Gynaecological cancer

There are six main gynaecological cancer’s 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 the menopause. There may also be a 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 aged of 50 and 60 who have not had children. Unfortunately there are no early detection tests for this type of cancer, however as the 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. The 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 the 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 detected early enough. New research has shown that the HPV virus, human papilloma virus, 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 it’s 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 color and the way the vulva looks are at a high risk to get 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 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 the 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 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 pr 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 tumors) 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 the 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 the 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 treatment. Surgery will involve either a ‘skinning vulvectomy’ to take out only the skin of the vulva that contains the 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.

Recommended Reading:

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14 thoughts on “Gynaecological cancer

  1. I have a kind of cheesey Stomach button, below it I have tromendous pain Then below that, just above my virgina have lumps & bumps Have pressed them whilst soaking in bath Now in real great extreme pain So affaird to see or go to doctors Especially alone, but have no one who will support me

    1. Nicky, please go to your GP I am not one for visiting mine and had big hang ups about anything medical particularly in that area but had to go in the end and put my fears aside and although it resulted in me having hysterectomy five weeks ago I am so pleased that I went as it turns out I had a cyst on one of my ovaries and they have found early stage cancer in my uterus. My boss actually took me to two of my appointments! Please please go to your doctor.

  2. I’ve experienced slight bleeding now and again when I wipe myself after urinating. I’m 54 and gone/going through menopause still. I’ve noticed now and again a small red spot/mark in the groin area right next to the vaginal wall towards the back of that area near the buttocks and know definitely it’s not anything to do with STD’s as my husband and myself have been loyal to each other and not had sex for a long time. Plus I’m not experiencing any pain or discharge. I’m booking an appointment to see my doctor, but I’m wondering if anyone else has experienced the same symptoms as me and knows what it may be.

  3. Can anyone put my mind at ease. I had a total hysterectomy 11yrs and I’m now 42. During intercourse I found that it was becoming more and more uncomfortable and sometimes painful. On self examination I found I had 3 lumps inside me. After a few months I finally plucked up the courage to go get them checked out by the doctor. She said there not really worth bothering about but I disagreed as the one lump is Bigger than the other two and even the doctor examining me found it straight away even though it’s quite deep inside. She has agreed to give me a local aniethetic and as she said “burn or remove them if she can” this did not leave me with much confidence in the doctor. Especially as she said she said she wouldn’t have bothered if I hadn’t asked. My mum has had cervical cancer twice now and I would rather be safe than sorry. Should I ask if they can do a biopsy ……is that even possible? Or am I just stressing over nothing?!

  4. Hi can anyone put my mind at ease I’m litterly thinking the worst I’m a worrier anyway!! For a good couple weeks I’ve been getting this really bad watery discharge it’s like a brown in colour and smells awful! I have pelvic and abdominal pain/ dull ache and my back aches too I went to my go he prescribed me with antibiotics for bv but since it’s still not gone it’s really getting me down and doing research on my own is not helping my anxiety!

    Thanks in advance xxx

  5. Can someone answer my question please.
    I have 2 of the 11 symptoms on the list
    The adominal pain ( but rarely do I get pain and only in the bottom right hand part of my abdomen) also the vaginial dishcharge what should I do?

    1. First go to a health clinic and do not panic

  6. Hi there I wonder if anyone can help me I have endermitreous and have had really bad pelvic pain and stomach pain and my stomach is very tender to touch and has been for months I have been back and forth to the hospital and doctors and all they keep doing is a load of test and giving me tablets that none seem to work. I really don’t know what you do next I am really worried please help

  7. Hi I’m wondering if any of you ladies could help me,
    I’m 22 years old, I’ve been having pelvic pain, discharge, and generally feeling unwell,
    Then I noticed I had quite a big lump on the inside of my vagina.
    It’s very painful during sex, it’s not a std,
    I will be booking a drs appointment on Monday!
    I’m just wondering if any of you have had similar

    Thank you in advance! ?

  8. I had an internal vaginal scan 9 months ago as My periods had stopped & I was getting stabbing pains in my rectum & vagina, there was no signs of anything abnormal.
    Blood tests had suggested I was pre menopausal. About 4-5months ago I started getting a yellowish green watery discharge (sometimes has blood) which is continuously leaking out & if I don’t wear pads etc I look like I’ve wet myself. I have constant pain on the left side of my lower back & a dull ache in my abdomen & with some movement I get a stabbing pain. I’ve been cleared of STD’s are these symptoms of being pre menopausal. I’m thinking if there was any abnormalities surely the scan 9months ago would have picked something up?

  9. I would go straight back to see your surgeon, not your GP. My sister had exactly the same cancer, it is very very rare, only 41 reported cases in the world apparently.

  10. Just had radical hysterectomy with part of vaginal wall taken away because I had squamous cell carcinoma there. Op was performed on the 30th April 2014 and in the last couple of days I have had lymphatic fluid leaking from my vagina which is excruciatingly painful. Each time the fluid is released I get very sharp stabbing pains! Is this normal? Should I be worried?

    1. No it’s not normal and you need to speak with your GP Lynn.

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