Obstetrics focuses on pregnancy, childbirth and the postpartum period. Gynaecology deals with the female reproductive system (vagina, uterus, and ovaries) health. Cancer is the uncontrolled division of cells due to the mutations in the cell DNA. Gynaecologic cancer is any cancer that starts in a woman's reproductive organs. Five main types of cancer affect a woman's reproductive organs are cervical, ovarian, uterine, vaginal, and vulvar. All women are at risk for gynaecologic cancers, and risk increases with age. When gynaecologic cancers are found early, treatment is most effective. Cervical, endometrial, and ovarian cancers are relatively common, whereas vulvar, vaginal, fallopian tube cancers, and choriocarcinomas (cancer of placenta) are very rare. Endometrial cancer affects postmenopausal women almost exclusively. Cervical cancer is a type of cancer that occurs in cervical cells. Cervix is the lower part of the uterus that opens into the vagina. It is most often caused by infection with human papilloma virus. Multiple sex partners, unprotected sex, puts a person at high risk.

Only cervical cancer has screening tests that can detect the at an earlier stage, when treatment can be most effective. Uterine or endometrial cancer does not have any cause evident. It usually occurs in the inner lining of the uterus called endometrium. Ovarian cancer is common after the age of 50 and has a strong genetic predisposition. Cervical cancer is the third most common cancer in women worldwide, Endometrial cancer is the sixth most common cancer in women worldwide. Cancers of the ovary and ovarian adnexae(benign growth), including fallopian tube cancer, constitute the eighth most common cancers among women worldwide. Cancer treatment may include surgical removal, radiation therapy, and chemotherapy, depending on the type and stage of cancer.

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Frequently asked questions about Gynecology Cancer

What are the types of gynaecologic cancers, and who’s at risk?

There are five major types:

  • Cervical cancer
  • Uterine (endometrial) cancer
  • Ovarian cancer
  • Vaginal cancer
  • Vulvar cancer

The risk may be higher when the patient:

  • is at or beyond the age of menopause (50+)
  • Has a family history of ovarian cancer or cancers of the uterus, colon or breast.
  • Has never been pregnant or have had infertility problems.
  • is obese.
  • Has hypertension, diabetes, chronic vulvar irritation or late menopause
  • Use the medication tamoxifen or use unopposed estrogen
  • Do not undergo regular Pap screenings or have a history of abnormal pap smears
  • Smoke
  • Have had multiple sexual partners
  • First had intercourse before the age of sixteen
  • Are infected with HIV or HPV
What are the causes of gynecologic cancers?

There is no definitive cause but the risk factors associated are as follows

  • No history of having children
  • Diabetes
  • Human pappilomavirus infevtion(hpv)
  • Smoking
  • Weak immune system
  • Hiv infection
  • Menopause
  • Family history of gyanecological cancers
  • Use of oral birth control or fertility drugs
  • Estrogen therapy
  • High fat diet
  • Prior radiation to pelvic area
What are the symptoms or early warning signs of gynecologic cancers?

Symptoms vary depending on the organ that’s involved and should always be evaluated by the doctor. Abnormal vaginal bleeding or discharge is observed in Cervical, Ovarian, Uterine and Vaginal Cancer.  Feeling full too quickly or difficulty eating, bloating abdominal or back pain seen only in ovarian cancer. Pelvic pain or pressure complaints of uterine and ovarian cancer.  More frequent or urgent need to urinate and/or constipation seen in ovarian and vaginal cancer. Itching, burning, pain, or tenderness of the vulva, changes in vulva color or skin, such as a rash, sores, or warts seen only in vulval cancer. Apart from these symptoms such as weight loss, change n bowel habits, constipation, bleeding between periods or after menopause.

What is a gynecologic oncologist?

A gynecologic oncologist is a physician who specializes in diagnosing and treating cancers that are located on a woman's reproductive organs. 

How are gynecologic cancers treated?

Gynecologic cancer may be treated with surgery, chemotherapy, and radiation Treatment depends on many factors, including whether the cancer has spread, and whether the patient is young enough to have children. 

What is a Pap test and what is its purpose?

A Pap smear, also called a Pap test, is a procedure to test cervix for any cells that are not normal for gynecological cancer in women. The cervix is the lower part of the uterus (womb), which opens into the vagina.  It involves collecting cells from your cervix so that they can be looked at under the microscope to find cancer and pre-cancer. The main purpose of screening with the Pap test is to detect abnormal cells that may develop into cancer if left untreated. Abnormal cervical cells, if not found and treated, can lead to cervical cancer The Pap test can also find non-cancerous conditions, such as infections and inflammation. It can also find cancer cells. 

How to prevent gynaecological cancers?

Leading a healthy lifestyle can help to prevent cancers. During and after menopause is no different. The following measures will help you reduce your risk of cancer:

  • Take part in the cervical and breast screening programmes 
  • Exercise
  • Eat a healthy diet
  • Do not smoke and avoid second-hand smoke
  • Maintain a healthy body weight
  • Go for routine Pap tests. 
  • Practice safe sex.
  • HPV vaccination protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers.
What treatment side effects should I expect for the treatment of gynaecological cancer?

Gynecologic cancer and its treatments can cause side effects. Side effects are problems that occur when treatment affects healthy tissues or organs. 

Manage the side effects listed below:

  • Anemia
  • Appetite Loss
  • Bleeding and Bruising (Thrombocytopenia)
  • Constipation
  • Delirium
  • Diarrhea
  • Edema (Swelling)
  • Fatigue
  • Fertility Issues in Girls and Women
  • Flu-Like Symptoms
  • Hair Loss (Alopecia)
  • Infection and Neutropenia
  • Lymphedema
  • Memory or Concentration Problems
  • Mouth and Throat Problems
  • Nausea and Vomiting
  • Pain
  • Skin and Nail Changes
  • Sleep Problems and Insomnia
  • Urinary and Bladder Problems

one needs to keep in mind that side effects vary from person to person, even among people receiving the same type of cancer treatment.

Are there any other gynecologic cancer tests that I need, based on my personal health and family cancer history? If so, what are they? Why do I need them? How do they work?

In addition to Pap smears, women who are 18 years of age or sexually active should consider a pelvic exam. Women close to menopause are considered high risk may want to consider an endometrial biopsy tissue sample. apart from this HPV typing test  is similar to a Pap test Certain types or strains of HPV, such as HPV16 and HPV18, are seen more often in women with cervical cancer and may help confirm a diagnosis, colposcopy to check the cervix for abnormal areas using a colposcope which magnifies the cells of the cervix and vagina similar to a microscope.

Which gynecologic cancer is the most common?

Uterine cancer is the most common gynecologic cancer. Ovarian causes the most deaths. Cervical is the most preventable and the only gynecologic cancer with a screening test and a vaccine.

How does the patient decide on which Treatment is right for her?

Choosing the treatment that is right for can be hard. Talking to the oncologist about the treatment options available for the specific type and stage of cancer. 

of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments. The doctor lays out the pros and cons of the course of the treatment. The patient has an option of a second opinion( review of treatment advised with another specialist) or discuss with family about the same.

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Each reproductive system part cancer has different symptoms. However, sometimes symptoms can be hard to recognize. According to the CDC(centre for disease control)  the patient should meet a doctor if there is any abnormal bleeding or any of the below symptoms are present for two weeks or greater than two weeks. Abnormal vaginal bleeding or discharge is observed in Cervical, Ovarian, Uterine and Vaginal Cancer.  Feeling full too quickly or difficulty eating, bloating abdominal or back pain seen only in ovarian cancer. Pelvic pain or pressure complaints of uterine and ovarian cancer.  More frequent or urgent need to urinate and/or constipation seen in ovarian and vaginal cancer. Itching, burning, pain, or tenderness of the vulva, changes in vulva color or skin, such as a rash, sores, or warts seen only in  vulval cancer. Apart from these symptoms such as weight loss, change n bowel habits, constipation, bleeding between periods or after menopause. Cancers can spread in the following ways Directly invade nearby tissues and organs. Spread (metastasize) through the lymphatic vessels and lymph nodes (lymphatic system) or through the bloodstream to distant parts of the body. Endometrial cancer risk has been previously associated with several host factors, including high body mass index, nulliparity or low parity, early age at first birth, history of type 2 diabetes mellitus (non-insulin dependent), and family history of cancer, particularly endometrial cancer. 

Diagnosis involves regular pelvic examination, biopsy. . Screening for cervical cancer includes the Papanicolaou (Pap) test and human papillomavirus (HPV) testing. A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina. The staging of cancer is based on how large the cancer is and how far it has spread. Some commonly used imaging techniques include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest x-rays, and positive emission tomography (PET). Doctors often determine the stage of cancer after they remove the cancer and biopsy the surrounding tissues, including lymph nodes.

The main goal of treatment is to remove the cancer if possible (through a single treatment or through a combination of surgery, radiation therapy, and chemotherapy). For endometrial cancer or ovarian cancer, the main treatment is surgical removal of the tumor. Surgery may be followed by radiation therapy or chemotherapy or, for advanced endometrial cancer, hormonal therapy. For ovarian cancer, treatment often starts with chemotherapy, followed by surgery, followed by chemotherapy. Treatment of cervical cancer may include surgery, radiation therapy, and/or chemotherapy. Radiation therapy may be external (using a large machine) or internal (using radioactive implants placed directly on the cancer) or both. External radiation therapy is usually given several days a week for several weeks. Internal radiation therapy involves staying in the hospital for several days while the implants are in place. When a gynaecologic cancer is very advanced and a cure is not possible, radiation therapy or chemotherapy may still be recommended to reduce the size of the cancer or its metastases and to relieve pain and other symptoms.

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