Gynaecological Cancer

I’ve been told that I have gynaecological cancer. What is it exactly? 

Gynaecological cancer is a group of cancers that affect the tissue and organs of the female reproductive system. There are six main types of cancer that affect a woman’s reproductive organs: 

As a group, they are referred to as gynaecological cancer. 

What are the risk factors for gynaecological cancer?  

The following are some common risk factors associated with the different types of gynaecological cancer. Each cancer has its own general risk factors, and may affect women in various ways: 

  • Post Menopausal (aged 50 years or over) 
  • Smoking 
  • Obesity 
  • Diabetes 
  • Other cancers (colon, rectal, breast) 
  • Early age of first menstruation 
  • Women who have never been pregnant 
  • Hormone-related issues 
  • Family history of breast or ovarian cancer 
  • HPV infection 
  • DES exposure (synthetic estrogen given to women before 1971 during pregnancy to prevent miscarriage, but ultimately causing health risks to the expectant mother and unborn child they carried) 
  • Endometrial hyperplasia – a condition where the cells of the endometrium are abnormal 
  • Cervical dysplasia – a condition where the cervical cells are abnormal 

What are the symptoms of gynaecological cancer? 

As well as risk factors, there are also common symptoms of gynaecological cancer which you should be aware of: 

  • A change in bowel or bladder habits 
  • A sore that does not heal 
  • A thickening or lump that either causes pain or can be seen in the pelvic area 
  • Pain or pressure in the pelvic area 
  • Abnormal vaginal bleeding 
  • Vaginal bleeding during or after sexual intercourse 
  • Persistent abdominal swelling or bloating 
  • Unintended weight gain or loss 
  • Persistent bowel changes (diarrhoea or constipation)

How is gynaecological cancer is diagnosed? 

How gynaecological cancer is diagnosed depends on what type of cancer is suspected. Pelvic exams, imaging tests, biopsies, colposcopy exam and possible diagnostic surgery are all methods of diagnosing gynaecological cancer. Once cancer is confirmed, the stage of the cancer is determined and a treatment plan is developed. Staging refers to how far the cancer has spread to nearby tissue or organs. Among each of the various types of gynaecological cancer, early detection is crucial. However, detection can be very difficult, especially in the early stages. 

 

Tests such as the following may be carried out: 

 

Transvaginal ultrasound 

An ultrasound used to build up a picture of the tissues in your womb. During a transvaginal ultrasound a small metal ‘probe’, covered with a gel is inserted into the vagina. This creates the images in your scan. This test is not painful but may be a little uncomfortable. 

 

Hysteroscopy 

A hysteroscope is a thin, flexible tube with a light at the end which is passed through the vagina and into the womb. This allows the doctor to look inside the womb and take tissue samples or a biopsy. 

 

Biopsy 

A small amount of tissue samples are taken from the womb during a hysteroscopy. Biopsies are sent to a laboratory and looked at under a microscope to detect if cancer cells are present. 

 

D&C - dilatation and uurettage 

During a D&C the cervix and entrance to the womb are gently opened. Samples of tissue from the inner lining of the womb are taken with an instrument shaped like a spoon called a curette. The samples are then sent to the laboratory to be examined. 

 

Rare types of gynaecological tumour:

 

Gestational trophoblastic tumour 

Gestational trophoblastic tumour is a rare type of malignancy in which the tissues formed in the uterus following conception become cancerous. There are 3 types of gestational trophoblastic tumour:

  • Hydatidiform mole: a cyst which forms from the tissue after the sperm and egg have joined.
  • Choriocarcinoma: this can begin from a hydatidiform mole or from tissue that remains in the uterus following the delivery of a baby.
  • Placental-site trophoblastic disease: a very rare form which starts in the area of the uterus where the placenta was attached. 

 

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. 

 

Uterine sarcoma 

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. Uterine sarcoma 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.