptoms for many years; in the advanced stage, it manifests as 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, thin stools like a pencil, a feeling of incomplete evacuation, pallor due to occult blood loss, mucus in the stool, and weight loss.

Who Is at Risk?

• People with a family history of colon cancer,

• Those with intestinal polyps,

• People who previously had breast, uterine, or 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 who follow a Western-type diet,

• Those who consume animal fats and red meat more heavily,

• Excessive smokers and alcohol users,

• Those living a life away from exercise,

• Obese patients are at risk.

Early Diagnosis and Treatment

Although the process of noticing the disease is late because it progresses insidiously, if it is diagnosed early with regular screening tests, the chance of recovery from the disease increases. In particular, people with a family history of colon cancer should have the following tests regularly.

• Checking for blood in the stool every year; 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 a family history of colon cancer should have this test every year under doctor supervision)

In our country, colon cancers cannot be detected at the initial stage because patients do not consult a doctor when symptoms appear. The main treatment for colon cancer at all stages is surgery. The tumor area is removed surgically and the upper/lower sides of the removed part of the intestine are connected. However, the form of surgical treatment changes according to the location, size, stage, and problems it creates in the patient (if the tumor is located close to the anus, due to the shortness of this area, the anus is completely removed and the colon is connected to the abdominal wall). After surgery, treatment continues with chemotherapy depending on the stage of the disease. Radiotherapy is not used in this disease.

Ways of Protection

A diet rich in fiber is protective against colon cancer. Since there is a direct relationship between fatty foods and colon cancer, low-fat foods should be consumed; red meat and fatty foods should be avoided as much as possible, and regular exercise should be done. 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. Studies in recent years have shown that consuming calcium-rich foods and nonsteroidal anti-inflammatory drugs also contribute to protection.

Liver Cancer

Liver cancer is abnormal growth in the cells of the liver. The liver has very important functions such as removing harmful substances from the body, producing bile that helps digest fats, storing sugar, and producing proteins. Because of its importance in the body and the cell structure of the liver, it is among the highest-risk and most common cancer types. Cirrhosis (alcohol), Hepatitis B and C infections play an important role in its development. The annual risk of HCC development in patients who have developed cirrhosis for any reason 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 starts in the liver and spreads from there, it is called primary; if it starts in another organ and later spreads to the liver, it is called 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 often develops in association with cirrhosis and hepatitis B or C infections. In addition, all diseases that cause cirrhosis are also supportive factors for HCC cancer. It is the most common primary liver cancer type, at a rate of 75%. It is most often seen between the ages of 40 and 60; it is 5 times more common in men than in women. It presents with liver enlargement, fluid accumulation in the abdomen (this fluid may also be bloody), severe abdominal pain, weakness, loss of appetite, weight loss, and a palpable mass in the abdomen. However, a definitive diagnosis can only be made by liver biopsy.

Cholangiocarcinoma: This is a cancer type rarely seen in bile duct cells. The disease presents with abdominal pain, weakness, fever, and weight loss and is usually seen between the ages of 50 and 70. A definitive diagnosis is made with ultrasound, CT, increased ALP, and biopsy.

Who Is at Risk?

• Alcohol users,

• Patients with Hepatitis B and Hepatitis C,

• Chronic liver patients,

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

What Are the Symptoms?

Liver cancer is an insidious disease. Therefore, it does not show symptoms in the early period. By the time diagnosis is made, the disease has usually reached advanced stages. As the cancer grows in diameter, it makes itself known with widespread and noticeable pain on the right side of the abdomen. In the advanced stage, symptoms such as loss of appetite, weakness, severe weight loss, jaundice of the skin, fluid accumulation in the abdomen, abdominal swelling, and easy fatigue may accompany this severe abdominal pain. Since it has almost the same symptoms as cirrhosis, the patient may be diagnosed with cirrhosis if it is not examined carefully. 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, with regular check-ups you can catch the disease before it progresses to advanced stages. The disease can be diagnosed 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 sufficient liver function, the entire mass can be removed surgically if the tumor is confined to the liver; if the patient is not suitable for surgery, chemoembolization treatment is applied (treatment aimed at limiting the growth of the mass by administering medication into the hepatic artery). Chemotherapy used in other cancer types is not an effective method in liver cancers.