Reproductive Cancers
Cervical Cancer
Cervical cancer is the growth of abnormal cells in the lining of the cervix. The most common cervical cancer is squamous cell carcinoma, accounting for 70% of cases.
Symptoms
Precancerous changes in cervical cells rarely cause symptoms. Undergoing regular cervical screening tests will provide early detection. If early cell changes develop into cervical cancer, the most common signs include:
• Vaginal bleeding between periods
• Menstrual bleeding that is longer or heavier than usual
• Pain during intercourse
• Bleeding after intercourse
• Pelvic pain
• Changes to vaginal discharge
• Vaginal bleeding after menopause
Causes
Almost all cases of cervical cancer are caused by persistent infection with some high-risk types of the human papillomavirus (HPV). The other main risk factor for cervical cancer is smoking.
Other risk factors include:
• A weakened immune system
• If your mother was prescribed diethylstilbestrol (DES), an artificial form of the female hormone oestrogen during pregnancy (between 1939 and 1971)
Diagnosis
If your screening test results suggest you have symptoms of cancer you will be referred to a specialist for further tests.
The standard tests for cervical cancer are:
• Colposcopy with biopsy - a colposcopy identifies where abnormal cells are located in the cervix, and the appearance of these cells. A speculum is inserted into the vagina so that the doctor can view the cervix and vagina via a colposcope. If the colposcopist identifies any suspicious looking areas, they will usually take a tissue sample (biopsy) from the surface of the cervix for further examination
• Large loop excision of the transformation zone (LLETZ) - if any of the tests show precancerous cell changes, you may have a LLETZ. This is the most common method to remove cervical tissue for examination and treating precancerous changes of the cervix
Treatment
Staging - if cervical cancer is detected, it will be staged. Staging begins at stage 1, which means abnormal cells are found only in the tissue of the cervix, through to stage 4, which means the cancer has spread beyond the cervix. This helps your doctors plan the best treatment for you.
Types Of Treatment
Treatment depends on disease stage. For early and smaller cancers, treatment is generally surgery, sometimes with chemoradiation afterwards.
If the tumour is small, a cone biopsy may suffice, in some cases hysterectomy is required.
For locally advanced disease, a combination of radiotherapy and chemotherapy is used.
For metastatic disease, the treatment is chemotherapy or palliative care alone.
Treatment Team
Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
• GP - oversees general health and liaises with specialists to coordinate treatment
• Gynaecological oncologist - diagnoses and treats cancers of the female reproductive system
• Radiation oncologist - prescribes and coordinates radiation therapy treatment
• Medical oncologist - prescribes and coordinates the course of chemotherapy
• Cancer care coordinators - coordinate your care, liaise with the multidisciplinary team and support you & your family throughout treatment
• Dietician / Nutritionist - oversees a nutritional plan during treatment and recovery
• Other allied health care professionals - such as social workers, pharmacists, counsellors, Naturopaths
Ovarian Cancer
Ovarian cancer is a malignant tumour in one or both ovaries. While there are many types of ovarian cancer, the three most common types of ovarian cancer are:
• The common epithelial type (90% of cases) that arises from the cells on the outside of the ovary
• The germ cell type (around 4% of cases) that arises from the cells with produce eggs
• The rare stromal type arising from supporting tissues within the ovary
Signs & Symptoms
There are no obvious signs of ovarian cancer, however you have have one or more of the following:
• Abdominal bloating
• Difficulty eating or feeling full quickly
• Frequent or urgent urination
• Back, abdominal or pelvic pain
• Constipation or diarrhoea
• Menstrual irregularities
• Fatigue
• Indigestion
• Pain during intercourse
• Unexplained weight loss / gain
Causes
• Age (risk increases for women over 50)
• Family history of ovarian, breast or bowel cancer
• Changes in the genes BRCA1 or BRCA2
• Being of Ashkenazi Jewish descent
• Early onset of periods (before 12 years) and late onset of menopause
• Women who have not had children or had their first child after age 35
• Using oestrogen only hormone replacement therapy or fertility treatment
Diagnosis
If you are experiencing possible symptoms of ovarian cancer your doctor may suggest several tests or scans to look for cysts, tumors or other changes. These may include:
• Physical examination - the doctor will check your abdomen for any lumps and do an internal vaginal examination
• Blood tests - check for a common tumour marker for ovarian cancer, CA125
• Pelvic ultrasound - uses echoes from soundwaves to create a picture of your ovaries an uterus
• CT scan - uses x-rays to take images of the inside of the body to check for cancer
• PET scan - highlight abnormal tissues in the body
• Colonoscopy - a bowel examination to ensure that symptoms are not caused by a bowel problem
Treatment
Treatment depends on the extent of the cancer. Surgery is used to determine the extent of disease, and if localised, is the main treatment. If the cancer has spread, an attempt is made to remove as much of it as possible.
• Chemotherapy - uses anti-cancer drugs to destroy cancer cells. Most women will have chemotherapy after surgery to destroy any remaining cancer cells
• Radiation therapy - can be used to treat the pelvic or other sites of cancer that have spread. It may be used on its own or after chemotherapy
• Palliative care - in some cases of ovarian cancer, your medical team may talk to you about palliative care. Palliative care aims to improve the quality of life by alleviating symptoms of cancer
Treatment Team
Depending on your treatment, your treatment team may consist of a number of different health professionals, such as:
• GP - oversees general health and liaises with specialists to coordinate treatment
• Gynaecological oncologist - diagnoses and treats cancers of the female reproductive system
• Radiation oncologist - prescribes and coordinates radiation therapy treatment
• Medical oncologist - prescribes and coordinates the course of chemotherapy
• Radiologist - interprets diagnostic scans (including CT, MRI and PET scans)
• Gynaecological pathologist - examines tissue removed from the abdomen or ovaries
• Cancer nurse - assists with treatment and provides information and support throughout your treatment
• Other allied health care professionals - such as social workers, pharmacists, counsellors, Naturopaths