Gynecological Cancers: Everything You Need to Know
Updated: Feb 26, 2021
By: Jordan Atkins
Edited by: Francine nori Oblero
Introduction
Gynecological cancers are cancers unique to women, and all who house a female reproductive system in their body. With cancer being amongst the leading causes of death in Canada and the U.S., it’s important to know the risk factors, symptoms, different types of gynecological cancers, and the details of these reproductive system malignancies.
To begin with, what even are gynecological cancers?
Gynecological cancers are cancers that form in the reproductive system. All cancer cells derive from abnormalities in the genes of normal cells. These gene mutations make the cell behave differently. When these mutated cells form in the reproductive system, it is considered gynecological cancer. The reproductive system consists of the vulva, the vagina, the cervix, the uterus and the endometrium, the fallopian tubes, and the ovaries. The anatomy of the reproductive system and its functions are complicated and unknown to many people, however, this basic knowledge is key to understanding the main types of gynecological cancers.
Cervical Cancer
Your cervix is located at the base of your uterus and connects your uterus to your vagina. The uterus is made up of three different components:
The external orifice, which connects to your vagina, the internal orifice, which connects to your uterus, and the cervical canal that connects both of the orifices together. The cervix acts as a filter, preventing pathogens from your vagina from entering your uterus, while still allowing sperm to go to the fallopian tubes.
Types of Cervical Cancer
Cervical cancer is cancer that forms in your cervix, usually over some period of time. It often starts with abnormal cells appearing in your cervical tissue, and over time becoming cancerous and starting to metastasize. The most common type of malignant cervical tumor is the squamous cell carcinoma. This type of cancer starts in squamous cells on the outside of the cervix. Other tumors include adenocarcinomas (that start in the inside of the cervix) and adenosquamous carcinomas.
Who is at Risk for Cervical Cancer?
All women are at a risk for this cancer, but it usually affects women below the age of 50, and women above 30, as pediatric cervical cancer is rare. The biggest risk factor for cervical cancer is the HPV virus, Human Papillomavirus. It is a very common sexually transmitted disease that many sexually active people will contract in their lifetimes. HPV does not always lead to cancer, and usually clears up on its own. Unfortunately when you have a long-lasting HPV infection that does not clear, cancer is a possible outcome.
What are the Symptoms of Cervical Cancer?
Cervical cancer usually does not show symptoms until it is at an advanced stage, but symptoms may include…
irregular bleeding between periods
bleeding after sexual intercourse
painful sexual intercourse
abdominal bloating
abnormal amounts of discharge
difficulty passing feces or urine
What should I do if I believe I may have Cervical Cancer?
These are all potential symptoms, but the only real way to know if you have cervical cancer is to talk to your doctor and see an OB-GYN. Routine Pap smears and pelvic exams are important to screen for cervical cancer and to maintain overall gynecological health. HPV tests are also important when screening for cervical cancer.
Ovarian Cancer
Ovaries are the female reproductive organ that produces ovum (eggs) and the sex hormones estrogen and progesterone.
There is an ovary and a fallopian tube on each side of the uterus. Though the fallopian tubes are not directly attached to the ovaries, they carry the ova to the uterus.
Types of Ovarian Cancer
Your ovaries are made up of three different types of cells, all that can develop into a different type of cancer. Epithelial tumors are made from large groupings of abnormal epithelial cells that cover the surface of the ovary. This is the most common form of ovarian cancer, and abnormalities in these cells can either be benign, malignant, or borderline meaning that these cells will grow on the tissue, but tend to not invade it. The other two types of ovarian cancer are germ cell tumors that start from the cells that produce the ova, and stromal tumors that start from the cells of the tissue that hold the ovary together and produce the female sex hormones.
Who is at Risk for Ovarian Cancer?
There are numerous risk factors to developing ovarian cancer. A family history of ovarian cancer can mean you have a higher chance of developing it. Having a first-degree, or multiple first-degree relatives (mother, sister, daughter) that have or have had ovarian cancer, as well as having first and second-degree family members (grandma, aunt, niece) with a history of ovarian cancer can increase your chances significantly. Having mutations in the BRCA 1 and BRCA 2 genes can also increase your risk for ovarian cancer. These genes usually help to control the growth of breast cancer cells and repair damaged DNA, but these gene mutations can be passed down from family members. Mutations in these genes can make you more susceptible to not only breast cancer, but ovarian cancer as well.
Other risk factors for ovarian cancer:
starting menstruation at an early age and having a late menopause
never carrying out a pregnancy
getting older
being overweight
Ovarian cancer usually affects older women who have gone through menopause, but it can happen at any age.
What are the Symptoms of Ovarian Cancer?
Symptoms of ovarian cancer usually do not appear until advanced stages, but they include…
bloating and abdominal swelling
abdominal and pelvic pain
constipation
frequent need to urinate
becoming full quickly
unintentional weight loss
indigestion and heartburn
a lump in the abdomen
What should I do if I believe I may have Ovarian Cancer?
Diagnosing ovarian cancer can be difficult, but diagnosing methods for this cancer include ultrasounds and CT scans. Ovarian cancer is the most deadly of all gynecological cancers because of its nonspecific symptoms that usually only appear once the cancer has progressed.
Vaginal Cancer
The vagina is the elastic and muscular canal, otherwise known as the birth canal.
The vagina connects the external genitalia to the reproductive organs.
Types of Vaginal Cancer
Like all cancers, vaginal cancer is cancer that begins in the vagina. Squamous cell carcinomas, and adenocarcinomas are the most common vaginal cancers, affecting the squamous cells and glandular cells. Very rare types of vaginal cancer can include melanomas that affect the pigment producing cell, and sarcomas that affect the cells of the connective tissue and muscles. The changes that are present in these cells can be malignant or benign, as well as precancerous such as vaginal intraepithelial neoplasia (VAIN), that can develop into cancer.
Who is at Risk for Vaginal Cancer?
Vaginal cancer is uncommon, and rarely occurs in women under 40, though it is still possible. Vaginal cancer usually affects women above the age of 70. Some of the factors that may increase your chances of developing vaginal cancer, aside from age, are HPV infections and having a history of vulvar or anal cancer. Another risk factor is being the daughter of a woman who took diethylstilbestrol (DES) during her pregnancy. DES was a form of estrogen that women took from the 1940’s to 1970’s to prevent miscarriages. Since DES has not been in use for fifty years, it is not a common risk factor anymore.
What are the Symptoms of Vaginal Cancer?
Symptoms of vaginal cancer may include…
a lump in the vagina
painful sexual intercourse
pain in the pelvis, legs, back or between the vaginal opening and anus
foul or bloody discharge
abnormal vaginal bleeding
What should I do if I believe I am at Risk for Vaginal Cancer?
Screening for vaginal cancer may include pap tests and pelvic exams, and it is important to talk to your healthcare provider if you experience any changes in your health. A colposcopy may also be a form of screening, where your doctor inserts a magnifying lens into the vagina to view the vagina and cervix. Any abnormal areas will be biopsied. A colposcopy may seem scary, but it is almost painless.
Vulvar Cancer
The vulva is the external portion of the reproductive system.
It comprises the outer lips and inner lips (your labia majora and your labia minora), the clitoris and clitoral hood, the urethra (the bladder opening) and the vaginal opening (vestibule).
Types of Vulvar Cancer
Vulvar cancer starts in your vulva, and is the rarest gynecological cancer, accounting for less than one percent of cancers in all women. The most common kind of vulvar cancer is squamous cell carcinomas (SCC), where there are abnormalities in the squamous cells of your vulva that cause them to behave differently than normal cells. Melanomas are the second most common vulvar cancer, when changes occur to the melanin-producing cells in your vulva.
Who is at Risk?
The majority of women affected by vulvar cancer are above the age of 50 and post menopausal, with the peak age for this disease being in the 70s. Factors such as HPV infections, a history of vulvar intraepithelial neoplasia (a precancerous vulvar condition), and a history of vulvar skin conditions can all increase the risk of developing vulvar cancer.
What are the Symptoms of Vulvar Cancer?
The symptoms of this rare malignancy that occur in the vulva include...
a constant itching sensation
wart-like growths
thickened rough skin or lumps
changes in skin color
ulcers
one or more swollen lymph nodes in your groin area.
These could be symptoms of other medical conditions as well, but you will not know until you consult with your healthcare provider.
What should I do if I believe I may have Vulvar Cancer?
Some tests that may be provided to diagnose vulvar cancer are vulvar skin samplings to be biopsied to determine whether it is cancerous or of another condition, and the use of a colposcope. Upon being diagnosed with vulvar cancer, treatment plans will be determined depending on the stage and grade of the cancer. Treatments for vulvar cancer may include removal of some or all of the vulva, radiation and chemo therapies, and the removal of nearby lymph nodes.
Uterine Cancer
The uterus, or the womb, is a muscular organ that is lined with the endometrium. The uterus houses a fetus during a normal pregnancy.
The endometrial lining thickens each month during child-bearing years, and sheds during menstruation.
Changes to cells in the uterus aren’t always malignant, and may result in benign conditions such as endometriosis, and precancerous conditions such as atypical endometrial hyperplasia. When these cell abnormalities are in fact cancerous, they can cause uterine cancer, the most common gynecological cancer.
Types of Uterine Cancer
Two of the main types of uterine cancer are endometrial carcinomas that affect the cells in the endometrium, and uterine sarcomas that affect the cells of the supporting tissues such as the muscle, fat and bones.
Who is at Risk for Uterine Cancer?
Some factors that may put individuals at a higher risk for developing uterine cancer include…
having a history of hormone replacement therapy with solely estrogen (and no progesterone)
taking tamoxifen (a hormone therapy used to treat breast cancer)
having polycystic ovarian syndrome (PCOS)
having more periods in your lifetime and more time to produce estrogen (late menopause and having your first period at an early age).
What are the Symptoms of Uterine Cancer?
Symptoms of uterine cancer that may occur are…
pelvic pain or pressure
blood in the urine and a difficulty urinating,
bleeding from the bladder or rectum
rapid unintentional weight loss
unusual vaginal discharge.
These symptoms do not always denote uterine cancer, but it is important to inform your healthcare provider about them.
What should I do if I believe I may have Uterine Cancer?
They may run tests that include pelvic ultrasounds, transvaginal ultrasounds, endometrial tissue sampling, and a hysteroscopy where your doctor uses a tiny telescope to look into your uterus. When treated quickly and properly, uterine cancer has a good outlook.
In Summary
Cancer can be scary, especially when it comes to gynecological cancers as reproductive health can be such a taboo topic. It is important to educate yourself about reproductive health, and talk to your doctor or OB-GYN about any changes that may have occurred in your gynecological health to ensure that they can help you to the best of their abilities.
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