Health-e News Service - February 3, 2012
World Cancer Day is commemorated on 4 February and the theme for
this year's celebration is: "Together it is possible".
"Every South African is affected by this disease, we need to find
solutions together and ensure that those facing this disease are
afforded their constitutional- and human rights," says Lauren
Pretorius from the cancer advocacy group Campaign for Cancer. "It
is only by every person, organisation, and government,
individually and together doing their part, that we will be able
to reduce South Africa's cancer burden."
Cancer is a common health problem around the world and kills more
people than Aids, tuberculosis and malaria combined. In South
Africa one in six men will develop some type of cancer, while one
in every eight women will be affected in her lifetime.
Cancer is not a death sentence and when it's caught early and
treated effectively, many patients go on to live long, healthy
lives. However, not many people are aware of the risks and early
symptoms of cancer, causing it to be diagnosed at a more
progressed stage making it difficult to treat effectively.
"Creating awareness about cancer symptoms and treatment options
should take priority in cancer campaigns, because catching the
disease early can make all the difference as far as survival
goes," reads a Campaign for Cancer statement.
The disease is not the only problem cancer patients have to deal
with and they also face challenges such as a lack of access to
screening services, the social stigma attached to the disease,
misconceptions about how cancer only affects certain communities,
the 'death sentence' perception, and also the financial burden
that cancer treatment can have for patients and their families.
Pretorius explained that for patients in the private health
sector, cancer treatment can be financially devastating if a
person's medical scheme benefits don't cover the necessary
treatment. While in the public health sector, patients often wait
long periods for treatment or have to travel vast distances to
access healthcare services. And "time is deadly in the case of
cancer," she warned.
To help South Africans understand their risk for developing
cancer and to help them identify the early stages of the disease,
Health-e has put together basic information on some of the most
common cancers affecting men and women in South Africa. While
skin cancer is common in both men and women, prostate-, lung- and
oesophagus cancer affect many men South Africa, while breast-,
cervical- and endometrial cancer is most common in women.
It is important to note that having the symptoms explained in
this article does not mean a person has cancer, and may be
attributed to a number of other conditions. It is, therefore,
important to consult a medical professional for an accurate
Common cancer among men and women in South Africa
Skin cancer is very common among South African men and women.
There are several types of skin cancer depending on where on the
skin surface it occurs. Basil Cell Carcinoma (BCC) and Squamous
Cell Carcinoma (SCC) are the most common types of skin cancers,
while melanoma is less common, but more dangerous.
South Africa has the highest rate of skin cancer in the world
after Australia, and is common in both men and women. Most skin
cancers form in older people on parts of the body exposed to the
sun or in people who have weakened immune systems.
What are the risk factors?
Factors that may increase your risk of skin cancer include:
Fair skin: Anyone of any skin colour can get skin cancer.
However, having less pigment (melanin) in your skin provides less
protection from damaging UV radiation. If you have blond or red
hair and light-colored eyes, and you freckle or sunburn easily,
you're much more likely to develop skin cancer than is a person
with darker skin.
A history of sunburns: Every time you get sunburned, you
damage your skin cells and increase your risk of developing skin
cancer. Having multiple blistering sunburns as a child or
teenager increases your risk of developing skin cancer as an
adult. Sunburns in adulthood also are a risk factor.
Excessive sun exposure: Anyone who spends considerable time
in the sun may develop skin cancer, especially if the skin isn't
protected by sunscreen or clothing. Tanning, including exposure
to tanning lamps and beds, also puts you at risk.
Moles: People who have many moles or abnormal moles are at
increased risk of skin cancer. These abnormal moles - which look
irregular and are generally larger than normal moles - are more
likely than others to become cancerous.
A family history of skin cancer: If one of your parents or a
sibling has had skin cancer, you may have an increased risk of
A weakened immune system: People with weakened immune systems
have a greater risk of developing skin cancer. This includes
people living with HIV/Aids or leukemia and those taking
immunosuppressant drugs after an organ transplant.
The warning signs of skin cancer
Warning signs for the various types of skin cancer differ:
Basal cell carcinoma usually occurs in sun-exposed areas of
your body, such as your face, ears or scalp. Basal cell carcinoma
may appear as a pearly or waxy bump, or a flat, flesh-colored or
brown scar-like lesion.
Squamous cell carcinoma also occurs on sun-exposed areas of
your body, and may appear as A firm, red nodule, or a flat lesion
with a scaly, crusted surface.
Melanoma can develop anywhere on the body, in otherwise
normal skin or in an existing mole that becomes cancerous and can
occur on skin that hasn't been exposed to the sun. Melanoma signs
-- A large brownish spot with darker speckles
-- A mole that changes in color, size or feel or that bleeds
-- A small lesion with an irregular border and portions that appear red, white, blue or blue-black
-- Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes lining
your mouth, nose, vagina or anus.
Most common cancers among South African men
South African males have a one in six lifetime risk of getting
cancer. The three most common cancers affecting men in the
country are prostate cancer, affecting one in every 23 males,
lung caner, one in 69 males, and cancer of the oesophagus, which
occurs in one in every 82 men.
Prostate cancer is not only common among South African males, but
is one of the leading cancers in men worldwide. It is most
prevalent among white South African males, but recent statistics
showed that it is also increasing among black males who often
develop an aggressive type of the disease.
Prostate cancer is caused by changes in the DNA of a normal
What are the risk factors?
Some of the main risk factors for prostate cancer are:
Age: Prostate cancer occurs more frequently in older men, and
most men diagnosed are over 65 years of age. The disease is rare
in men under 45.
Family history: There is often a history of a brother or father
who had prostate cancer, and studies suggest the existence of a
gene that raises one's susceptibility to the disease.
Lifestyle: As with many cancers, diet and certain lifestyle
factors have been linked to a higher risk of developing prostate
cancer. Factors include a high fat intake, high red meat intake,
low consumption of vegetables, obesity, lack of physical
activity, and smoking. High alcohol intake (more than two
alcoholic drinks per day) also raises a man's risk for prostate
Race: Although prostate cancer occurs across all cultures, is
more common among certain races. The lifetime risk of developing
prostate cancer in the South African male population is as
follows: Black males are least susceptible with a one in 49
chance; one in 45 Asian males will develop prostate cancer in
their lifetime; the risk drastically increases for coloured males
who have a one in 17 chance; and white males are at highest risk
at one in 11.
A risk factor affects a person's chance of getting a particular
disease. Having a risk factor, or even several risk factors, does
not mean that a person will get the disease, and nor does having
no risk factors exclude a person from developing the disease.
Warning signs of prostate cancer
Warning signs of prostate cancer include:
-- Difficulty or inability to pass urine
-- A slow stream of urine, often with dribbling at the end
-- Inability to start or stop the flow of urine
-- Frequent need to pass urine, especially at night
-- Swelling in legs
-- Discomfort in pelvic area
-- Lower back pain
-- Blood in the urine or semen
-- Painful ejaculation
-- Erectile dysfunction
Lung cancer is the most common cancer worldwide, and the second
most common cancer among South African men - although it kills more
of its patients that the number one ranked prostate cancer.
What are the risk factors?
The main cause of lung cancer is tobacco smoke, and in South
Africa it is estimated that about 60% of lung-cancer deaths are
caused by smoking. Experts reckon that as many 8% of all deaths
in South Africa can be ascribed to tobacco smoke.
Other known causes of lung cancer include breathing in
second-hand tobacco smoke, and domestic and industrial pollution.
Warning signs of lung cancer
The warning signs of lung cancer include:
-- Chronic cough
-- Coughing up blood-stained sputum
-- A dull ache or sharp pain when coughing or taking a deep breath
-- Loss of appetite and weight loss
The oesophagus, also known as the gullet, is the long muscular
tube that connects the throat and the stomach. In South Africa,
men are twice as likely to develop cancer of the oesophagus than
women. It is the third most common cancer among men in the
country and one in 73 men will be diagnosed with it in their
What are the risk factors?
Oesophageal cancer occurs mostly in older people, and although
the exact causes are unknown, smoking, excessive drinking (and
particularly a combination of the two), and a poor diet are
important factors. The risk for developing oesophageal caner is
also greater in people who eat maize meal contaminated with
fungal toxins, and regular infection with Candida Albicans (a
fungus that causes diseases in the digestive system).
Warning signs of oesophageal cancer
The warning signs of oesophageal cancer include:
-- Progressive difficulty in swallowing (dysphagia)
-- Persistent heartburn
-- Indigestion or regurgitation
-- Unexplained weight loss
-- Physical tiredness and weakness
Most common cancers among South African women
South African women have a one in eight lifetime risk of getting
cancer. The three most common cancers affecting women in the
country are breast cancer, affecting one in every 29 women,
cervical caner, one in 35 women, and endometrial cancer, which
occurs in one in every 144 women.
Breast cancer is not only the most common cancer among South
African women, but is widespread among women worldwide. Although
rife, women with breast cancer have an excellent chance of
recover if it is detected early - that's why every woman should
examine her breasts and underarms regularly to check for any
What are the risk factors?
The causes of breast cancer are not yet fully known, although a
number of risk factors have been identified. These include:
Age: A woman's chance of developing breast cancer increases as
she gets older, and most advanced breast cancers are found in
women over the age of 50.
Family history: There is a higher risk for breast cancer if there
is a history of a close relative who has had breast, endometrial,
ovarian, or colon cancer. About 20% to 30% of women with breast
cancer have a family history of the disease which indicates to a
genetic predisposition to breast cancer. The most common gene
defects are found in the BRCA1 and BRCA2 genes. Women with one of
the defects have up to an 80% chance of getting breast cancer
sometime during her life.
Menstrual cycle: Women who started menstruating before age 12, or
who went through menopause late (after age 55) have an increased
risk for breast cancer.
Alcohol use: Drinking more than one alcoholic drink per day
increases a woman's risk for breast cancer.
Childbirth: Women who have never given birth, or who only gave
birth after the age of 30 have an increased risk for breast
cancer. Being pregnant more than once or becoming pregnant at an
early age reduces the risk of breast cancer.
Hormone replacement therapy: There is a higher risk of breast
cancer in women who have received hormone replacement therapy
with oestrogen for several years.
Obesity: Obesity has been linked to breast cancer. It is believed
that obese women produce more oestrogen, which can fuel the
development of breast cancer.
Lack of exercise: Studies have shown that exercise reduces the
risk for breast cancer, and it is suggests that women exercise 45
to 60 minutes, five days a week.
Dense breast tissue: Women with denser breast tissue have a
higher risk of breast cancer as there is more gland tissue and
less fatty tissue. Dense tissue can also make it harder for
doctors to spot problems on mammograms.
Race: Caucasian (white) women are more likely to develop breast
cancer than women from other races.
Warning signs of breast cance
Breast cancer may cause any of the following signs and symptoms:
-- General pain in or on any part of the breast
-- Irritated or itchy breasts
-- Presence of a lump in or near the breast or in the under-arm area
-- Thickening in or near the breast or in the under-arm area
-- A change in the size or shape of the breast
-- A dimple or puckering in the skin of the breast
-- A nipple turned inward into the breast
-- Fluid, other than breast milk, coming from the nipple, especially if it is bloody
-- Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin that is around the nipple)
-- A change in breast colour
-- Changes in the appearance of one or both nipples
-- Dimples in the breast that look like orange peel
-- Skin changes, such as swelling, redness, or other visible differences in one or both breasts
CANCER OF THE CERVIX
The cervix is the lower, narrow end of the uterus (the hollow,
pear-shaped organ where a foetus grows). The cervix leads from
the uterus to the vagina (birth canal). Worldwide, cervical
cancer is the third most common type of cancer in women, but in
South Africa it is the second most common and one in every 35
women in the country will develop it in her lifetime. The high
burden of HIV/Aids in South Africa also aggravates the prevalence
of cervical cancer as it lowers women's resistance to the human
papillomavirus (HPV) which causes most cervical cancer cases.
Cervical cancer tends to appear during midlife. Over half of the
women diagnosed are between the ages of 35 and 55.
What are the risk factors?
Most cervical cancers are caused by certain strains of HPV - a
common virus that is spread through sexual intercourse. Several
risk factors have been linked to the development of cervical
cancer, these include:
-- Having sex at an early age
-- Having many sexual partners
-- Having first sexual intercourse at a young age
-- Smoking tobacco
-- Using oral contraceptives
-- Having a weakened immune system
-- Not being able to afford regular Pap smears or have limited
access to screening services through which cervical cancer is
-- Sexual partners who have multiple partners or who participate
in high-risk sexual activity
Warning signs of cervical cancer
The warning signs of cervical cancer may include:
-- Abnormal vaginal bleeding between periods, after intercourse,
or after menopause
-- Any bleeding after menopause
-- Continuous vaginal discharge, which may be pale, watery,
pink, brown, bloody or foul-smelling
-- Periods becoming heavier and last longer than usual
Endometrial cancer, also known as uterine cancer, is the third
most common cancer among women in South Africa and one in every
144 women will be diagnosed with it in her lifetime.
The exact cause of endometrial cancer is unknown, however,
increased levels of the female hormone oestrogen appear to play a
role. Oestrogen helps stimulate the build-up of the lining of the
uterus. Studies have shown that high levels of oestrogen in
animals result in excessive endometrial growth and cancer.
Most cases of endometrial cancer occur between the ages of 60 and
70 years, but a few cases may occur before age 40.
What are the risk factors for endometrial cancer?
The following increase your risk of endometrial cancer:
-- Oestrogen replacement therapy without the use of progesterone
-- History of endometrial polyps or other benign growths of the
-- Infertility (inability to become pregnant)
-- Infrequent periods
-- Tamoxifen, a drug for breast cancer treatment
-- Never being pregnant
-- Polycystic ovarian syndrome (PCOS)
-- Starting menstruation at an early age (before age 12)
-- Starting menopause after age 50
Warning signs of uterine cancer
The symptoms of uterine cancer include:
-- Bleeding between normal periods before menopause
-- Vaginal bleeding or spotting after menopause
-- Extremely long, heavy, or frequent episodes of vaginal
bleeding after age 40
-- Lower abdominal pain or pelvic cramping
-- Thin white or clear vaginal discharge after menopause
Sources: CANSA, American Cancer Association, 2000-2001 NCR
Report, National Cancer Institute, Men's Health 4-men, PubMed
Health, Mayo Clinic, Cancer Treatment Centers of America
MedlinePlus Medical Encyclopedia, CervicalCancer.org