Gynaecological cancers always start in a woman’s reproductive organs. There are, in fact, five main types of gynaecological cancer: cervical cancer, ovarian cancer, womb (uterine) cancer, vaginal cancer, and vulval cancer.
Cervical cancer is the only one of the five which can be detected through screening. As a result, most developed countries have routine screening programmes. It is estimated that cancer screening saves around 4,000 lives every year in the UK.
In 2018, the American Cancer Society reported an estimated 110,070 new gynaecological cancer cases annually. In the same year, 32,120 women died of the condition.
The figure for gynaecological cancer cases in the UK is around 21,000 every year. That’s 58 people diagnosed every day. Of those women, 21 will die from cancer.
It is estimated that more than 13,240 women in the UK are diagnosed with cervical cancer annually, with 4,170 women dying as a result. Cervical cancer usually affects women aged 30 to 50 and those who smoke are at increased risk since smoking weakens the immune system. An HPV virus infection usually causes the cancer. A pap smear and testing can identify HPV and pre-cancerous changes in the cervix and vagina.
Around 7,500 people are diagnosed with ovarian cancer every year in the UK. That makes it the sixth most common cancer overall. Ovarian cancer is more likely to strike women as they reach menopause. Those who have had breast cancer or have a family history of the disease are especially at risk. Childless women are also more vulnerable since pregnancy reduces the risk.
Uterine (womb) cancer
Taking the hormone oestrogen without progesterone can increase the risk of uterine cancer, as can being overweight. Childless women and those with late menopause are believed to be more susceptible. So too are those with diabetes, high blood pressure and a family history of colon or endometrial cancer.
This cancer is uncommon, with 1300 women diagnosed in the UK every year. Skin conditions such as Lichen sclerosus are risk factors for vulval cancer, and as with some other gynaecological cancers, the incidence increases with smoking or persistent HPV infection.
The rarest of all the five gynaecological cancers, vaginal cancer affects just over 250 women in the UK each year. Those aged 60 and over are more likely to have vaginal cancer. Smoking is a risk factor, as is an HPV infection.
The World Population Review in 2022 recorded cancer survival rates by country. Researchers focused on 18 different types of cancers in adults and children
and analysed 37.5 million records of cancer patients from 71 countries and territories. Their results weren’t restricted to only gynaecological cancers but all types of cancers.
The data reveals which countries have the best five-year survival rates. In 2021, the most successful country in treating cancer was the USA, followed by Canada, Australia, New Zealand and Finland. Iceland was 6th, then Norway and Sweden.
Survival trends are generally increasing, according to the Review’s statistics. This is particularly the case for some of the more lethal cancers, such as those of the liver, pancreas, and lung.
Tests for gynaecological cancers
There are several ways in which gynaecological cancers can be diagnosed. Most commonly, irregularities on the cervix, uterus, ovaries, vagina and vulva are revealed during a physical examination of the pelvis. Cervical cancer is typically picked up by a pap screening test to check for cancer cells in the cervix.
Concerned doctors can then ask for further tests, such as an ultrasound, CT scan or MRI. Other recognised tests include a colposcopy where the cervix and vagina are examined under magnification.
Another is a Dilation and Curettage (D&C), which involves dilating the cervix to remove abnormal tissue from the cervical canal and uterine lining. A Loop electrosurgical excision procedure (LEEP) involves removing cells and tissue with a heated wire loop.
A biopsy is a common way to examine tissue, while a laparoscopy involves inserting a tube into the abdomen and viewing the area via video monitor. Blood tests, called CA-125, HE4 or OVA 1 can help identify ovarian cancer.
Treatment of gynaecological cancers
Minimally invasive surgery
Surgical procedures without major incisions can be carried out using hysteroscopy and laparoscopy or robotic surgery. Radiofrequency ablation can be used to remove or reduce minor tumours and growths.
This involves using high energy x-rays or gamma rays to damage the DNA of cancerous cells, thus killing the cells or preventing them from reproducing. Online MRI-guided radiation therapy (oMRgRT) is being billed as the next step in high-precision radiation therapy.
This is where anti-cancer (cytotoxic) drugs are used to destroy cancer cells. It is most often used for gynaecological cancers that start in the ovaries, fallopian tubes or peritoneum.
Also called endocrine therapy, this is used for certain types of ovarian cancer, especially if surgery and chemotherapy have proved unsuccessful. Drugs are used to block the actions of hormones such as oestrogen.
Alternative: intraperitoneal chemotherapy
The drugs cisplatin and paclitaxel are injected into the abdomen via a catheter. The latter is usually connected to a port, and a needle is placed into it via the skin to give chemo. This gives the most concentrated dose of the drugs directly to the cancer cells.
Finding the best cancer hospital for gynaecological and other forms of cancer can be daunting, so we have compiled a shortlist of some of the leading international hospitals from the East to the West in this article.
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