Gynaecological Cancer
Cancer occurs almost equally in men (51.5%) as in women (48.5%). However, the cells affected by cancer are different in the two sexes. Gynaecological cancers are those affecting the ovaries, womb, cervix, vulva and vagina. One woman in 20 will develop a gynaecological malignancy and 1 in 40 will die of the disease.
Ovarian Cancer
Cancer of the ovaries is the commonest gynaecological cancer. The greatest risk of developing this occurs in the first two decades after the menopause. Each year 14 out of 100,000 women will be diagnosed with ovarian cancer and there can be a family susceptibility to developing this disease. Few develop symptoms until they present, often at an advanced stage of the disease. Pain is uncommon, but increase abdominal girth or a feeling of pressure on the bladder or bowel may be some of the non-specific symptoms. Surgery usually takes the form of an abdominal hysterectomy and removal of both the ovaries, as well as removing some of the omentum (tissues within the abdomen). The aim is to remove as much of the cancer as is possible. Women are offered chemotherapy in many cases after this. Survival rates, however, suggest only about 1 in 3 women will survive 5 years after diagnosis.
Cancer of the Cervix
The cervical screening programme has helped reduce the number of deaths due to cancer of the cervix. However, there are still approximately 3,500 new cases of invasive cancer each year. Often these present with bleeding in between the periods or after intercourse or maybe as a result of an abnormal smear. In the early stages treatment to the cervix may be curative. In more advanced cases surgery to remove the whole womb and ovaries and to sample some lymph nodes may be necessary and often radiotherapy is offered to these more advanced cases. Five years survival of this disease is in the order of about 80% overall.
Cancer of the Uterus (Womb)
This most commonly presents after the menopause with spotting or bleeding. Only about 10% of women, however, with postmenopausal bleeding will have such a malignancy. Treatment in the form of removing the womb and both the ovaries is the commonest form of surgery, but there are an increasing number being offered radiotherapy post-operatively as well.
Cancer of the Vulva and Vagina
These are uncommon conditions affecting women often in their 70s. They present with unusually abnormal bleeding or discharge. Some may notice a lump or an ulcer of the affected area and some may notice persistent itching of the skin. Treatment usually involves surgery to excise the affected area with sampling of the lymph nodes. Five year survival rates, overall, are in the order of about 50%.
A A Evans July 2004