Cancers of the Female Reproductive System

Cancers can occur in any part of the female reproductive system: vulva, vagina, cervix, uterus, fallopian tubes, or ovaries. The cancers from these organs can spread locally into the surrounding tissues or spread to other organs through the lymphatic system or blood stream.

Cancer of the Uterus

  • Also called endometrial cancer, it develops in the lining of the uterus.
  • Usually affects women after menopause
  • Causes abnormal uterine bleeding
  • A biopsy of the endometrium or lining of the uterus confirms the diagnosis

Risk Factors for Endometrial Cancer

  • Obesity
  • Diabetes
  • Hypertension
  • Early start of periods
  • Delayed menopause after 52 years
  • Having no children
  • Have estrogen producing tumors
  • Family history of breast, ovarian, colonic or endometrial cancer
  • Having had pelvic radiation therapy

Symptoms

  • Vaginal bleeding
  • Bleeding after menopause
  • Bleeding between periods
  • Periods that are heavy, irregular or prolonged
  • Watery blood tinged discharge

Diagnosis

  • Pap test
  • Endometrial biopsy
  • Dilatation and curettage
  • Sometimes a hysteroscopy
  • Transvaginal ultrasonography

Once diagnosed

  • Blood tests
  • Kidney function tests
  • Liver function tests
  • Chest x ray
  • ECG
  • CT

Stages are based on how far the cancer has spread:

  • Stage I: The cancer occurs only in the upper part of the uterus, not in the lower part (cervix).
  • Stage II: The cancer has spread to the cervix.
  • Stage III: The cancer has spread to nearby tissues, the vagina, or lymph nodes but is still within the pelvis (which contains the internal reproductive organs, bladder, and rectum).
  • Stage IV: The cancer has spread to the bladder or intestine or to distant organs

Prognosis

If detected early, nearly 70 to 95 % of women survive 5 years. If it has spread beyond the uterus, the prognosis is poor

Treatment

  • Surgery, where uterus, ovaries and fallopian tubes are removed. Nearby lymph nodes are also removed
  • This is followed by radiation and sometimes chemotherapy
  • The treatment is tailor made to each patient

Ovarian Cancer

  • Symptoms occur only if it is large or has spread
  • Develops in women between 50 – 70 years of age

Risks factors

  • Age
  • Not having children
  • Having the first child late in life
  • Early onset of periods
  • Delayed menopause
  • Family history of breast, colon or ovarian cancers

Symptoms

  • Vague discomfort in the lower abdomen
  • Bloating, loss of appetite
  • Backache

Diagnosis

  • Ultrasound abdomen
  • CT and MRI
  • Laparoscopy

Stages are based on how far the cancer has spread:

  • Stage I: The cancer occurs only in one or both ovaries.
  • Stage II: The cancer has spread to the uterus, fallopian tubes, or nearby tissues within the pelvis (which contains the internal reproductive organs, bladder, and rectum).
  • Stage III: The cancer has spread outside the pelvis to the lymph nodes, the surface of the liver, the small intestine, or the lining of the abdomen.
  • Stage IV: The cancer has spread outside the abdomen or to the inside of the liver

Treatment

  • Surgery: the ovaries, fallopian tubes and uterus are removed. Lymph nodes in the area may also be removed. All visible cancer tissue is removed
  • In advanced cases, chemotherapy may be given

Cervical Cancer

  • Occurs due to Human Papilloma Virus (HPV) transmitted through sexual intercourse
  • It can occur in women of all ages, although the average age at diagnosis is around 50 years

Risk factors

  • Early initiation of sexual activity
  • Multiple partners
  • Having intercourse with men who have had partners with cancer cervix
  • Tobacco smoking
  • Immunosuppression

Staging of Female Reproductive System Cancers

TypeStage IStage IIStage IIIStage IV
Endometrial or uterine cancerOnly in the upper part of the uterusSpread to cervixSpread to nearby tissues within the pelvisSpread to bladder or intestine (A) or distant organs (B)
Ovarian cancerOnly in one or both ovariesSpread to uterus, fallopian tubes or nearby tissues within the pelvisSpread outside the pelvis to lymph nodes, surface of the liver, small intestine or lining of the abdomenSpread outside the abdomen or inside the liver
Cervical cancerOnly in the cervixSpread outside the cervix (including the upper part of the vagina) but still within the pelvisSpread throughout the pelvis (including the lower part of the vagina) sometimes blocking the ureters and/ or causing a kidney malfunctionSpread to the bladder or rectum (A) or distant organs (B)
Vulvar cancerOnly in the vulva and/ or the area between the opening of the rectum and vagina (perineum)Spread to nearby tissues, such as the lower part of the urethra or vagina but not to nearby lymph nodesSpread to nearby lymph nodes with or without spread to nearby tissuesSpread beyond nearby tissues to the bladder, the upper part of the urethra or vagina, the rectum or more distant lymph nodes
Vaginal cancerOnly in the vaginaSpread to nearby tissues but still within the pelvisSpread throughout the pelvisSpread to the bladder or rectum or outside the pelvis
Fallopian tube cancerOnly in one or both fallopian tubesSpread to nearby tissues but still within the pelvisSpread to abdominal organs (such as the intestine and liver) or nearby lymph nodesSpread to distant organs
     

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