Gynecological oncology is a specialized field of medicine focusing on all cancers related to female reproductive organs, including uterine cancer, cervical cancer, ovarian cancer, vaginal cancer, and vulvar cancer, as well as their treatments. If diagnosed with cancer, there are many treatment options available. Effective treatment methods include surgery, chemotherapy, and radiation therapy.
What is Gynecological Oncology?
Gynecological oncology deals with the diagnosis and treatment of cancers of the female reproductive system. All women are at risk for gynecological cancers, and this risk increases with age. Therefore, gynecological oncology, which focuses on the prevention, diagnosis, and treatment of diseases affecting the female reproductive system, is extremely important. Early diagnosis of diseases is crucial for effective treatment.
Doctors who are specially trained to diagnose, treat, and follow up on cancers and precursors occurring in women’s genital areas are called gynecological oncologists. It is important to regularly see a gynecological oncologist for early diagnosis, which is the best way to reduce the risk of serious health complications.
What are the Symptoms of Gynecological Cancer?
Among the five main types of gynecological cancers—cervical cancer, ovarian cancer, uterine cancer, vulvar cancer, and vaginal cancer—only cervical cancer can be detected through screening tests. For the diagnosis of other types of cancer, you need to recognize symptoms and report them to specialist doctors. Symptoms associated with each gynecological cancer may vary. However, some common symptoms to be aware of include:
- Abnormal vaginal discharge or bleeding
- Sudden weight loss
- Frequent urination
- Swelling in the legs
- Loss of appetite and persistent feeling of fullness
- Pain in the pelvis or abdomen
- Persistent fatigue
- Abdominal bloating
- Prolonged nausea
- Burning or itching of the vulva (the external part of the female genital organ)
Having these symptoms does not mean you have cancer. However, if they persist for two weeks or longer, you should make an appointment with a gynecologist as soon as possible to have your condition evaluated.
What are the Causes of Gynecological Cancer?
Each type of cancer has its own unique risk factors and causes. Some of these causes that lead to cancer are within your control, while others are not.
Controllable causes of gynecological cancer include:
- Health issues like diabetes and hypertension
- HIV infection or AIDS
- Obesity
- Smoking
- HPV infection
- Not going for regular gynecological examinations
Uncontrollable causes of gynecological cancer include:
- Age factor
- Polycystic ovary syndrome
- Infertility
- Family history of cancer
- Exposure to diethylstilbestrol (DES) while in the womb
- Menstrual issues such as starting menstruation before age 12 or entering menopause after age 50
What are the Risk Factors for Gynecological Cancer?
Risk factors are factors that increase your chances of developing any disease. Each cancer has different risk factors. For example, smoking is a risk factor for most cancers. However, having these factors does not mean you will develop the disease.
Risk Factors for Cervical Cancer
The risk of cervical cancer is known to be influenced by the human papillomavirus (HPV). Sexually transmitted HPV is a common infection. Smoking and long-term use of birth control pills in patients diagnosed with high-risk HPV can increase the risk of developing cervical cancer.
Cervical cancer can also develop due to exposure to the drug diethylstilbestrol (DES). This drug is a synthetic form of estrogen that was prescribed to pregnant women between 1940 and 1971. If you were exposed to this drug while in the womb, you may want to consult your doctor about your risk of cervical cancer.
Risk Factors for Ovarian Cancer
Most women can develop ovarian cancer without being at high risk. However, the following conditions may increase the risk of developing ovarian cancer:
- Genetic predisposition
- Family history of breast or ovarian cancer
- Increasing age
- Obesity
- No history of pregnancy
- Hormone replacement therapy after menopause
Risk Factors for Uterine Cancer
The following factors may increase the risk of developing uterine cancer:
- Age: Uterine cancer often occurs after age 50.
- Genetics: Patients with a family history of colon cancer or other cancers have a higher risk of uterine cancer.
- Type 2 diabetes: Patients with type 2 diabetes, which is often associated with being overweight, may have an increased risk of uterine cancer.
- Other cancers: Individuals who have had colon, breast, or ovarian cancer have a higher risk of developing uterine cancer.
- Radiation therapy: Having received radiation therapy to the pelvic area for another cancer increases the risk of uterine cancer.
Risk Factors for Vaginal Cancer
Vaginal cancer is mostly caused by the HPV virus. Other risk factors for vaginal cancer include:
- Being over 60 years old
- History of uterine cancer or cervical cancer
- Smoking
- Exposure to DES while in the womb
Risk Factors for Vulvar Cancer
As with various types of cancer, a significant risk factor for vulvar cancer is the HPV virus. Smoking in individuals with HPV further increases the risk of developing cancer.
Another factor that can cause vulvar cancer is lichen sclerosus. Lichen sclerosus is a rare autoimmune disease that causes thinning of the vulva. Its most common symptom is itching.
What are the Symptoms of Uterine Cancer in Young Age?
Although uterine cancer is most commonly seen in the post-menopausal period, most patients are between the ages of 50 and 60. However, uterine cancer can rarely occur in younger patients as well. There is a strong relationship between the development of uterine cancer in young women and obesity.
One of the main symptoms of uterine cancer at a young age is abnormal uterine bleeding. If you experience bleeding between your menstrual periods, if your menstrual bleeding lasts longer than it should, or if you have excessive bleeding, this is considered an abnormal situation.
Pelvic pain is another symptom seen in patients who develop uterine cancer at a young age.
Pain after sexual intercourse, urinary dysfunction, and abnormal vaginal discharge can also be symptoms seen in individuals diagnosed with uterine cancer at a young age.
If you experience one or more of the symptoms of uterine cancer at a young age, you should not ignore this situation and should contact a specialist as soon as possible.
What are the Diagnosis and Treatment Methods in Gynecological Oncology?
The diagnosis of gynecological cancer can be made in various ways depending on the patient’s family history, medical history, and symptoms observed. The treatment plan for patients diagnosed with gynecological cancer may vary based on several factors, including the type of cancer, how far it has spread, and whether the patient is of childbearing age.
Diagnosis in Gynecological Oncology
Diagnosis in gynecological oncology is made through various diagnostic tests. After a physical examination, your doctor will determine which diagnostic tests are necessary. Diagnostic tests include:
- Blood tests: There are specific blood tests that show tumor markers and other blood components to determine the presence of cancer. Your doctor can plan the next steps in the diagnosis phase based on the test results.
- Pap Smear test: These tests are usually performed during routine gynecological examinations. Even if there are no signs of cancer, cells are taken from the surface of the cervix and sent for testing. This test is an effective way to detect cell abnormalities before they turn into cancer.
- Imaging tests: These tests create images of the tissues in the pelvis and abdomen to visualize any tumors. Ultrasounds, magnetic resonance imaging (MRI), X-rays, positron emission tomography (PET) scans, and computed tomography (CT) scans are commonly used imaging tests. A hysteroscopy (H/S, used to observe the inside of the uterus, take biopsies, and treat adhesions) may also be performed.
- Hysterosalpingography (HSG): This is another diagnostic method used to visualize the uterine cavity. It is an X-ray procedure that visualizes the uterus and fallopian tubes. The normal size and shape of the uterus can be examined.
- Biopsy: This involves taking a small piece from tissue suspected of being cancerous for laboratory examination. A biopsy is a necessary procedure to confirm the diagnosis of gynecological cancer.
Treatment of Gynecological Cancer
Treatment options include surgery, medication, chemotherapy, and radiation therapy. Surgery is usually the best option for advanced cases. Hysterectomy (removal of the uterus) is a very common treatment option for patients with cervical, uterine, and ovarian cancer. Non-surgical treatment options include:
- Chemotherapy: Special combinations of drugs are used to slow down or stop cancer. These drugs can be administered intravenously or taken orally as pills.
- Radiation therapy: This involves using high-energy rays to destroy cancer cells. If the patient cannot undergo surgery, the doctor may recommend radiation therapy. One radiation therapy option to consider is “brachytherapy.” Brachytherapy can be applied using two techniques depending on the stage of the tumor. One involves placing a device containing the radiation source into the vagina. The other technique, used in the presence of larger tumors, involves placing several needles along with the radiation source into the tumor. A study indicates that patients who received brachytherapy as part of their treatment lived longer. Comments from patients with cervical cancer receiving brachytherapy confirm the effectiveness and quality of the treatment.
Frequently Asked Questions:
Pain occurring in the pelvis, lower back, and lower abdomen may be a sign of cervical cancer.
In gynecological oncology, the diagnosis and treatment of diseases of the female reproductive system are provided. Diagnosis is made through a gynecological examination. Your doctor will first ask about the symptoms during a general examination. Then, you will be asked to lie on your back for an external visual examination. The visual examination checks for any redness, irritation, or abnormal condition in your vagina. Diagnostic tests are performed based on your family history of cancer and your medical history. An ultrasound is used to check the health of your uterus and ovaries. A sample of cells is taken from the cervix through a test called a smear test. This way, precursors of cancer can be diagnosed.
Doctors specially trained to diagnose and treat cancers developing in women’s genital areas, known as “gynecological oncologists,” look after gynecological oncology.
Uterine cancer can often be detected using imaging techniques such as ultrasound. It appears as a mass on ultrasound. However, it is not possible to definitively say that the observed masses are cancerous. A biopsy is required to confirm the diagnosis of masses suspected to be cancerous.
There are two types of uterine cancer. The first is the commonly seen endometrial cancer, which is also defined as cancer of the uterine wall and is the most frequently encountered type of gynecological cancer. The other type of uterine cancer is the rarer uterine sarcoma, which occurs in the muscular wall of the uterus.
To combat these cancers commonly seen in women and to protect your health, you can regularly see a gynecological oncology specialist. Early diagnosis is an important part of increasing the chance of treatment and securing your health.
