Gynecologic or female reproductive system cancers include cancers of the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. Surgery, radiation therapy, chemotherapy, and combination therapy are the standard treatment options available for most gynecologic cancers. Hormone therapy may be used for hormone-dependent tumors. In advanced cases where a cure is not possible, the main aim of treatment is to limit further growth of the cancer and offer relief from pain and other distressing symptoms. This is known as palliative therapy.
Cancers of any part of the female reproductive system are known as gynecologic cancers. These include cancers of the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva. Early diagnosis is the key to successful treatment in all types of cancer. Routine screening has helped greatly in this regard.
Ovarian cancer is often detected late because of the absence of symptoms in the early stages. Symptoms that are present are often nonspecific in nature. Also, there are no reliable early screening methods for detection of ovarian cancer and Pap tests can only detect ovarian cancer that has metastasized to the vagina or cervix.
Menopause marks the cessation of a woman’s reproductive ability. It is characterized by the discontiuation of ovulation and monthly periods and usually arises in the 50s although some women may enter menopause earlier or later in life. If menopause sets in earlier than the age of 40 years then it is referred to as premature menopause or early menopause. This is also known as premature ovarian failure because the ovaries do not produce sufficient estrogen and ovulation does not occur regularly if at all. In the true sense of the word, premature menopause would mean a complete cessation of ovulation and menstruation for the rest of a woman’s life. With premature ovarian failure, there may be the occasional period sometimes even after years and some woman may even fall pregnant. Nevertheless the terms ‘premature menopause’ and ‘premature ovarian failure’ are used interchangeably.
Cancer of the vagina is a rare type of cancer which is more likely to develop in older women. Cancers that originate in the vagina are primary vaginal cancers, while those that spread to the vagina after originating at other locations are known as secondary vaginal cancers. Certain risk factors may be linked to the development of primary vaginal cancers, such as age, certain infections and exposure to the drug diethylstilbestrol (DES) in fetal life. It is also possible for vaginal cancer to develop in a woman who has had a hysterectomy operation.
Menstrual bleeding is the only regular vaginal bleed that occurs in girls and women after menarche. The menstrual cycle starts with menstruation (vaginal bleeding) which usually lasts between 3 to 7 days and the entire cycle runs for approximately 28 days on average. Bleeding at any other time should be considered as abnormal. If it occurs as a once-off episode between periods or even in menopause without any other signs and symptoms, it may not be a cause for concern. Sometimes the abnormality may be associated with the menstrual bleed which can be heavier or longer than norma. However, when persistent then it should be investigated as it could be associated with serious disease which could even be life-threatening.
Cancer developing in the cervix, the narrow lower portion of the uterus that leads into the vagina, is known as cervical cancer. It is a very common type of cancer of the reproductive system in women, especially in the developing countries, although its incidence in the USA has decreased significantly in recent years. It can be detected in the very early or precancerous stage by routine Pap smear, when treatment can successfully cure the disease.
Most cervical cancers are caused by the human papilloma virus (HPV), which is transmitted by sexual intercourse. Vaccines are available which can prevent infection with some strains of HPV responsible for cervical cancer. Practicing safe sex by using condoms can reduce the chance of HPV infection and other sexually transmitted diseases.
Cancer of the uterus is one of the most common cancers of the female reproductive system, especially in postmenopausal women. The female hormone estrogen seems to play a significant role in development of uterine or endometrial cancer. The most common presenting symptom is abnormal vaginal bleeding. Postmenopausal bleeding is a particularly ominous sign. Almost all cancers of the uterus start in the endometrium, the inner lining of the uterus, hence uterine cancer and endometrial cancer are almost synonymous. Cancer starting in the supporting connective tissue (stroma) and muscle cells of the uterus, known as uterine sarcoma, is less common. Cancer of the cervix is very different from endometrial carcinoma.
Ovarian cancer, or cancer that develops in the ovaries, can occur at any age but it is predominantly a disease of postmenopausal women. Although rare, more women die from ovarian cancer than they do from uterine and cervical cancer put together. This is mainly due to the fact that there are few discernible symptoms in the early stages (when the disease may still be curable) and those that do occur, such as abdominal pain, discomfort, or bloating, are mistakenly thought to be due to gastrointestinal problems and treated as such. A combination of surgery and chemotherapy is the treatment of choice for ovarian cancer.
Bacterial vaginosis is a common vaginal infection which arises with overgrowth of bacteria in the vagina. It is not like with other vaginal infections where pathogenic microorganisms infiltrate the vagina and injure the tissue. Instead bacterial vaginosis arises when the various types of naturally-occurring bacteria (vaginal flora) multiply excessively. There are several species of bacteria in the vagina. These bacteria are usually harmless and necessary because it prevents other dangerous bacteria and yeasts from infecting the vagina. However the population of these bacteria need to be carefully controlled or it can pose a problem to the vagina.
Trichomoniasis is a protozoal sexually transmitted infection that can affect both men and women. It usually does not cause significant symptoms and resolves spontaneously in men. In women, however, it persists and can affect the unborn child. Trichomoniasis increases the susceptibility of a person to contract viral infections like HIV. However, with proper preventative measures, the risk of contracting trichomoniasis as with most other sexually transmitted infections is greatly reduced. Asymptomatic partners should also be treated as the person may be a carrier and can infect or re-infect others.
