Medical Terminology and Cancer

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14: The Reproductive System and Development

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Function of the Reproductive Systems

The reproductive system includes the gonads -male testes and female ovaries and other accessory ducts and glands (gonos = seed). These provide the means for reproduction, the continuation of the species, and passing on of genetic material to the next generation. Many of the hormones associated with the reproductive system have already been covered in the section about the Endocrine system. Puberty begins when hormones are secreted by the pituitary glands, these control the growth and development of the gonads.

The Male Reproductive Organs

Male reproductive organs include testes which produce spermatoza and hormones; a series of ducts that store and transport the sperm; accessory sex glands (including the prostate gland) secrete seminal fluid, and the penis .

The Female Reproductive Organs

Female reproductive organs include the ovaries which produce mature ova (eggs) and hormones; the fallopian tubes which transport ova to the uterus; the vagina; the vulva; and also the mammary glands of the breasts

The Breasts

Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. The lobes and lobules are connected by thin tubes called ducts.

Reproduction and Development

Development of the embryo. After successful fertilisation of the egg the embryo is formed. At the end of the embryonic period (first two months) the basis for all the main adult organs are present. This is followed by the fetal period, during which the fetus develops.

Inheritance is the passing of hereditary traits from one generation to the next - genetics .

Roots, suffixes, and prefixes

componentmeaningexample
ANTE- before antenatal = before the birth of a baby
COLP- vagina e.g colpotomy = incision into the vaginal wall.
MAMM-breast mammography = imaging of the breasts
MAST- breast mastectomy =surgical removal of a breast or part of a breast
NEO-new neonatal = the first 4 weeks after birth
GYN-woman gynocologist = medical specialist in diseases of the genital tract in women.

Cancer Focus

Breast Cancer Overview
Breast cancer is the most common type of cancer in women aged between 35 to 54, incidence has increased such that 1 in 9 women develop breast cancer in the USA. Worldwide 700,000 cases are diagnosed each year. The most common type of breast cancer that found in the cells of the breast ducts, other types include those of the lobes, and inflammatory breast cancer. If a lump is detected a biopsy will be required to see if it malignant (most lumps are benign). If the lump is cancerous hormone tests will be carried out on the cells (estrogen and progesterone receptor tests). If the cells are responsive to these hormones then these may be used to stop the lump growing. Further treatment depends on the stage of the cancer. Chemotherapy, surgery and radiotherapy may be required. Total mastectomy is removal of the whole breast, in radical mastectomy the chest muscles and under-arm lymph nodes are also removed. More recently there has been an increased use of lumpectomy where only the lump and surrounding tissue is removed. Following surgery radiotherapy may be required. Reconstructive surgery is the rebuilding the breast with other tissue or implants, this may be done at the time of mastectomy or at a later time. Between 5 and 10% of breast cancers are known to be hereditary, women with the defective BRCA1 gene are more likely to develop breast or ovarian cancer.

Internet Resources for Breast Cancer

Breast Cancer Prevention and Early Detection
When breast cancer is found and treated early, a woman has more treatment options and a better chance of cure. Both breast self examination and screening programs have the potential to catch breast cancer at a less advanced stage with a better chance of survival.

Male Breast Cancer
Male breast cancer is uncommon, men account for approximately 1% of all breast cancer cases. Incidence in Western populations is under 1 case per 100,000 men, though rates reported in some African countries are much higher. The majority of male breast cancers are of the infiltrating ductal type, this is where the cancer has spread beyond the cells lining ducts in the breast. In many respects male breast cancer is similar to that found in women, though in general men tend to be older than women at diagnosis. Treatment tends to be the same as that for women with breast cancer of the same type and stage.

Internet Resources for Male Breast Cancer

Gynacological (women's) Cancers
Gynaecological cancers are a group of different malignancies of the female reproductive system. The most common types of gynaecologic malignancies are cervical cancer, ovarian cancer, and endometrial (uterus) cancer. There are other less common gynaecological malignancies including cancer of the vagina, cancer of the vulva, gestational trophoblastic tumours, and fallopian tube cancer. Occasionally skin cancers or sarcomas can also be found in the female genitalia. Generally, most gynaecological cancers are found in women aged over 50, though the incidence rates for younger women have been rising.

Internet Resources for Gynaecological Cancers

Cervical Cancer
Cervical cancer is a common type of malignancy accounting for about 6% of all cancers found in women. It is a disease in which cancerous cells develop in the uterine cervix (this is the connecting passage between the uterus and vagina). The peak incidence of cervical cancer occurs between the ages of 40 to 55. It is rare before the age of 35, however the incidence of cervical cancer in younger women rose dramatically during the two decades after 1960. Regular Pap smear tests may detect abnormal changes in the cervical tissues, before cancer develops. Symptoms of cervical cancer may include vaginal bleeding after intercourse or bleeding between periods. However, in the early stages of the disease there are often no obvious signs or symptoms, so regular smear tests are important.

Internet Resources for Cervical Cancer

Ovarian Cancer
Cancer of the ovaries are the second most common group of gynaecologic cancers, and account for about 5% of all women's cancers. There are two main types; (i) epithelial tumours (carcinomas) which account for 90% of ovarian cancers, and (ii) non-epithelial tumours (eg. Stroma cell and germ cell tumours of the ovary). The epithelial ovarian cancers are usually found in women aged over 40, while the non-epithelial tumours are more common in girls and young women. Epithelial ovarian cancer has few early symptoms, a risk factor is having a family history of the disease. Taking the contraceptive pill is known to be protective against ovarian cancer.

Internet Resources for Ovarian Ca.

Vaginal Cancer
Cancer of the vagina is relatively rare, accounting for about 2% of gynaecological malignancies. There are two main types of vaginal cancer; squamous cell cancer and adenocarcinoma. Over four fifths of all vaginal cancers are squamous carcinoma, this is more common in women between the ages of 60 and 80. The other type of vaginal cancer; adenocarcinoma is usually found in young women under 30 years old.

Internet Resources for Vaginal Cancer

Uterus and Endometrial Carcinoma
Endometrial cancer is a malignancy of the endometrium (the inner lining of the uterus, or womb) and is the most common gynaecological cancer, and accounts for 13% of all cancers in women. It is most frequently in women over age 50. A know risk factor is prior oestrogen-replacement therapy (however, oestrogen replacement also lowers risk of heart disease). Symptoms can include pelvic pain, and blood-soaked discharge - though these are also common symptoms related to menopausal changes.

Internet Resources for Endometrial Ca.

Cancer of the Vulva
The vulva is the outer part of the vagina, cancer of the vulvar is a rare type of malignancy, usually found in women aged over 50 - though the incidence of this cancer in younger women has been reported to be increasing. Women with persistent itching and changes in the colour vulva have a higher risk of cancer of the vulva. Research suggests that human papillomavirus (HPV) may have a role in causing this and other gynaecological cancers.

Internet Resources for Vulva Cancer

Uterine Sarcoma
Uterine sarcoma is a rare kind of cancer in which the cells in the muscles or other supporting tissues of the uterus become cancerous, and represents 1% of gynaecological cancers overall. This is very different to endometrial (uterus) cancer - see above. There are two main histological sub-types; leiomyosarcoma, and stromal sarcoma. A known risk factor for developing uterine sarcoma is prior radiotherapy to the pelvic area, this is estimated to account for between 10% to 25% of cases.

Internet Resources for Uterine sarcoma

Gestational Trophoblastic Cancer
Gestational trophoblastic tumour is a rare type of malignancy in which the tissues formed in the uterus following conception become cancerous. There are three types of gestational trophoblastic tumours: (i) hydatidiform mole - this is where the sperm and egg have joined but the tissues formed develop into a cyst; and (ii) choriocarcinoma - this can begin from a hydatidiform mole or from tissue that remains in the uterus following the delivery of a baby; (iii) placental-site trophoblastic disease - this is very rare and starts in the area of the uterus where the placenta was attached.

Internet Resources for Gestational Trophoblastic Disease

Fallopian Tube Cancer
Cancer starting in the fallopian tubes is very rare, less than 2,000 cases have been reported world-wide. Most cancers found in the fallopian tubes have actually spread from other places such as the ovaries. Most fallopian tube cancers are found in post menopausal women.

Internet Resources for Fallopian Tube ca.

Genitourinary (Men's) Cancers
The most common type of male genital malignancy is prostate cancer (over 90% of male genital cancers), This is more common in older men. Incidence rates have increased in recent years (SEER data). Testicular cancer is less common (6% of male genital cancers), but it is the most frequent cancer in young men between the age of 15 to 35. Other types of cancers arising in the male genitals are rare, these include penile cancer, scrotum cancers and spermic cord cancer

Internet Resources for Genitourinary Cancers

Testicular Cancer
Testicular cancer is most common cancer in men between 15 to 35 years old. There are two broad types: seminoma and nonseminoma histologies. The nonseminoma group of cancers includes embryonal carcinoma, teratoma, yolk sac carcinoma and choriocarcinoma. The two testicles (or testis) produce sperm and male hormones. Men who have an undescended testicle (a testicle that didn't move down into the scrotum) are at higher risk of developing testicular cancer. World-wide about 36,000 men are diagnosed with testicular cancer each year.

Internet Resources for Testicular Cancer

Prostate Cancer
Prostate cancer accounts for over a quater of all cancers in men. The prostate is a small male sex gland located below the bladder, it produces fluid that becomes semen. Prostate cancer occurs mostly in older men, it is rare before the age of 50, and the risk increases with age. There has been an increase in the incidence of prostate cancer since the early 1980's, most likely due to an increased use of screening using the prostate-specific antigen (PSA) test. However, the role as screening for prostate cancer remains controversial. World-wide about 395,000 men are diagnosed with prostate cancer each year.

Internet Resources for Prostate Cancer

Penile Cancer
Cancer of the penis is rare in industrialised countries, accounting for about 1% of male genital cancers, there are however large international and racial differences in incidence. The disease is more common in developing countries.

Internet Resources for Penile Cancer

Childhood Germcell Tumours
Germ cell tumours (GCT) are most commonly found in children and young adults. Germ cell tumours found in children tend to be of different histology compared to those found in adults. Germ cells are cells which become the embryo that develops in the womb. Some germ cells may remain in different parts of the child's body after birth and may give rise to tumours. The most common sites are the testes, the ovaries or the sacrococcygael region. They may also arise in other sites in the body e.g in the brain (intracranial GCT). Germ Cell tumours produce alphafetoprotein (AFP) and human chorionic gonadotrophin (HCG) that can be detected in blood samples to aid diagnosis.

Chemotherapy and Fertility
Fertility may be affected by chemotherapy. Depending on the type of drugs given there may be a risk of infertility. For female patients certain drugs can cause permanent damage to the ovaries, and the patient may have an early menopause. Male patients may also be effected by chemotherapy which may cause a low sperm count. Male patients who are old enough may leave a sample of sperm in a sperm bank prior to chemotherapy.

Related Abbreviations and Acronyms:

ABC

Advanced Breast Cancer

AFP

Alphafetoprotein - eg. expressed by germ cell tumours and other cancers

BSE

Breast Self Examination

DCIS

Ductal Carcinoma In Situ - type of breast cancer

FIGO

Federation Internat. Gyn. Obst. (FIGO Gynaecological staging system)

GCT

Germ Cell Tumour

GU

Genito-urinary

HPV

Human Papilloma Virus - implicated in some gynacological cancers

HRT

Hormone replacement therapy

LCIS

Lobular Carcinoma In Situ - type of breast cancer

LMP

Low Malignant Potential (context: ovarian tumours)

Lx

Lumpectomy

Mx

Mastectomy

NABCO

National Alliance of Breast Cancer Organizations

PSA

prostate-specific antigen - PSA test used in screening for prostate cancer

SGO

Society of Gynecologic Oncologists

YST

Yolk sac tumour - (aka. germ cell tumour)

More Cancer Related Abbreviations

This guide by Simon Cotterill

First created 04/03/96
Last modified: 31/08/2000