What You Need To Know About Female Cancers

There Are Five Types

According to The Eve Appeal, there are five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal – but awareness remains low. Each year in the UK, over 21,000 women are diagnosed with a gynaecological cancer, equivalent to 58 daily diagnoses. Sadly, 21 of these women die every day in the UK. “Gynaecological cancers account for 10% of cancer deaths in the UK and the incidence is rising,” says Dr John Butler, medical director of The Lady Garden Foundation and consultant gynaecologist at The Royal Marsden Hospital. Women’s health expert Victoria Howell adds that a lack of funding in women’s health has created a huge knowledge gap and stigma around these cancers, too: “Public funding in women’s reproductive health research is as little as 2%. Just over half of the UK’s population is female, so with limited funding it impacts on the availability of training, and subsequently, the profile of gynaecological cancers. The more we talk about these cancers, the better we can raise their profile and keep women informed.”

Some Are More Common Than Others

“The most common gynaecological cancer is uterine (also referred to as endometrial) cancer,” says John, with around 9,500 cases each year in the UK and 2,300 deaths. “Ovarian cancer has 7,500 cases and 4,100 deaths; cervical cancer 3,200 cancers and 852 deaths; and vulval and vaginal cancers 1,500 cases with 550 deaths,” he says. According to The Royal Marsden, uterine cancer is the fourth most common cancer in women after breast, lung and bowel cancers and its incidence has increased by over 50% since the early nineties mainly due to increasing obesity rates and an ageing population. “While obesity does play a role, for many patients, gynaecological cancers are caused by hereditary genetic conditions such as BRCA mutation and Lynch syndrome,” John explains, stressing the importance of genetic knowledge. 

Keep An Eye Out For Changes

While each of the five female cancers has its own unique symptoms, there are certain things you should always flag with your GP, says John. “Symptoms of particular concern are vaginal bleeding after the menopause, between periods or after sex, abdominal swelling or bloating, and the presence of any new lumps or ulcers. For most women, there will be non-cancer-related causes to these issues, but it’s always important to get it checked out.” Keep an eye out for the following symptoms, too…

• OVARIAN CANCER: Persistent bloating or abdominal pain; difficulty eating, feeling nauseous or full quickly; changes in bowel habits; and needing to urinate more frequently.

• UTERINE CANCER: Bleeding in between periods, after menopause or after sex; heavier periods, and abnormal discharge – pink, watery or brown discharge could be a sign of uterine cancer.

• CERVICAL CANCER: Bleeding between periods or after sex; pain during sex; and an unpleasant smelling discharge.

• VAGINAL CANCER: Bleeding between periods, post-menopause or after sex should always be investigated, as should blood-stained discharge; pain during sex; a vaginal lump; or a persistent vaginal itch.

• VULVAL CANCER: A lasting itch; pain or soreness; thickened, raised, red, white or dark patches of the skin of the vulva; or lumps on the vulva.

Age Plays A Part

“Most gynaecological cancers are diagnosed in women over the age of 55, although we see these types of cancers in all age groups,” John says. Victoria adds that when it comes to ovarian cancer, there is a very low incidence up to the age of 30, with the risk increasing with age and peak cases at 75-79; uterine cancer peaks at 75-79; the risk of vaginal cancer rises from the age of 55; and the risk of vulval cancer increases from 35. When it comes to uterine cancer, the UK’s most common gynae cancer, three-quarters of those diagnosed are aged 40 to 74, while just over one in 100 cases occur in women under the age of 40.

Always Attend Your Smear

The cervical screening test, offered to all women in the UK aged 25 to 64, tests for human papilloma virus (HPV) infection and changes in the cells covering the neck of your womb. These changes could later develop into cervical cancer if they aren’t treated. While screening isn’t a test for cancer, it’s a test for abnormal pre-cancerous changes, which can then be treated to stop cancer developing. There are around 200 different types of HPV – around 40 affect the genital area and are low risk, but 13 HPV types are high risk and two types cause 70% of cervical cancer cases. Cervical screening is highly effective at preventing cervical cancer, saving around 4,500 lives every year in England alone. Worryingly, cervical screening attendance is at its lowest in 21 years in the UK, with recent figures showing one in four women recently skipped an appointment. 

Know The Next Steps

If your cervical screening test comes back negative, no further action will be taken, and you will be called back on the regular three to five year pattern. If, however, your test comes back positive for HPV and abnormal cells, you will require a colposcopy, explains Victoria. “The area that has the abnormal cells is usually treated under local anaesthetic. A small cone-like section of the cervix is removed and sent to histology. Stats show 95-98% of women are cured after a one-off treatment. The process can be uncomfortable, rather like a period pain, and sex should be avoided for six weeks, but this will prevent cells from becoming cancerous.” Victoria also explains a smear test can come back ‘inadequate’, which means there was not enough of a sample to provide a clear reading – in this case, you’ll need to have a repeat test, but it is not a cause for alarm.