Gynaecological cancers can be treated and cured if detected early

By Dr Mamta Rath Datta

Cancer is a disease in which cells in the body grow out of control. When cancer starts in a woman’s reproductive organs, it is called gynaecologic cancer. The five main types of gynaecologic cancers are: cervical, ovarian, uterine, vaginal, and vulvar. A sixth type of gynaecologic cancer is the very rare fallopian tube cancer.

Ovarian cancer has emerged as one of the most common malignancies affecting women in India and has shown an increase in the incidence rates over the years. Although cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer.

Of all the gynaecologic cancers, only cervical cancer has screening tests that can find this cancer early, when treatment can be most effective. Since there is no simple and reliable way to screen for any gynaecologic cancers except cervical cancer, it is especially important to recognize warning signs, and learn if there are things you can do to reduce your risk. Family history, obesity, age and HPV are important risk factors for gynaecologic cancer.

Symptoms of gynaecologic cancer vary, depending on the type of cancer. A broad spectrum of gynaecologic cancer symptoms may include pelvic pain, abnormal vaginal bleeding, vaginal bleeding during or after sexual intercourse, persistent abdominal swelling or bloating, unintended weight gain or loss, persistent bowel changes, like diarrhoea or constipation. These are common symptoms of gynaecologic cancer, but there are more symptoms that relate specifically to each type.

How gynaecologic cancer is diagnosed depends on what type of cancer is suspected. Pelvic exams, colposcopy exams, imaging tests, biopsies, and possibly even diagnostic surgery are all methods of diagnosing gynaecologic cancer.

Once cancer is confirmed, the stage of the cancer is then determined and a treatment plan is developed. Staging refers to how far cancer has spread to nearby tissue or organs. Treatment for gynaecologic cancer depends on the type of cancer, stage, and other general health factors. Common methods of treating include chemotherapy, radiation therapy, and surgery.

India alone contributes 25.41% and 26.48% of the global burden of cervical cancer cases and mortality, respectively. Ironically, unlike most other cancers, cervical cancer can be prevented through screening by identifying and treating the precancerous lesions, any time during the course of its long natural history, thus preventing the potential progression to cervical carcinoma. Human papillomavirus (HPV) vaccine is advocated for young girls and is very effective in reducing the risk of cervical cancer, vaginal cancer, and vulvar cancer. HPV is a common sexually transmitted virus that in some cases, when left undetected or untreated, may progress to cervical cancer. Getting a regular Pap smear is a highly effective way to reduce one’s risk of cervical cancer. The Pap smear is a simple test that can detect abnormal cervical changes long before they become cancerous. The key to the effectiveness of the Pap smear is having it done regularly every three years starting at the age of 21 years. Treatment includes surgery, chemotherapy and radiation therapy depending on the stage of disease.

Ovarian cancers symptoms are non-specific and can be mistaken for bowel symptoms or menopause. Later stages can have symptoms like loss of appetite and weight loss. Diagnosis of Ovarian Cancer is based on radiological tests like ultrasound, CT scan and MRI. Treatment includes surgery to remove the tumour and clearance surgery as indicated along with chemotherapy.

Endometrial cancer is a type of cancer that begins in the lining of uterus called endometrium. It is usually detected in early stage because of vaginal bleeding. Factors that increase the risk of endometrial cancer include change in the balance of hormones in the body, obesity, diabetes, hypertension, never having being pregnant, hormone therapy for breast cancer. Diagnosis needs a small surgical procedure called biopsy. Treatment includes cancer clearance surgery followed by chemotherapy and radiation.

The key message is that gynaecological cancers can be treated and cured if detected early.

(Author is Chief Consultant and HOD, Department of Obstetrics & Gynaecology, Chief of Medical Support Services, Tata Main Hospital, Jamshedpur)