Gynaecological cancer

Specialty of Medical oncology

What is gynaecological cancer?

Gynaecological cancer refers to any cancer that occurs in any of the organs of the female reproductive system, which is located in the pelvic region below the stomach and between the hips. There are five types of gynaecological cancer, differentiated by location:

  • Cervical cancer
  • Ovarian cancer
  • Uterine cancer
  • Vaginal cancer
  • Vulvar cancer

Symptoms of gynaecological cancer

Each type of gynaecological cancer has its own signs, symptoms and risk factors:

Cervical cancer:

  • Bleeding between periods.
  • Abundant vaginal discharge with small amounts of blood.
  • Bleeding after sexual intercourse.
  • Abdominal pain and discomfort in the lower back.

Ovarian cancer:

  • Discomfort in the lower abdomen, similar to indigestion.
  • Pelvic pain.
  • Anaemia and weight loss.
  • Fatigue, loss of appetite.
  • Increased body hair due to hormonal disturbances.

Uterine cancer:

  • Bleeding between periods.
  • Abundant vaginal discharge with blood.
  • Bleeding after sexual intercourse.

Vaginal cancer:

  • Bleeding between periods.
  • Back and/or pelvic pain.
  • Pain while urinating.
  • Small lumps in the vagina.

Vulvar cancer:

  • Burning sensation or bleeding in the vulva.
  • Colour is more reddish or paler than usual.
  • Appearance of warts or irritation similar to rash in the area.
  • Non-healing ulcers or lumps.
  • Pelvic pain during sexual intercourse or urination.

What are the risk factors for gynaecological cancer?

Cervical cancer:

  • HPV (human papilloma virus).
  • Being a smoker.
  • Being HIV-positive.
  • Having sexual intercourse with different people continually.
  • Having given birth to more than three babies.

Ovarian cancer:

  • Being middle-aged or older.
  • Family history.
  • Certain genetic changes (mutations) can increase the risk of ovarian cancer. Mutations in the two breast cancer predisposition genes (BRCA1 and BRCA2) and those associated with Lynch syndrome increase the risk of ovarian cancer.
  • History of breast, uterine or colorectal cancer.
  • Having endometriosis.
  • Having no children or having difficulty conceiving.

Uterine cancer:

  • Being older than 50.
  • Obesity.
  • Taking oestrogen-only (without progesterone) hormone replacement therapy during the menopause.
  • Having had difficulty conceiving.
  • Taking tamoxifen.
  • Family history of uterine, colon or ovarian cancer.

Vaginal cancer:

  • Vulvar cancer
  • Having HPV (human papilloma virus).
  • History of cervical cancer.
  • Weakened immune system.
  • Being a smoker.
  • Chronic burning sensation in the vulva.

Can it be prevented?

There is a different prevention strategy for each type of gynaecological cancer. The following aspects may help to lower the probability of developing one of the gynaecological cancers.

Cervical cancer:

  • The two tests that help to prevent cervical cancer are cytology and the HPV test.

Ovarian cancer:

  • Taking contraceptive pills for 5 years or longer.
  • Removal of ovaries, tubal ligation, hysterectomy.
  • Giving birth.
  • Breastfeeding.

Uterine cancer:

  • Using contraceptive pills.
  • Maintaining a healthy body weight and doing physical exercise.
  • If you are taking oestrogen: taking it in combination with progesterone.

Vaginal cancer and vulvar cancer:

  • being vaccinated against HPV (which causes this type of cancer) and having cytology done.

What is the treatment?

If the cancer is detected at an early stage, it is very likely that it can be cured completely and that you can live a long life with a good quality of life. The different types of treatment are surgery, chemotherapy and radiotherapy, depending on the patient and the stage of the cancer.

  • Surgery: the cancerous tissue is removed.
     
  • Chemotherapy: specific medications to reduce or eliminate the cancerous tissue. The medications may be given intravenously, in tablet form, or by both routes.
     
  • Radiotherapy: radiation administered to “kill” the cancer.
     
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