Endometrial cancer is the most common gynaecological cancer and the 4th most common malignancy in women. While there has been a rise in incidence of endometrial cancer, there has been a fall in death rate. This could be due to the increase in the use of hormone replacement therapy (HRT). While the use of the contraceptive pill reduces the risk of endometrial cancer, obesity and late menopause increase the risk. In pre-menopausal women, endometrial cancer presents as menstrual irregularity with heavy vaginal bleeding. In post-menopausal women, the cancer usually presents itself as post-menopausal bleeding.
A diagnosis can be made via a smear test, bloods, an ultrasound; to test the endometrial thickness and a biopsy. The prognosis of patients with endometrial cancer is related to the stage of the disease and the histological grade of the tumour, but overall the cure rates are very high.
In terms of mortality, ovarian cancer is the most common cancer affecting the female reproductive system. While it can occur at any age, women between the ages 55-59 are mostly affected. The associated death rate has doubled over the past 40 years. This is in contrast to the incidence of breast cancer, which has remained constant, and cervical and endometrial cancers which have fallen in incidence. This trend is probably due to women having smaller families and increasingly high fat diet. Risks include infertility, marked premenstrual tension, family history, celibacy, increased number of abortions and early menopause.
Much effort is currently being made to develop a screening test for ovarian cancer. Unfortunately, most ovarian cancers are present at an advanced stage. The screening includes vaginal examination, ultrasound scanning and certain blood tests. Because ovarian cancer is sometimes genetic, the above screening methods are recommended for women with one first-degree relatives diagnosed with ovarian cancer.
Fallopian Tube Cancer
Cancer of the Fallopian tubes is rare and is often mistaken for ovarian cancer until a laparotomy (an examination of the internal abdominal organs) is performed.
Vulval cancer accounts for 3-5% of all genital tract malignancies in women and is primarily a disease of the elderly. A link has been shown between Human Papilloma Virus (HPV) and vulval cancer, but no cause or effect has been proven. Most lesions are squamous and probably develop over a long period of time. Many are of wart-like growth and may be asymptomatic. However if they are symptomatic, the may be painful, bleeding and have a foul smell. Vulval intra-epithelial neoplasia (VIN) precedes vulval cancer by 10-40 years and is detectable by examinations such as vulvoscopy.
It is essential to biopsy any vulval lesion to determine diagnosis and treatment.
Treatment of Gynaecological Cancers
Treatment options depend on the individual, your doctor and the specific cancer. Whether it is surgery, radiotherapy or chemotherapy, your doctor will discuss all treatment options with you.