Gynecological Cancer
Understanding the causes and symptoms of gynaecological cancer for effective treatment and prevention to improve the survival rate
Gynaecological cancer refers to all cancers of the female reproductive system, including cervical cancer, uterine cancer, ovarian cancer, vulvar cancer, vaginal cancer and fallopian tube cancer. Gynaecological cancer can be asymptomatic in the early stage and the survival rate depends on the type of cancer. For example, in 2019, cervical cancer ranked 8th among the most common and fatal cancers among women in Hong Kong, accounting for 2.6% of female cancer deaths.
Women of all ages are at risk for gynaecological cancer. Since most of these diseases are asymptomatic in their early stages, regular check-ups and prevention are important. If patients only seek medical advice when symptoms appear, they may have delayed the best opportunity for treatment. The best approach is to have a healthy diet from the age of 25. Women who have sex experience should have regular Pap smear tests and receive HPV vaccination as early as possible.
婦科癌症的初期沒有明顯病徵，發展至中後期可能出現以下婦科癌症狀。如果持續感到不適，應立刻進行檢查。
- Abnormal vaginal bleeding
- Heavier and longer periods
- Bleeding after menopause
- Increased and persistent vaginal discharge
- Pain during or bleeding after sex
- Abnormal swelling of the body
- Pain or pressure in the pelvic cavity
- Abdominal pain or back pain
- Abnormal fatigue
- Bloating in the abdomen
- Change in bowel habits (diarrhoea, constipation, frequent urination)
Risk factors for gynaecological cancer
The hectic schedule of the urban people, along with a series of physical and psychological factors such as an imbalanced diet, lack of exercise, excessive work-related stress, and heredity may easily facilitate diseases. Compared to men, women are more prone to diseases. In particular, gynaecological diseases have been affecting more and even younger women in recent years, posing a serious threat to modern women. The risk factors of gynaecological cancer include:
- Aged 50 years or above
- Have excessive body fat, diabetes or high blood pressure
- Have taken oestrogen after menopause
- Have never given birth
- Have taken Tamoxifen (a hormone therapy drug for breast cancer)
- Have never given birth
- Have a family medical history of gynaecological cancer
Symptoms of Gynaecological Cancer
Screening and Diagnosis of Gynaecological Cancer
The two most common tests for ovarian cancer screening (except for a complete pelvic exam) are transvaginal ultrasound (TVUS) and CA-125 blood test. TVUS uses sound waves to observe the uterus, fallopian tubes and ovaries by inserting an ultrasound transducer into the vagina. Other cancer diagnostic tests include:
Medical consultation:
Medical History (e.g. gynaecological disease, obstetric history), allergies, family medical history, plans for pregnancy and contraception methods, menstrual cycle, etc.
Physical examination:
Measure height, weight, blood pressure, check for anaemia and thyroid disease.
Abdominal examination:
Check for palpable tumours in the abdomen, which are usually large uterine fibroids, ovarian cysts or ascites caused by cancer.
Cervical smear test:
The doctor will use a device to examine the cervix and collect cells with a brush for testing. The procedure takes only a few minutes and brings no pain but only minor discomfort.
Pelvic ultrasound:
A pelvic ultrasound can be conducted through the abdomen or vagina to check the uterus and ovaries for fibroids, ovarian cysts, etc.
Treatment of Gynaecological Cancer
此外，運動在康復過程中尤其重要，醫生建議婦科癌患者按個人的病情、年紀和體質，可循序漸進地進行一些復康運動，以減低手術後帶來的不適和情緒問題。簡單的上肢運動，如使用彈力帶伸展雙臂，以鍛煉肌力，並提升上臂和肩膀的活動能力，減少上身僵硬和疲勞。如果身體情況許可，可以嘗試一些心肺功能運動，如急步行、太極和游泳等帶氧運動。特別於水中運動，水的浮力和阻力使肌肉在負重較輕的情況下得到鍛煉，水的壓力更可速進淋巴循環。
Treatment of Gynaecological Cancer
Prevention of Gynaecological Cancer
Gynaecological cancer has a profound effect on women and is absolutely considered their greatest enemy. Therefore, the following preventive measures should always be considered.
- Women with sex experience should undergo pelvic examination and cervical smear test every 3 years after the age of 25
- Maintain a healthy diet and regular exercise for optimal body weight
- Limit alcohol consumption
- Use condoms during sexual intercourse
- Limit the number of sexual partners
- Receive HPV vaccination
Gynaecological Cancer FAQ
Q. What are the 5 types of gynaecological cancer?
Gynaecological cancers refer to cancers in the female reproductive organs. The five main types of gynaecological cancer are cervical cancer, ovarian cancer (including fallopian tube cancer and primary peritoneal cancer), uterine cancer, vaginal cancer, and vulvar cancer.
There are four main approaches for gynaecological cancer treatment: surgery, chemotherapy, radiotherapy, and targeted therapy. Depending on the patient's condition, the treatments can be adopted alone or in conjunction with other palliative methods.
- Surgery
Depending on the patient’s condition, the doctor may conduct surgery to remove the cancer cells.
- Chemotherapy
Chemotherapy, commonly known as chemo, is a treatment which primarily includes the intravenous injection of cytotoxic drugs. The drugs will circulate through the bloodstream and kill cancer cells by destroying or inhibiting their division and proliferation.
- Radiotherapy
Radiotherapy, also known as electrotherapy, is the use of high-energy radiation to destroy cancer cells, usually as a curative treatment of early-stage cancer. It can treat locally advanced tumours and eradicate the remaining cancer cells after surgery. Radiotherapy is also suitable for patients who cannot receive surgery due to their old age or other diseases.
- Targeted Therapy
Some patients, especially those with ovarian cancer, inherit certain mutations in the BRCA 1/2 genes which damage their normal function of repairing DNA and increase the risk of ovarian and breast cancer. In this case, a target therapy drug called PARP inhibitors can be used to block PARP from repairing the damaged DNA of cancer cells. The cancer cells will then die with synthetic lethality, which occurs when two mechanisms of repairing DNA are both blocked. Only tumour cells will be targeted since normal cells without mutated BRCA genes will not be affected by synthetic lethality triggered by PARP inhibitors. Studies have shown that the use of PARP inhibitors after surgery for early-stage ovarian cancer and consolidation chemotherapy can greatly reduce the chance of recurrence.
Q. What are the causes of gynaecological cancer?
Many factors contribute to gynaecological cancers. According to medical research, mutations in proto-oncogenes and tumor suppressor genes contribute to the growth of cancer. A number of factors such as smoking, aging, environmental influences or heredity can cause abnormal function of these genes. Almost all cervical cancers and some vaginal and vulvar cancers are caused by a virus called HPV (human papillomavirus).
Q. Can gynaecological cancers be prevented?
Regular screening and self-tests can detect certain types of gynaecological cancers in an early stage, in which treatments will be more successful and more likely to achieve a complete cure. Diet, exercise, and lifestyle also play an important role in cancer prevention. Moreover, knowing your family medical history can identify possible inherited genetic mutations which may cause cancer, thus increasing the chance of prevention and early diagnosis.
