stilbestrol

Vaginal cancer is a rare type of cancer. It is more common in women 60 and older. You are also more likely to get it if you have had a human papillomavirus (HPV) infection or if your mother took diethylstilbestrol (DES) when she was pregnant. Doctors prescribed DES in the 1950's to prevent miscarriages. You are also at higher risk if you have had abnormal cells in the vagina, cervix, or uterus.

It often doesn't have early symptoms. However, see your doctor if you notice:

• Bleeding that is not your period
• A vaginal lump
• Pelvic pain

A Pap test can find abnormal cells that may be cancer. Vaginal cancer can often be cured in its early stages. Treatment might include surgery, radiation therapy, and chemotherapy.

NIH: National Cancer Institute

Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.

Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.

Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.

There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:

• Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
• Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
• Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
• Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.

Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.

But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.

There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.

Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.

The factors that raise your risk of breast cancer include:

• Older age
• History of breast cancer or benign (noncancer) breast disease
• Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
• Dense breast tissue
• A reproductive history that leads to more exposure to the estrogen hormone, including
  • Menstruating at an early age
  • Being at an older age when you first gave birth or never having given birth
  • Starting menopause at a later age
• Taking hormone therapy for symptoms of menopause
• Radiation therapy to the breast or chest
• Obesity
• Drinking alcohol

The signs and symptoms of breast cancer include:

• A new lump or thickening in or near the breast or in the armpit.
• A change in the size or shape of the breast.
• A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
• A nipple turned inward into the breast.
• Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
• Scaly, red, or swollen skin in the nipple area or the breast
• Pain in any area of the breast.

Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:

• A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
• A medical history.
• Imaging tests, such as a mammogram, an ultrasound, or an MRI.
• Breast biopsy.
• Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.

If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:

• Genetic tests for genetic changes such as in the BRCA and TP53 genes.
• HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
• An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.

Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.

Treatments for breast cancer include:

• Surgery such as
  • A mastectomy, which removes the whole breast
  • A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
• Radiation therapy
• Chemotherapy
• Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
• Immunotherapy

You may be able to help prevent breast cancer by making healthy lifestyle changes such as:

• Staying at a healthy weight
• Limiting alcohol use
• Getting enough exercisee
• Limiting your exposure to estrogen by
  • Breastfeeding your babies if you can
  • Limiting hormone therapy

If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.

It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.

NIH: National Cancer Institute

The cervix is the lower part of the uterus, the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The virus spreads through sexual contact. Most women's bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You're at higher risk if you smoke, have had many children, use birth control pills for a long time, or have HIV infection.

Cervical cancer may not cause any symptoms at first. Later, you may have pelvic pain or bleeding from the vagina. It usually takes several years for normal cells in the cervix to turn into cancer cells. Your health care provider can find abnormal cells by doing a Pap test to examine cells from the cervix. You may also have an HPV test. If your results are abnormal, you may need a biopsy or other tests. By getting regular screenings, you can find and treat any problems before they turn into cancer.

Treatment may include surgery, radiation therapy, chemotherapy, or a combination. The choice of treatment depends on the size of the tumor, whether the cancer has spread and whether you would like to become pregnant someday.

Vaccines can protect against several types of HPV, including some that can cause cancer.

NIH: National Cancer Institute

The uterus, or womb, is the place where a baby grows when a woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, outside the uterus, usually in the fallopian tubes. The result is usually a miscarriage.

Ectopic pregnancy can be a medical emergency if it ruptures. Signs of ectopic pregnancy include:

• Abdominal pain
• Shoulder pain
• Vaginal bleeding
• Feeling dizzy or faint

Get medical care right away if you have these signs. Doctors use drugs or surgery to remove the ectopic tissue so it doesn't damage your organs. Many women who have had ectopic pregnancies go on to have healthy pregnancies later.

Dept. of Health and Human Services Office on Women's Health

Infertility means not being able to get pregnant after at least one year of trying (or 6 months if the woman is over age 35). If a woman keeps having miscarriages, it is also called infertility. Female infertility can result from age, physical problems, hormone problems, and lifestyle or environmental factors.

Most cases of infertility in women result from problems with producing eggs. In primary ovarian insufficiency, the ovaries stop functioning before natural menopause. In polycystic ovary syndrome (PCOS), the ovaries may not release an egg regularly or they may not release a healthy egg.

About a third of the time, infertility is because of a problem with the woman. One third of the time, it is a problem with the man. Sometimes no cause can be found.

If you think you might be infertile, see your doctor. There are tests that may tell if you have fertility problems. When it is possible to find the cause, treatments may include medicines, surgery, or assisted reproductive technologies. Happily, many couples treated for infertility are able to have babies.

Dept. of Health and Human Services Office on Women's Health

Infertility means not being able to become pregnant after a year of trying. If a woman can get pregnant but keeps having miscarriages or stillbirths, that's also called infertility.

Infertility is fairly common. After one year of having unprotected sex, about 15% of couples are unable to get pregnant. About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause can be found.

There are treatments that are specifically for men or for women. Some involve both partners. Drugs, assisted reproductive technology, and surgery are common treatments. Happily, many couples treated for infertility go on to have babies.

NIH: National Institute of Child Health and Human Development

A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. Most miscarriages happen very early in the pregnancy, often before a woman even knows she is pregnant.

Factors that may contribute to miscarriage include:

• A genetic problem with the fetus
• Problems with the uterus or cervix
• Chronic diseases, such as polycystic ovary syndrome

Signs of a miscarriage include vaginal spotting, abdominal pain or cramping, and fluid or tissue passing from the vagina. Bleeding can be a symptom of miscarriage, but many women also have it in early pregnancy and don't miscarry. To be sure, contact your health care provider right away if you have bleeding.

Women who miscarry early in their pregnancy usually do not need any treatment. In some cases, there is tissue left in the uterus. Doctors use a procedure called a dilatation and curettage (D&C) or medicines to remove the tissue.

Counseling may help you cope with your grief. Later, if you do decide to try again, work closely with your health care provider to lower the risks. Many women who have a miscarriage go on to have healthy babies.

NIH: National Institute of Child Health and Human Development

Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, and supplements.

Always speak with your health care provider before you start or stop any medicine. Not using medicine that you need may be more harmful to you and your baby than using the medicine. For example, many pregnant women take prescription medicines for health problems like diabetes, asthma, seizures, and heartburn. The decision about whether or not to take a medicine depends on the risks and benefits. You and your health care provider should make this choice together.

Pregnant women should not take regular vitamins. They may have too much or too little of the vitamins that you need. There are special vitamins for pregnant women. It is important to take 0.4 mg of folic acid every day before you become pregnant through the first part of your pregnancy. Folic acid helps to prevent birth defects of the baby's brain or spine.

Food and Drug Administration

Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. Cancer itself rarely harms the baby, and some cancer treatments are safe during pregnancy. You and your health care provider will work together to find the best treatment. Your options will depend on how far along the pregnancy is, as well as the type, size, and stage of your cancer.

Another type of tumor that women can get is called a gestational trophoblastic disease (GTD). It happens when a fertilized egg doesn't become a fetus. GTD is not always easy to find. It is usually benign, but some types can be malignant. The most common type of GTD is a molar pregnancy. In its early stages, it may look like a normal pregnancy. You should see your health care provider if you have vaginal bleeding (not menstrual bleeding).

Treatment depends on the type of tumor, whether it has spread to other places, and your overall health.