Gynecological Cancers; the “Silent Killers.” (Gynecological Cancers Awareness Month)

TRIGGER WARNING: Contains detailed information about women’s genitalia and references to fetal fatality. 

Gynecological cancers aren’t necessarily something that we hear a lot about, however, they are something every woman should know about and be on the lookout for. As defined by, gynecological cancer is “an uncontrolled growth and spread of abnormal cells that originate from the reproductive organs.”

These abnormal cell growths can then also spread to other parts of the body, which results in more tumours forming where they spread.  There are several types of gynecological cancers; including ovarian cancer, cervical cancer, uterine or endometrial cancer, vaginal cancer, and vulval cancers.

Some gynecological cancers have been referred to as “silent killers” because women can often be unaware of their signs and symptoms. In these cases, the cancers may not be caught or treated until it is too late.

Types of gynecological cancers:

Gynecological Cancers; the “Silent Killers.” (Gynecological Cancers Awareness Month)

Cervical cancer: Cervical cancer is a cancer that develops in the cervix, the part of the uterus that opens up into the vagina. Cervical cancer is caused by abnormal changes in one of the two main cell types of the cervix.

Cervical precancers normally don’t have symptoms, however, it is the only gynecological cancer that can be prevented by regular smear tests. Symptoms will often only show once the cells turn into cancer and start to invade the deepest parts of the cervix or other surrounding organs.

Ovarian cancer: Ovarian cancer is cancer that develops in the ovaries. Ovarian cancer is the seventh most common cancer in women. There are four types of ovarian cancer:

  • Epithelial ovarian cancer, which is the most common ovarian cancer, forms on the surface of the ovary or the fallopian tube;
  • Germ cell cancer, which is an uncommon ovarian cancer that develops in the cells which form the eggs in the ovaries. This cancer normally afflicts teenagers and young women, and usually is found in only one ovary;
  • Stromal cell cancer, which is also rare and starts in the cells that hold the ovarian tissues together and create female hormones
  • Familial breast-ovarian cancer syndrome, which is a common inherited condition that causes 15-20% of all ovarian cancers. It is recommended that all women who have epithelial ovarian cancer are tested for this condition.

Uterine/Endometrial cancer: Uterine/Endometrial cancer is cancer that develops in the lining of the uterus (also called the endometrium). The most common symptom for this cancer is abnormal vaginal bleeding. Postmenopause, any abnormal vaginal bleeding or brown discharge may be a sign of uterine/endometrial cancer. However, younger women must be aware of these symptoms too.

Vaginal cancer: Vaginal cancer is cancer that develops in the vagina, which is the muscular tube that connects the uterus to the outer genitalia. Most vaginal cancers are in the lining (squamous epithelium) of the vagina.

There are four different types of vaginal cancer, their diagnoses depending on where the cancer began:

  • Vaginal squamous cell carcinoma is the most common type of vaginal cancer, and begins in the thin, flat cells that line the surface of the vagina;
  • Vaginal adenocarcinoma begins in the glandular cells on the surface of the vagina;
  • Vaginal melanoma begins in the pigment-producing cells in the vagina;
  • Vaginal sarcoma, which develops in the smooth muscle cells or the connective tissue cells of the vagina walls.

Vulvar cancer: Vulvar cancer is a rare cancer that develops on the inner or outer lips of the vagina, the clitoris, or the opening of the vagina and its glands. Vulvar cancer is highly curable if caught early, however, treatment can impact the appearance of the vulvar area, sexual function, and the function of the bladder and rectum.

Protection from Human Papillomavirus (HPV) infection reduces the risk of developing vulvar cancer. Both self-examinations of the vulvar area for abnormalities and annual pelvic examinations can result in the early detection of vulvar cancer.

Gestational Trophoblastic Disease (GTD): Gestational Trophoblastic Disease is a rare group of pregnancy-related interrelated tumours that lead to the abnormal development of the placenta. Over 80% of these cases are non-cancerous, however, I feel this disease is important to mention in this article.

There are three types of GTD:

  • Hydatidiform mole (also called “molar pregnancy”) occurs when the fertilization of an egg that lacks maternal genes causes an abnormal pregnancy. Common symptoms of a hydatidiform mole are feeling pregnant while experiencing vaginal bleeding, abdominal bloating, severe nausea and vomiting, fatigue and shortness of breath due to anemia from blood loss, signs of an overactive thyroid, and high blood pressure due to pre-eclampsia. 
  • Choriocarcinoma is a form of GTD that is even rarer than molar pregnancy and spreads rapidly throughout the body and requires intense treatment. It can sometimes begin as a molar pregnancy or as the tissue that remains in the uterus following a birth or miscarriage.
    • Choriocarcinoma can be symptom-free, but some symptoms may occur based on the organs that are involved. It can cause complications in the uterus resulting in vaginal bleeding and unusual discharge; complications in the lungs resulting in coughing up blood, shortness of breath or chest pain; complications in the liver resulting in abdominal pain; complications in the brain resulting in headaches, issues with vision, convulsions, and weakness or loss of function; complications in the kidneys causing blood in urine; and complications in the bowel causing blood in stool/poo.
  • Placental-site trophoblastic tumour is a very rare form of GTD that develops in the uterus at the spot where the placenta is attached. These tumours dig into the muscle layer of the uterus but don’t normally spread throughout the body. All types of GTD can be treated, and in the majority of cases, the treatment leads to a cure. Most women who have had a single case of GTD can then have normal future pregnancies.

Signs and symptoms of gynecological cancers

Gynecological Cancers; the “Silent Killers.” (Gynecological Cancers Awareness Month)

General gynecological cancer symptoms to look out for:

  • Unusual vaginal bleeding or discharge
  • Abdominal (stomach) pain
  • Pain or burning
  • Pain during sex
  • Itchy skin around the vagina
  • Lump/s in the vagina
  • Sores, growths, or ulcers in the genital area
  • Vaginal odor
  • Trouble passing urine or bowel movements

Ovarian cancers, while being the deadliest of the gynecological cancers, do not currently have any effective screening tests to detect it. There are, however, some specific symptoms women can look out for:

  • Bloating of the abdomen
  • Pain in the abdomen/ pelvic area
  • Having trouble eating or feeling full quickly.

Is gynecological cancer preventable?

There are some things you can do to help lessen your chances of developing gynecological cancers.

  1. Reduce your exposure to the HPV virus: Having safe sex with all sexual partners -by using condoms- will reduce the risk of becoming exposed to HPV. Certain types of HPV can cause gynecological cancer or precancerous lesions, which are growths that can develop into cancer. There is also an HPV vaccine that can be administered before girls become sexually active that can protect them from the HPV virus and can help prevent vulval, cervical, and vaginal cancers.
  2. Be smoke-free: Not only does quitting smoking improve your general health, it can also decrease your risk of developing cancer, especially cervical cancer.
  3. Living a healthy lifestyle: eating healthy and regularly exercising can help to prevent you from developing gynecological cancer.
  4. Regular cervical smear tests (Pap tests): Smear tests detect cell changes that may become cervical cancer if left untreated. According to the Cancer Society NZ, having a cervical smear test every three years, from the age of 20, will help prevent cervical cancer. However, the recommended ages for cervical smears and the duration between them can vary from country to country. 

Like most cancers, the risk of developing gynecological cancer increases with age.

Are smear tests accessible to all women, including disabled and chronically ill women?

Gynecological Cancers; the “Silent Killers.” (Gynecological Cancers Awareness Month)

You’d think a procedure that is so important to women’s health would be equally accessible to everyone, right? Unfortunately, this isn’t the case. There are many testimonials online of women who have had bad experiences trying to get a smear test due to being disabled or having chronic illnesses. Age can also be a limiting factor in this, depending on what country you live in. 

There are many reasons a woman with chronic illness may struggle to get a smear test. For example, symptoms of disabilities or chronic illnesses may cause difficulties during the procedure. One example is that a woman with Cerebral Palsy may not be able to hold her legs in the requested position. Another example is that a woman who experiences spasms in the lower half of her body may not be able to remain still for the procedure. 

It isn’t only symptoms that can make getting smears difficult, however. Smear tests can also be made inaccessible by the professionals conducting them or the equipment (or lack thereof) they have on hand. 

If you use a wheelchair, you may find it more difficult to have a smear test than those who don’t. Many women have reported that they have had difficulty getting a smear test because a hoist isn’t available at their clinic. There have even been reports of medical professionals claiming disabled women don’t need smear tests, on the assumption that due to their disabilities they must not be sexually active. This is an especially ridiculous misconception. 

It is important that all women are aware of gynecological cancers and their signs and symptoms. That is why Gynecological Cancer Awareness Month is so important. Every time another woman learns about these things, it is a potential life saved. Make sure all your female family members are aware of gynecological cancers and their signs and symptoms. If you or a loved one experiences any of these symptoms, consult your doctor immediately.

About The Author

Amy Clements is a 20-year-old who has lived with chronic pain, the result of Fibromyalgia, since childhood. In her teens she was diagnosed with Complex Regional Pain Syndrome in her wrist, which was the result of a netball injury. Amy lives in New Zealand and studies Business part-time at University. She enjoys reading novels and writing. She especially enjoys writing about her experience with chronic illness.