There are six main gynaecological cancers of the female reproductive organs; cancer of the uterus, cancer of the fallopian tubes, cervical cancer, ovarian cancer, cancer of the vagina, and cancer of the vulva.
Cancer of the uterus (endometrial cancer) starts in the lining of the endometrium and may then spread to the fallopian tubes, ovaries, and the lymphatic system. The symptoms may include bleeding between periods or spotting if you have already gone through menopause. There may also be pink to brown and intermittent period-like pains. It is the fifth most common cancer amongst women 1 and it occurs mainly in women between the ages of 50 and 60 who have not had children. Unfortunately, there are no early detection tests for this type of cancer, however as cancer grows very slowly, it is essential that any symptoms are reported as early as possible.
Cancer of the fallopian tubes is very rare It accounts for around 0.1 to 0.5% of all gynaecological cancers. Patients may have a watery vaginal discharge, pelvic pain, vaginal bleeding, and a small lump. Cancer grows very slowly and as bleeding occurs quite early on it is usually easy to detect and remove before it spreads to the lymph nodes and ovaries.
Cervical cancer most often develops in women who have changes in the skin on the outside of the cervix, this is why it is important to ensure that regular smear tests are carried out. The main symptoms are a watery, bloody discharge which may smell and bleeding between periods or after menopause or after sex. Although it is one of the most common cancers in women, affecting 1 woman in 80 with 2000 women dying every year, it is one of the easiest to diagnose, treat, and cure if it is detected early enough. New research has shown that the HPV virus, human papillomavirus, is probably the cause of most cervical cancers and a new vaccine is now being developed.
Ovarian cancer causes the deaths of up to 4,000 women every year, although it is rare in women under the age of 40. It is caused when abnormal tissue develops in the ovary and is sometimes related to ovarian cysts. It is very difficult to detect in its early stages because the ovaries are buried in the abdominal cavity. Any swelling is often not noticed until the disease is very far advanced, it is at this stage that there may be other symptoms including lower abdominal pain weight loss, and general ill-health.
Vaginal Cancer is extremely rare. The vagina connects the cervix with the vulva (the folds of skin around the opening to the vagina). There are two types of cancer of the vagina: squamous cell cancer (squamous carcinoma) and adenocarcinoma. Squamous carcinoma is usually found in women between the ages of 60 and 80. Adenocarcinoma is more often found in women between the ages of 12 and 30.
Cancer of the Vulva occurs in the outer part of a woman’s vagina. Most women with cancer of the vulva are over age 50. However, it is becoming more common in women under age 40. Women who have constant itching and changes in the colour and the way the vulva looks are at a high risk of getting cancer of the vulva. A doctor should be seen if there is bleeding or discharge not related to menstruation (periods), severe burning/itching, or pain in the vulva, or if the skin of the vulva looks white and feels rough.
Symptoms
• unusual growths or sores around the vagina
• vaginal discharge
• spotting between periods or after sex
• changes in the pattern of menstrual bleeding
• lumps in the abdomen
• bloating of the abdomen
• pain in the abdomen
• painful urination – there may also be an increase in urinating
• nausea and vomiting
• weight loss and/or loss of appetite
• the glands in the groin become swollen
What Treatment is Available?
In almost all cases the preferred method of treatment is surgery in some form.
Cancer of the Uterus (or endometrial cancer) is very slow-growing and is usually diagnosed before it has spread further than the uterus. A hysterectomy is the preferred method of treatment. There is a risk that cancer can spread to the ovaries, therefore discussion needs to take place with your surgeon before the operation about this possibility. It may be necessary to have further treatment with either radiation and/or chemotherapy following surgery, particularly if the cancer is known to have or suspected of spreading to other parts of the body.
Cervical cancer treatments will depend on the extent of the disease, the type of cancer, the age and general health of the woman, and her desire to have children. Surgery may range from very specific for surface cancer (carcinoma in situ) up to a radical hysterectomy (removal of the uterus and surrounding pelvic lymph nodes) when cancer has spread beyond the cervix.
In some cases, a cone biopsy, where a wedge of the cervix is removed for analysis, is sometimes enough to remove all of the malignant cells of a surface cancer, and cryosurgery (freezing of the tissue) is also used frequently to treat pre-invasive cancer. As the cancer is very invasive and frequently spreads to the pelvic lymph nodes, additional treatment such as radiotherapy or chemotherapy may be required.
Treatment for Ovarian cancer is usually centred around surgery and is frequently necessary to obtain a diagnosis. Additional treatments such as chemotherapy or radiotherapy may also be used.
Vaginal cancer treatments are again centred around surgery (removal of the cancerous tissue, radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumours), or chemotherapy (using drugs to kill cancer cells). Surgery is the preferred method of treatment and may be performed in one of the following ways: Laser surgery uses a narrow beam of light to kill cancer cells and is useful for stage 0 cancer. Wide local excision takes out cancer and some of the tissue around it. A patient may need to have skin taken from another part of the body (grafted) to repair the vagina after the cancer has been taken out.
Where cancer has spread beyond the vagina it is sometimes possible to remove the vagina (vaginectomy), this may also be combined with a radical hysterectomy which removes the uterus, ovaries, fallopian tubes, and lymph nodes.
Cancer of the vulva will require either surgery, radiotherapy, chemotherapy, or a combination of treatments. Surgery will involve either a ‘skinning vulvectomy’ to take out only the skin of the vulva that contains cancer. A ‘simple vulvectomy’ will remove the entire vulva. A ‘partial vulvectomy’ removes a part of the entire vulva. A ‘radical vulvectomy’ will remove the vulva and the lymph nodes around it.
The treatment of cancer of the fallopian tubes can involve only chemotherapy if it is spotted early enough. This will ensure that a woman’s fertility will remain intact. If it is diagnosed at a later stage, treatment will involve surgery.
Surgical treatments may require the removal of one or both ovaries, together with the fallopian tubes. A hysterectomy may also be carried out, this is due to the fact that this cancer, like a lot of others, can spread. further treatment with chemotherapy or radiation therapy may be necessary after surgery.
If any of these cancers have spread further than the reproductive organs then the removal of the lower colon, rectum, or bladder (depending on where the cancer has spread) may become necessary.