As this Women’s Health Week, we’re taking a look at gynaecological cancers and the novel research into ovarian and endometrial cancer being doing by one amazing female researcher.
In the same way that some cancers only affect men, the cohort of cancers known broadly as ‘gynaecological cancers’ only affect women. These cancers affect the female reproductive system and genitals and encompass:
- cervical cancer
- uterine cancer
- ovarian cancer
As well as the rarer forms of cancer, such as:
- fallopian tube
- cancer vulva and
- vaginal cancers.
As with any cancers, gynaecological cancers occur when cells ‘mutate’ and grow in an uncontrolled way. Gynaecological cancers are estimated to be diagnosed in 6,652 women and account for 9.4% of female cancer deaths in Australia this year alone.
Cervical cancer
The cervix is a cylindrical tube of tissue which connects the vagina and the uterus. Almost all cervical cancers are caused by the common, sexually transmitted human papillomavirus, or HPV.
Symptoms of cervical cancer can include:
- Bleeding between periods or during intercourse
- Pain during sex
- Longer/heavier periods than usual
- Unusual discharge from the vagina
- Vaginal bleeding after menopause
- Extreme tiredness/Fatigue
- Pain/swelling of the legs
- Lower back pain
Because almost all cervical cancers are caused by HPV infection, preventing HPV can also prevent cervical cancer. You can get vaccinated against HPV, reducing your risk of both infection and cancer. The HPV vaccine is most effective when given around the age of 11 or 12 to both boys and girls.
Cervical cancer can also be prevented by getting regular Cervical Screening Tests (sometimes called a smear test) recommended every five years unless advised otherwise by your GP.
If you’re experiencing symptoms, it’s important you talk to your doctor. In 2020, it is estimated that 933 females will be diagnosed with cervical cancer, and 238 females will die from cervical cancer.
Uterine cancer
The uterus (also called the womb) is a hollow muscular organ located in the pelvis. It is main purpose is to nurture a pregnancy until a baby is ready to enter into the world. Uterine cancer is a type of cancer which affects the uterus. There are two main types of uterine cancer:
- endometrial cancer (occurs in the lining of the uterus)
- uterine sarcomas (occurs in muscles of the uterus or other tissues that support the uterus)
Symptoms of uterine cance r can include:
- Bloody/watery discharge or discharge with an unpleasant smell
- Bleeding between periods or after menopause
- Abdominal pain
- Pain/difficulty when urinating
- Pain during sex
There is no screening test for uterine cancer, so if you have concerns, make an appointment with your GP.
In 2020, it is estimated that 3115 females will be diagnosed with cervical cancer, and 562 females will die from uterine cancer.
Ovarian cancer
The ovaries are two small female glands which sit either side of the uterus. The female hormones oestrogen and progesterone (involved in the menstrual cycle, fertility, and pregnancy) are made in the ovaries. Eggs also form and are released from the ovaries. Ovarian cancer is cancer that occurs in one or both ovaries.
Ovarian cancer can be symptomless, although symptoms can include:
- Bloating
- Abdominal/pelvic pain
- Decreased appetite
- Feeling full quickly after eating
- Indigestion
- Changes in bowel or urinary habits
- Unexplained weight loss or gain
- Tiredness
There is no screening test for ovarian cancer so any concerning symptoms should be discussed with your doctor.
Having a family history of ovarian cancer, breast cancer or colon cancer , or a mutation in the BRCA1 or BRCA2 genes increases your risk of developing ovarian cancer. Smoking and obesity are also both linked to a higher risk of developing ovarian cancer, as are untreated sexually transmitted infections such as chlamydia.
Interestingly, having children, using the oral contraceptive pill and having tubal litigation (tubes tied) have been found to reduce the risk of ovarian cancer.
In 2020, it is estimated that 1,532 females will be diagnosed with cervical cancer, and 1,068 females will die from ovarian cancer.
Research into Ovarian and Endometrial Cancers
Ovarian and endometrial cancer respectively represent the most lethal and common gynaecological cancers in Australia. Cure Cancer Researcher of the Year 2020, Dr Tracy O’Mara is focusing her current research on combining genetic data from both diseases to identify changes in genetic sequences that predispose women to them. Her preliminary analyses have found several genetic markers that appear important for both diseases. She now leads the Endometrial Cancer Association Consortium, which holds data and genetic samples from more than 12,000 endometrial cancer patients from seven countries including Australia, United Kingdom and the USA.
Tracy, who is based at QIMR Berghofer Medical Research Institute in QLD recently led the largest genetic study of endometrial cancer, identifying 16 genetic markers which predispose women to the disease. She has a keen interest in cross-cancer studies, particularly in relation to the identification of genes that could be targeted using existing drugs.
‘Finding genes that impact a woman’s risk of ovarian and endometrial cancer risk could provide new opportunities for drug therapies for these cancers. In the last several decades only two drugs have been approved for endometrial cancer treatment and while there are more treatment options available for ovarian cancer, patient prognosis is still very poor.’
‘The vast majority of drugs fail during development so the use of genetic-based targets should increase the likelihood of success.’
‘Next steps will be to identify the ovarian-endometrial cancer risk genes that produce molecules that can be chemically targeted and to prioritise compounds for experimental testing through collaboration with our industry partners.’ ‘The work will provide the foundation for us to discover genes that reduce cancer risk and provide potential targets for drug repurposing, using medications currently in use to treat other diseases,’ explains Tracy. Tracy was recently awarded an NHMRC Project Grant (2019-2020) to continue to develop her ovarian and endometrial cancer cross-cancer research. Tracy’s 2-year grant (2018-2019) was co-funded 50% by our principal supporter The Can Too Foundation and Cancer Australia.
Rare Gynaecological Cancers
Fallopian tube cancer
The fallopian tubes are two slender tubes (one on either side of the uterus) that connect the ovaries to the uterus and transport the egg from the ovary to the uterus each month. Fallopian tube cancer occurs in one or both of the fallopian tubes.
Often, fallopian tube cancer won’t cause any symptoms . However, symptoms, can include:
- Lump or swelling in the abdomen
- Abdominal/pelvic pain
- Pressure-like sensation on the bowel or bladder
- Feeling unable to empty bowel/bladder completely
- Abnormal vaginal bleeding/discharge, particularly bleeding after menopause
Untreated sexually transmitted infections or inflammation of the fallopian tubes is associated with a higher risk of fallopian tube cancer. There is no screening test for fallopian tube cancer so if you have any concerns or symptoms, the best thing you can do is schedule an appointment to see your GP.
Cancer of the fallopian tube is rare and accounts for less than half of one percent of all cancers in Australian women.
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Vulvar cancer
The vulva refers the outer part of the female genitals and includes the opening of the vagina, the labia majora, the labia minora, the pubic mound, the perineum and the clitoris. Vulvar cancer is cancer that occurs on these genitals and is more common in women who have gone through menopause , although it can affect women at any age.
Symptoms of vulvar cancer can include:
- Itching, burning or pain at a point in the vulva
- A lump, sore, swelling or wart-like growth
- Thickened or raised patches of skin on the vulva
- A mole that changes colour or shape
- A lesion or sore on the vulva that releases blood, pus or discharge
- Hard/swollen lymph nodes in the groin
Vaginal cancer
The vagina is the internal passage that starts at the opening in your vulva and runs through to your cervix. Vaginal cancer is cancer that forms in the tissue of the vagina. It is one of the rarest forms of gynaecological cancer and tends to mostly affect older women, but it can affect women of any age.
Vaginal cancer is rare and often doesn’t cause any symptoms , however, symptoms can include:
- Blood stained vaginal discharge
- Bleeding after sex
- Pelvic pain
- Lump in the vagina
- Difficulty or changes to urination
- Rectal pain
If you have any concerns about cancer, display any worrying symptoms or have a family history of gynaecological cancers, the best thing to do is schedule an appointment with your GP for testing or referral to a specialist. The fastest and easiest way to search for and book healthcare appointments is to do it online through MyHealth1st.
Resources:
https://www.canceraustralia.gov.au
https://www.aihw.gov.au