By Dr Khushboo Shah Sawant
Last week in this column, we discussed in detail about the most common form of cancer see in women which is ‘breast cancer’, and today as we continue to go a little further in detail of our current subject of cancer, we shall look at a few more forms of cancers seen in the field of gynaecology or commonly seen cancers in the female reproductive tract. As described earlier, cancer is the uncontrolled growth of abnormal cells in a body, which may be triggered due to various reasons. Such forms of growth can sometimes be the cancer in the various parts of the female reproductive tract. While there are various forms and types of cancers seen in many parts like the vagina, cervix, the exterior organs etc, the most commonly seen types of cancers in gynaecology are the cancer of the cervix, the endometrial and the ovaries. We will look at some basic info about each of these types today.
We start with cancer of the cervix. This is by far, one of the most common forms of gynaecological cancers. We first begin with the basic question, what is the cervix? The cervix is a part of a woman’s reproductive system. It is located inside the pelvis. It is the lower narrow part of the uterus (which is also known as the womb) and connects the exterior reproductive parts to the uterus which is in the interior part of the body. The cervix remains tightly closed during pregnancy so as to protect the foetal growth and keep the baby safely inside the womb. During childbirth, the cervix opens up to allow the baby to pass through the vagina. Similar to other forms of cancer, even the exact cause for the cancer of cervix is not known, however some causes and risk factors have been identified as an infection of the human papilloma virus (also known as HPV), smoking, engaging in sexual activity very early in life, having multiple sex partners, taking birth control pills etc. It is still not known as to why a woman with certain risk factors is more likely to suffer as compared to another woman with same or similar risk factors. A risk factor is something that can increase the chances of developing the disease. It has been seen and noted that an infection of the virus HPV is cause of almost all the cervical cancers. However a HPV infection is a self clearing infection, meaning the infection can clear out on its own. So basically an HPV infection when affects a susceptible person with other positive risk factors, the probability of affection of the cancer of the cervix increases greatly. The most common symptoms and signs of cervical cancer are abnormal vaginal bleeding, increased vaginal discharge, bleeding in the middle of the menstrual cycle, bleeding in a post menopausal female, pain during sexual intercourse, and pain in the pelvic area. One of the most common and simplest methods of diagnosing cervical cancer is by performing a pap smear. Other methods of diagnosing may be by performing and MRI scan or a PET scan. Treatment options include radiation therapy, surgery and chemotherapy etc. while some pre-cancerous changes in the cervix may be treated by non invasive methods.
We now move on to the next form of cancer known as the endometrial cancer, a type of cancer, which begins in the uterus or the womb. The uterus is a pear shaped hollow structure inside the female reproductive tract where the development of the baby occurs during pregnancy. The endometrium is the lining which covers the walls of the uterus, which sheds during menstruation. Endometrial cancer begins as an abnormal growth in the lining around the uterus (endometrium). There are also some other forms of cancer in the uterus, though the cancer of the endometrium is most common. The exact cause of endometrial cancer is not known but there are certain risk factors like fluctuation in the hormonal balance of the body, due to any illness, medication etc. which may prove to be risky, increased years of menstruation due to early puberty and delayed menopause. Also, women who have never been pregnant have a higher risk when compared to women who have been pregnant. Increasing age is also a risk factor while excessive weight or obesity that alters the body’s hormonal balance can be a risk too. This type of cancer is often detected in the initial stages as it produces abnormal vaginal bleeding, which most often alarms women to seek the help of a doctor. The commonly seen symptoms are vaginal bleeding after menopause, bleeding between periods, an abnormal watery blood tinged vaginal bleeding, pain during intercourse and pelvic pain. If detected well in time, surgically removing the uterus often cures the patient.
Ovarian cancer, as the name suggests is the cancer of the ovaries. The causes of this are not known but a genetic predisposition towards ovarian cancer or breast cancer seems to play a vital role as a causative factor, age also plays a role. While this type of cancer can rear its head any age, it is most commonly seen between ages 50-60 years. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. Early stages of ovarian cancer rarely causes any symptoms and even as the disease progresses, it produces many non specific symptoms which may be wrongly diagnosed as a irritable bowel syndrome. Signs and symptoms of ovarian cancer include abdominal bloating or swelling, easy satiety or feeling of fullness even after eating very small quantities of food, weight loss, discomfort in the pelvic area, changes in the bowel habits, frequent constipation, increased frequency of urination etc. Early stage ovarian cancer in which the disease may be confined to only one ovary are more likely to be treated successfully. Surgery and chemotherapy are other options used to treat ovarian cancer.
As we have discussed earlier, while most risk factors may not be in our control, the avoidable risks must be kept at bay. Also it is advisable for women over the age of 40 years or those who have attained menopause to go for an annual ‘pap smear’ test. This simple test can prevent dire consequences. Another way is to consult a doctor in case any of the signs and symptoms mentioned above makes its presence felt. It may not necessarily be cancer, but it is best to be on the safer side.