While breast cancer seems to get more exposure, women — especially those who wish to have children — should pay attention to gynaecological cancers too.
Gynaecological cancers affect a woman’s reproductive organs. They include cervical, ovarian, uterine, vaginal and vulvar cancers. Each has its own characteristics, symptoms, risk factors and screening methods.
Ovarian cancer is the fifth most common cancer in Singapore, and the second most common gynaecological cancer. If discovered early, 95% of cases can be easily cured. However, seven in 10 of these cancers are diagnosed in advanced stages. Risk factors include a family history of the disease, late pregnancy, early onset of menstruation, late menopause, and endometriosis. Women who have not had children or had breast cancer also have an increased risk.
There is no standard screening test. However, if there is a family history of breast or ovarian cancer, see a doctor to assess your risk and schedule regular pelvic exams. This is important to spot the cancer early. Many of the signs may be mistaken for irritable bowel syndrome, Crohn’s disease or a malfunctioning gall bladder. In its later stages, ovarian cancer may result, with symptoms such as chronic irregular bleeding, abdominal pain or swelling, and discomfort or changes in bowel habits.
Uterine or endometrial cancer affects the lining of the uterus. This type of cancer is the fourth most common female cancer in Singapore. One of the biggest risk factors is age. Though it can occur in women of any age, 70% of cases are in women older than 50. Other risk factors include obesity, diabetes, hypertension and polycystic ovary syndrome as well as prior oestrogen replacement therapy.
One key symptom is abnormal vaginal bleeding (bleeding or discharge after menopause, between menstrual cycles), unusual lower abdominal pain or pelvis cramps. Some preventive steps include using oral contraceptives (combined hormone replacement therapy), pelvic ultrasound exam, weight management, and blood sugar control.
Cervical cancer occurs when there are cell changes in the lining of the cervix (lower part of the womb). Left untreated, these precancerous lesions can spread. In Singapore, cervical cancer is the 10th most common female cancer. In most cases, this form of cancer is due to infection by the human papillomavirus (HPV).
There are few symptoms in the early stages of the disease. Women in the late stages may experience abnormal vaginal bleeding. This greatly underscores the importance of preventing the disease by getting vaccinated. The newest HPV vaccine is effective against nine strains of HPV, which covers up to 90% of cervical cancers as well as genital warts. However, regular Pap smear tests are still recommended to check for cell irregularities. This is especially so because, if detected early, the disease is more likely to be treated successfully.
Vaginal cancer is a rare cancer that occurs in the birth canal. Causes are not known, but risk factors include age, presence of atypical cells in the vagina (the condition is known as vaginal intraepithelial neoplasia), HPV infection, multiple sexual partners, early sexual exposure, and smoking.
Vaginal cancer does not always cause symptoms in the early stage. But signs include unusual vaginal bleeding, watery vaginal discharge, the presence of a mass in the vagina, painful or frequent urination, constipation, and pelvic pain. The disease can be picked up during regularly scheduled pelvic exams and Pap smear tests. Receiving the HPV vaccine may also reduce the risk of vaginal cancer and other HPV-related cancers.
Vulvar cancer is rare and, if detected early, is easily treated and cured. Risk factors include HPV infection, a history of genital warts or abnormal Pap smears. Age is also a factor; while women of all ages can be affected, those in their 70s and 80s are most at risk. In women of this age group, the cancer may only be detected in advanced stages as they do not do regular pelvic examinations.
Vulvar cancer may not exhibit symptoms, but the most common sign is itching that does not abate. Regular gynaecological examinations are helpful in picking up the presence of this disease.