The ultimate guide to gynaecological cancer

Gynaecological cancers are a range of five cancers that are specific to the female reproductive organs. The female reproductive system consists of the cervix, the ovaries, the womb, the vagina, and the vulva, and anyone with these organs is at risk for developing cancer. Every year in the UK, there are around 22,000 cases of diagnosed gynaecological cancers. Expert obstetrician and gynaecologist Mr Mohan Kumar gives an overview of gynaecological cancers in this article.

The kinds of gynaecological cancers are:

• cervical cancer, on the lining of the cervix
• ovarian cancer, inside or on the surface of the ovaries
• womb cancer (also known as uterine or endometrial cancer), along the womb lining, called the endometrium
• vaginal cancer, a rare cancer that is mostly found in women over 75 years old
• vulval cancer, a very rare cancer that manifests on the external genitalia

What are the symptoms of gynaecological cancers?

The symptoms will vary for each of the cancers, but commonly, there will be:

• pain or ache in the pelvis and groin
• vaginal bleeding outside of the regular cycle, or at abnormal levels, or after menopause
• pain during intercourse or urination
• open sores, growths, and itching (vaginal and vulvar cancers)
• lumps or swelling in the pelvis
• stained or strange-smelling discharge

What causes gynaecological cancers?

Cancers form when abnormal cells grow in the tissues of organs, inside or on the surface. Factors that have the highest risk for gynaecological cancers include:

• women in menopause or post-menopause, due to changes in the normal levels of progesterone and oestrogen
• heavy smokers
• those with endometriosis or polycystic ovary syndrome (PCOS)
• those with a family history of cancer
• obesity
• older people
• human papilloma virus (HPV)

HPV is a sexually transmitted infection, and most kinds of it have no symptoms aside from warts on the hands, feet, and genitals. It is generally harmless and tends to go away after a couple of years, but there are strains (primarily types 16 and 18) that are very closely linked with and believed to cause gynaecological cancers, specifically cervical, vaginal, and vulvar. These strains change the cells in the cervix, causing abnormal growth (cervical dysplasia), which left unaddressed will become cancerous. HPV has been detected in more than 60% of women with vaginal cancer and 40% of women with vulval cancer.

How are gynaecological cancers diagnosed?

The diagnostic process for gynaecological cancers involves several tests and scans. A doctor will conduct a physical exam of the abdomen and the pelvis as they look for any swelling or lumps. They will ask the patient about their family history, lifestyle and any symptoms exhibited thus far. After this, the patient will be referred to a gynaecologist or specialist for further testing. A gynaecologist will be able to conduct a more thorough examination externally and internally. The gynaecologist is likely to recommend a biopsy, where a sample of tissue from the area of concern is extracted and examined under a microscope, and an ultrasound, either abdominal or transvaginal (internal), which can map the structure of the womb, cervix, and ovaries to see if there is any unusual growths or thickness. Further tests may include MRI and CT scans, and blood tests to see if there are any tumour markers or unusual hormone activity in the blood.

How are gynaecological cancers treated?

There is no one treatment plan as it depends on which gynaecological cancer needs to be treated, and what stage it is at. The most common forms of treatment are radiotherapy, surgery, and chemotherapy. Radiotherapy works by using a machine that beams high-power rays at the pelvis to kill cancer cells. There are many surgeries in the treatment of gynaecological cancers, all necessitating the removal of part or all of the affected organ, again depending on the severity of the cancer – for example, a hysterectomy is when the cervix and womb are removed. Unfortunately, these procedures will greatly impact the ability to give birth or become pregnant as the sexual organs are removed or impaired. Chemotherapy has been notedly less effective than radiotherapy, but some treatment plans use chemotherapy in conjunction with surgery or radiotherapy to further the results. Recent research has been looking into immunotherapy for treating gynaecological cancers, but there are still some ways to go before it is widely implemented.

If you believe you are at risk for a gynaecological cancer, book a consultation with Mr Kumar via his Top Doctors profile.