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LEARNING OBJECTIVES

  1. Describe the short- and long-term complications most frequently encountered in women receiving pharmacologic treatment for cancer.

  2. Discuss the etiology and management of chemotherapy-induced nausea and vomiting, alopecia, and diarrhea.

  3. Discuss the pharmacologic agents used for the management of cancer treatment-related menopausal symptoms (ie, vasomotor symptoms, genitourinary syndrome, and osteoporosis).

  4. Describe considerations for fertility preservation and treatment of cancer during pregnancy.

INTRODUCTION

In 2018, it is estimated that 878,980 new cases of cancer will be diagnosed in women, compared to 856,370 new cases in men.1 The most common cancer types to be diagnosed in women and estimated number of deaths are summarized in Table 34-1. From 1975 to 2014 the average annual cancer incidence rate has stabilized in women, partially due to the decline in lung and colorectal cancers and increasing rates of breast, thyroid, and uterine cancers.1 In 2002 to 2003 the incidence of breast cancer slightly declined by 7%, primarily due to a reduction in the use of hormone replacement therapy.1 More recent trends indicate that the rate of breast, thyroid, and liver cancers have slightly increased and the incidence of lung and colorectal cancer in women has been declining.1 The estimated number of deaths in women for 2018 is 286,010 compared to 323,630 in men.1 Lung, breast, and colorectal cancers are the leading cause of cancer related deaths in women (Table 34-1). Lung cancer death rates have declined in women since the early 2000s, breast cancer death rates have decreased by 39% between 1989 and 2015, and colorectal cancer death rates have steadily declined since the late 1940s. Liver and uterine corpus cancers, however, have been on the rise since the late 1990s.1

Table 34-1Ten Most Common New Cancer Cases and Estimated Number of Deaths in Women (2018)1
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