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Gynaecological Cancers

 Information kindly prepared by the Dorset Gynaecological Oncology Centre in Poole.
For more detailed information, visit our BITESIZE page

5 Gynaecological Cancers

There are 5 gynaecological cancers which affect women: cervical cancer, ovarian / peritoneal cancer, endometrial cancer, vulval cancer and vaginal cancer – the latter is very rare.

We have deliberately kept this short, as our experience tells us that women often do not want to be bombarded with too much information – certainly not to start with. 

If you want to read more on each type of cancer, excellent information is provided by both Cancer Research UK and Macmillan. Please use the links below to take you to their sites, so you can read more about the type of cancer you have been diagnosed with, when you are ready. These sites also include more detailed information on treatments, such as surgery, radiotherapy and chemotherapy.

As with all treatments, for all gynaecological cancers, these will be individually tailored and discussed with you by your consultant and specialist nurse. Your consultant will plan your treatment with you taking into account a number of factors including the type and size of tumour, stage of cancer, your age and general health. 

Please ask your team for more information about these treatments. You may find it helpful to write down some questions that you would like to ask your team and bring them to your appointment. It may be supportive to have your partner or a close family member or friend attend your clinic appointments with you and they may like to make notes on your behalf.

If you wish to receive a copy of your clinic letter, please ensure to ask your doctor. 

Useful Terminology

 Benign – means not a cancer diagnosis 
Ovaries – two small oval shaped organs attached to the fallopian tubes and uterus
Vulva - The vulva is the area of skin between a woman’s legs and is made up of all the visible sex organs. It consists of two outer lips (the labia majora), which are covered in pubic hair and surround two inner lips (the labia minora).Malignant – means a cancer diagnosis 
Cervix – the neck part of the womb (uterus)  
Lymph Nodes/Glands – small glands that act as the body’s defence system
Endometrium – lining of the uterus or womb 
Myometrium – muscle wall of the uterus or womb

Cervical Cancer

 What is the cervix? 

The cervix is the lowest part of the womb (uterus) and is often called the neck of the womb. 

It is possible for a doctor/nurse to see and feel the cervix during an internal (vaginal) examination. 

Situated near the cervix are small glands called lymph nodes, these make up part of the body’s lymphatic system, which is a network of small glands that act as the body’s defence system. 

What is cervical cancer? 

There are two main types of cancer of the cervix. 
The most common is called: squamous cell carcinoma; the other type is known as adenocarcinoma. These names indicate the type of cells on the cervix which are growing abnormally. 

As a cancer can take many years to develop, a smear test is designed to detect early cell changes in the cervix. You may also need further tests to help with the planning of your treatment. 

These may include: blood tests, chest x-rays, colposcopy examination, cone biopsy, pelvic ultrasound, MRI or CT scans and an examination under anaesthetic (EUA). 

What is the treatment for cervical cancer?

In the early stages of cancer of the cervix surgery and radiotherapy are both effective forms of treatment. In most cases surgery (hysterectomy) is usually considered to be the most appropriate initial form of treatment. 

If the cancer has spread beyond the cervix and, for example, involves the lymph nodes, there may be a risk of cancer coming back after surgery. Therefore treatment with radiotherapy may also be recommended. 

In some cases chemo-radiation may considered, as giving chemotherapy before the radiotherapy may shrink the tumour prior to radiotherapy, and may control the disease to give a good quality of life. 

Surgery may then be considered as an option.

Further information is available from Cancer Research UK
image of Cervical cancer

Ovarian & Peritoneal Cancer

What are the ovaries?

The ovaries are two small oval shaped organs, which are part of the female reproductive system. 

Between puberty and menopause the ovaries regularly release an egg every 28 days. If this is not fertilised it is shed, along with the lining of the womb, as part of the monthly cycle. The ovaries also produce female sex hormones, oestrogen and progesterone. The function gradually stops as a woman reaches the change of life – menopause.

What are the symptoms of ovarian cancer?

  • Loss of appetite
  • Vague indigestion nausea and bloating
  • Swelling in the abdomen – with fluid called ascites. 
  • Pain in the lower abdomen 
  • Changes in bowel or urinary function
  • Raised cancer marker level – CA125 
  • These symptoms are also common to other conditions. Ovarian cancer affects 6,500 women in the UK every year.
These symptoms are also common to other conditions. Ovarian cancer affects 6,500 women in the UK every year.

What causes Ovarian Cancer?

Research is ongoing to find the cause. There are some risk factors that are known which may increase a woman’s susceptibility to ovarian cancer, these include: 
  • Increasing age 
  • Women who have not had a pregnancy 
  • Women whose periods started at a young age and whose menopause came late 
  • A strong family history of ovarian and/or breast cancer
  • Endometriosis
You will be asked if you have any family members with a history of breast or ovarian cancer and if appropriate you will be referred to the genetics team for advice and counselling.

What is the treatment for ovarian cancer? 

Surgery - a hysterectomy, plus removal of the ovaries is often the first treatment for ovarian cancer. It may be recommended that you also have a course of chemotherapy. In some cases surgery may not be appropriate and chemotherapy may be recommended as your first treatment, with the consideration of surgery during or after your course of chemotherapy. 

GO Girls are partnering with Ovacome to provide you with a range of helpful and informative factsheets on all aspects of Ovarian Cancer: click on the button below to access.

You can visit our Bitesize page to learn much more about ovarian cancer
Ovacome
  • Endometrial Cancer

    What is endometrial cancer? 

    The uterus or womb is a muscular pear shaped organ which at its narrower end is closed by the neck of the womb (cervix). The lining of the womb (uterus) is called the endometrium and it is from here that the cancer usually starts, therefore it is called endometrial cancer. Situated near the uterus are small glands called lymph nodes, these make up part of the body’s lymphatic system, which is a network of small glands that act as the body’s defence system. 

    What is endometrial cancer? 

    The exact cause of endometrial cancer is not yet known although women who have taken the contraceptive pill have a reduced risk and women who have taken HRT for a long time have a slightly increased risk of developing endometrial cancer. Endometrial cancer is most common in women between the ages of 50-64. It is rare under the age of 50. 

    What is the treatment for endometrial cancer? 

    To assist in planning your treatment it may be necessary to have some further investigations including blood tests, chest x-ray, vaginal ultrasound, hysteroscopy, biopsy and MRI scan. For an early endometrial cancer where there is no evidence that the disease has spread then surgery (hysterectomy) will be recommended.
    Radiotherapy may be given following this if the histology suggests there is a risk of the disease coming back at a later date. If however the disease has spread and cannot be removed surgically or if you are physically unfit for surgery then radiotherapy will be recommended. 

    Please ask your team for more information about these treatments. 

    In some cases hormone treatment may be recommended and in a few cases chemotherapy may also be considered.

    You can read more about endometrial cancer - risk factors and prevention from our blog written by Dr Eleanor Jones & Professor Emma Crosbie: click on the link below "Endometrial Cancer Risk Factors and Prevention"

    Click on the link below to look at this animation showing your risk factors:  Source: Endometrial Cancer Research Team

    Endometrial Cancer Risk Factors & Prevention
    Image of Endometrial hyperplasia is an overgrowth of tissue in the endometrium uterus. The uterine lining becomes too thick which results in abnormal bleeding.

    Vulval Cancer

    What is cancer of the vulva? 

    Vulval cancer affects approximately 1,100 women in the UK every year. It is most likely to occur in women over the age of 60, however the number of younger women being affected is increasing. 

    There are some risk factors that are known which may increase a woman’s susceptibility to vulval cancer, these include: 
    • Age 
    • Vulval skin conditions 
    • Human papilloma virus (HPV) 
    • Vulval intraepithelial neoplasia (VIN) 
    • Smoking 
    • Paget’s disease of the vulva 
    • Itching, burning or soreness of the vulva that doesn’t go away
    • A lump, swelling or wart-like growth on the vulva 
    • Thickened, raised, red, white or dark patches on the skin of the vulva 

    What are the symptoms of vulval cancer? 

    • Bleeding, or a blood-stained vaginal discharge, not related to menstruation (periods) 
    • Burning pain when passing urine 
    • Tenderness or pain in the area of the vulva 
    • A sore or ulcerated area on the vulva 
    • A mole on the vulva that changes shape or colour

    What is the treatment for vulval cancer? 

    Surgery is the main treatment for cancer of the vulva. Many women are cured of their vulval cancer with surgery. It may be used alone or in combination with radiotherapy and chemotherapy. 

    You can read the RCOG Guidance here
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