Gynaecological cancer awareness – The Food Medic


This article was written by London-based GP Dr Nirja Joshi


When cancer is so prevalent, it is important to try and understand the different types of female cancers so that you know what to look out for, when to see a doctor and a bit about what is normal and abnormal.

Gynaecological cancers refer to those affecting the female reproductive system, and affect women, transgender men and some non-binary people. There are five gynaecological cancers: womb, ovarian, cervical, vulval and vaginal.

Ovarian Cancer

Around 7,500 women per year in the UK are diagnosed with ovarian cancer, making it the 6th most common cancer in women (1).

There are different types of ovarian cancer which will depend on the type of cell which they come from. 

Ovarian cancer is notoriously difficult to diagnose. There is no national screening programme to detect ovarian cancer. Ovarian cancer is something which is seen when someone may have a scan such as an ultrasound, CT scan or MRI scan. A blood test, called Ca-125, can help in some cases as it is a blood marker which can be raised in ovarian cancer. Having a low level does not rule out ovarian cancer, and hence it is not a test doctors would do routinely (1).

Common symptoms include:

  • feeling full quickly (early satiety)
  • no appetite 
  • bloating 
  • abdominal or pelvic pain 

As the symptoms of ovarian cancer are not very specific, and can be attributed to many different things, it is often detected late. . However if you are experiencing these symptoms and are female, have a history of female cancers in your family or are over 50 years old (1), you should ensure to have these symptoms checked promptly.

Vulval Cancer

Vulval cancer is a rare type of cancer affecting women. It predominantly affects women over the age of 65 and can involve the external genitalia (lips, Bartholin glands, clittoris). 

The symptoms may include (2):

  • a growth (lump or wart) on the vulva
  • persistent itch in the vulva 
  • pain or burning passing urine 
  • a new skin lesion (that can be red, white or dark) 

Survival rates for vulval cancer are overall quite good, however, this will depend on a person’s age and other medical issues. It is important if you have any symptoms of this nature you should see your doctor, however, there are generally a lot more common conditions which can cause these symptoms (3). 

Womb (uterus) Cancer

The womb is otherwise known as the uterus, and any of the layers could potentially develop cancer. The inner lining of the womb, known as the endometrium is the most common cancer people refer to when discussing cancer of the womb. The lining of the womb is what is built up and shed during a normal period. Endometrial cancer is generally detected when women have unusual bleeding e.g. bleeding in between their periods, unusual discharge, unusually heavy periods or bleeding after menopause (4).

If you have had a hysterectomy, surgery to remove your womb, you cannot develop this type of cancer.

There are several things which could put you at a higher risk for developing endometrial cancer, including (4):

  • obesity
  • polycystic ovarian syndrome
  • taking some types of HRT
  • having a late menopause
  • women who have never given birth

There is no screening test for womb cancer, but if you doctor suspect this, they will likely examine you and refer you have an ultrasound scan as this can measure the thickness of the womb lining. There are several treatment options for womb cancer depending on the size/site/type of cancer including surgery, radiotherapy, chemotherapy and hormone therapy (4).

Cervical Cancer

Cervical cancer is a type of cancer found in the cervix which sits between the vaginal opening and the womb. Most cervical cancers are caused by the presence of HPV which is a virus spread by close contact (5). 

Cervical screening tests are available to help to detect the presence of HPV and hence to reduce the risk of missing early changes to cells in the cervix. 

Women who have symptoms of cervical cancer often present with unusual bleeding e.g. bleeding after sex or in betwen periods [note: If you have another condition like fibroids or endometriosis, you may get symptoms like these regularly.] Although most women do not have symptoms which is why attending screening is so important. 

Girls and boys at school are now offered the HPV vaccine which can help to reduce the risk of developing cervical and anal cancers, and adults who have missed the vaccination programme can have this privately, although this is thought to be less effective as patients get older due to the likliehood of have been exposed to HPV (6). 

If you have been invited to screening, or missed screening during the pandemic, please do contact your doctor. Find more information about cervical cancer here.

Vaginal Cancer

This is a type of cancer found in the vagina, commonly caused by HPV. This is often detected as a result of cervical screening. Symptoms can include unusual bleeding, blood stained discharge, a lump or an ulcer (7). 

Vaginal cancer is rare, but if you are worried, do see your doctor.

Summary

Hopefully this article has helped you to understand and raise awareness of gynaecological cancers. Do share this article with the women in your life, as some of these cancer symptoms are less obvious and important to be aware of. With regards to cervical screening, do ensure you are up to date, and if you’re not sure, your doctor’s surgery can let you know if you are due. 

If you have any symptoms listed above which concern you, do seek medical advice. 

If you or a friend has been diagnosed with a cancer, and would like some advice, do contact Macmillan Cancer Support for help and guidance https://www.macmillan.org.uk/ or Eve Appeal who specialise in gynaecological cancers www.eveappeal.org.uk.


References

  1. NHS. Overview -Ovarian cancer [Internet]. 2022 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/ovarian-cancer/help-and-support/
  2. NHS. Vulval Cancer [Internet]. 2021 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/vulval-cancer/
  3. Cancer Research. Vulval Cancer [Internet]. 2019 [cited 2022 Sep 10]. Available from: https://www.cancerresearchuk.org/about-cancer/vulval-cancer
  4. NHS. Treatment -Womb (uterus) cancer [Internet]. 2021 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/womb-cancer/treatment/
  5. NHS. Overview -Cervical cancer [Internet]. 2021 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/cervical-cancer/
  6. NHS. HPV vaccine overview [Internet]. 2019 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/vaccinations/hpv-human-papillomavirus-vaccine/
  7. NHS. Symptoms -Vaginal cancer [Internet]. 2021 [cited 2022 Sep 10]. Available from: https://www.nhs.uk/conditions/vaginal-cancer/symptoms/

Gynaecological cancer awareness was last modified: September 15th, 2022 by Nirja Joshi



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