Gynaecological Cancers

In partnership with The Eve Appeal

It’s certainly not an easy topic to cover, but it’s one of the most important.

Gynaecological cancers (womb, ovarian, cervical, vulval, and vaginal) vary in severity and rarity, but they are all important to have an understanding of, so you know what to look out for. The Eve Appeal, a UK gynaecological cancer research charity, has graciously provided us with a thorough overview of gynaecological cancers, including a description of how they develop and the signs and symptoms to be conscious of.

WOMB

Womb cancer is the fourth most common cancer in women in the UK and the most common of the five gynaecological cancers, with over 9,300 women diagnosed every year in the UK. It is worth noting that cancer of the womb can be called several different names by healthcare professionals, including uterine cancer (because this is the medical name for the womb), or endometrial cancer (which is cancer within the lining of the womb).

How does it develop?

Most womb cancers begin in the endometrium (womb lining), where the cells that grow are then shed each month as menstrual loss (a period). When a womb cancer starts, the normal cells change their appearance, increasing in size and shape, until they become cancer cells that divide and grow into a tumour.

As the cancer develops, it often causes an unexpected vaginal bleed. Womb cancer is more common amongst post-menopausal women and therefore any vaginal bleeding should be reported to your GP immediately. Yet, if you’re a woman who is still menstruating and experience an unexpected bleed, whilst it could be a less serious issue e.g. hormonal imbalance, it is still important to see your GP to find the cause of the problem.

Key signs and symptoms

The most common symptom of womb cancer is abnormal vaginal bleeding – especially for women who have been through the menopause. Around 90% of endometrial cancer diagnoses are reported due to post-menopausal or irregular vaginal bleeding.

Please note though that most people with abnormal bleeding will not have a gynaecological cancer.

This irregular bleeding might be:

  • Vaginal bleeding after the menopause
  • Bleeding between periods
  • Bleeding that is unusually heavy
  • Vaginal discharge – from blood-stained to a light or dark brown

For post-menopausal women it can take a while to adjust to what is now ‘normal’ in terms of your vaginal discharge. If you are uncertain, the best course of action is to approach your doctor or nurse to ask: “Is this normal?”

The Eve Appeal have developed a resource for women and families if they have been recently diagnosed with womb cancer or are worried about the signs and symptoms – please click here to find out more.

OVARIAN 

In the UK over 7,300 women are diagnosed with ovarian cancer every year and is the sixth most common cancer among women after breast cancer, bowel cancer, lung cancer, cancer of the uterus (womb) and melanoma skin cancer.

What is ovarian cancer?

Cancer of the ovary is most common in post -menopausal women, although it can affect women of any age. There are many types of ovarian cancer, with epithelial ovarian cancer being by far the most common form. Germ cell and stromal ovarian cancers are much less common.

How does it develop?

In ovarian cancer, cells in the ovary start to change and grow abnormally. If the cancer isn’t identified at an early stage, it can breach the ovary skin and spread to the abdomen and pelvis (peritoneal cavity).

Key signs and symptoms

If ovarian cancer symptoms are identified and the cancer diagnosed at an early stage, the outcome is more optimistic. However, because some of the symptoms of ovarian cancer are often the same as for other less serious conditions, such as irritable bowel syndrome (IBS) or pre-menstrual syndrome (PMS), it can be difficult to recognise the symptoms in the early stages – which is why most women are not diagnosed until the disease has spread.

However, there are four main ovarian cancer symptoms that are more prevalent in women diagnosed with the condition. They are:

  • increased abdominal size and persistent bloating (not bloating that comes and goes)
  • persistent pelvic and abdominal pain
  • unexplained change in bowel habits
  • difficulty eating and feeling full quickly, or feeling nauseous

Other symptoms, such as back pain, needing to pass urine more frequently than usual, and pain during sex may be present in some women with the disease; however, it is most likely that these are not symptoms of ovarian cancer but may be the result of other conditions in the pelvic area.

CERVICAL

Cervical cancer is cancer of the cervix (also known as the neck of the womb) which connects a woman’s womb and her vagina.

Cervical cancer can affect women of all ages but affects women primarily 30 – 45 years of age. It is very rare in women under 25 years of age. In the UK we have a very successful cervical screening programme which is estimated to save over 4,000 lives each year.

How does it develop?

Nearly all squamous cervical cancers are caused by a common sexually transmitted infection called human papillomavirus (HPV). This is why the UK government is vaccinating girls at an early age before they are potentially exposed to the HPV virus (i.e. before they experience sexual activity). Sex is a normal, healthy activity, and the wearing of condoms is advised to protect both partners from unwanted pregnancies and reduce exposure to HPV, as well as other transmissible conditions.

Most women will contract HPV at some stage during their life, but this usually clears up on its own without the need for any treatment. HPV is a group of viruses, of which there are more than 100 different types. It is spread during sexual intercourse and other types of sexual activity (such as skin-to-skin contact of the genital areas).

If the body is unable to clear the virus, there is a risk of abnormal cells developing, which could become cancerous over time. Cervical cancer can affect women of all ages, but is most common in women aged 30 – 45; although in rare cases can occur in women under 25.

Key signs and symptoms

The symptoms of cervical cancer aren’t always obvious, it may not cause any symptoms at all until it’s reached an advanced stage. Some women do not experience any signs of cervical cancer at all. This is why it’s very important that you attend all of your cervical screening appointments.

Unusual bleeding
In most cases, vaginal bleeding is the first of the cervical cancer symptoms to be noticeable. It often occurs after having sex. Bleeding at any other time, other than your expected monthly period, is also considered unusual, this also includes bleeding after the menopause.

Other symptoms
Other signs of cervical cancer may include pain and discomfort during sex and an unpleasant smelling vaginal discharge. However, the vast majority of women with the cervical cancer symptoms listed above do not have cervical cancer, and are far more likely to be experiencing other conditions, such as infections.

VULVUL

Cancer of the vulva (also called vulvar cancer or vulval cancer) is one of the rarer cancers with just over 1,000 cases diagnosed in the UK each year.

What is cancer of the vulva?

The vulva describes a woman’s external genitals. It includes the soft tissue (lips) surrounding the vagina (labia minora and labia majora), the clitoris (sexual organ that when stimulated can achieve sexual climax), and the Bartholin’s glands, two small glands each side of the vagina that secrete a musk like fluid to enhance lubrication.

Around 80% of vulval cancers are diagnosed in women over 60; however we are increasingly seeing more and more women being diagnosed at a younger age.

How does it develop?

Skin conditions that cause inflammation MAY develop into an early vulval cancer. The two most common of these being vulval intraepithelial neoplasia (VIN) and Lichen Sclerosus. There are a number of rare sub-types of vulval cancer, including mucosal melanoma, which can predict how the cancer might behave. You may find that you are cared for by gynaecologists and melanoma specialists to give you the best all-round support.

VIN does not mean you have cancer of the vulva – it is the stage before a potential cancer may develop. Some of these cell changes will go away without the need for any treatment; however, finding these abnormal cells early can help to prevent vulvar cancer.

Key signs and symptoms

The signs and symptoms of vulva cancer can include:

  • a lasting itch
  • pain or soreness
  • thickened, raised, red, white or dark patches on the skin of the vulva
  • an open sore or growth visible on the skin
  • a mole on the vulva that changes shape or colour
  • a lump or swelling in the vulva

All these symptoms can be caused by other more common conditions, such as infection, but if you have any of these, you should see your GP.  It is unlikely that your symptoms are caused by a serious problem but it is important to be checked out… remember non- cancerous conditions can be uncomfortable and so much better when treated!

VAGINAL

Vaginal cancer is a very rare disease which originates in the vagina, and is diagnosed in just over 250 women in the UK each year. It is most commonly diagnosed in women over 60 years of age and is rare in women under 40.

How does it develop?

Cancer of the vagina is a skin (also known as squamous) cancer and is very uncommon. However, there is a sub-type of vaginal cancer called mucosal melanoma, which can predict how the cancer might behave. If you have this type of cancer, you would find that you were cared for by a team of gynaecologists and melanoma specialists to give you the best all-round support.

It begins when a cells change their growth pattern and structure, to develop into a lesion or tumour (lump). Surgery is the usual treatment for vaginal cancer; however, it can also be treated using chemotherapy and radiotherapy depending on its particular pattern change. The last section of this page has more details of treatments.

Key signs and symptoms

It is rare for vaginal cancer symptoms to manifest in the very early stages of cancer or the pre-cancerous changes called vaginal intraepithelial neoplasia (VAIN). Although many early-stage cancers do not have indicative signs, some possible symptoms include:

  • Unexpected bleeding, eg. between periods, after menopause or after sex
  • Vaginal discharge that smells or may be blood stained
  • Vaginal pain during sexual intercourse
  • A vaginal lump or growth that you or your doctor can feel
  • A vaginal itch that won’t go away and pain when urinating
  • Persistent pelvic and vaginal pain

However, as many as 20 per cent of women diagnosed with vaginal cancer have no symptoms at all and many of the above symptoms are far more likely to be due to other conditions, such as infections.

All in all, it’s always best to be cautious when it comes to any changes in the body and in your vagina. As explained, many of these symptoms do not (in most cases) mean you have cancer, but it is 100% best to be safe rather than sorry. Regular screenings and check-ups with your GP or gynaecologist are a great way to stay on top of your health so you have one less thing to worry about. Don’t be afraid, be proactive!

RELATED ARTICLE: VAGINAL ATROPHY


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