Gynaecological Cancer

Symptoms of gynaecological cancer vary, depending on the type and stage of the cancer. Some common symptoms may include abnormal or persistent vaginal bleeding or discharge, pelvic pain or pressure, bloating or swelling in the abdomen, changes in bowel or bladder habits, pain during sex, itching, burning, or soreness in the genital area, or lumps, sores or warts. These symptoms may be caused by other conditions, so it is always important to consult your doctor. 

Symptoms can often be vague and non-specific. Patients know themselves better than anyone else – if they are experiencing persistent symptoms, they should see their GP. Writing symptoms in a diary and bringing it to an appointment can be helpful for both the patient and health care professionals. 

Risk factors vary with specific types of gynaecological cancer, but generally include:

• getting older 

• a family history 
• a genetic mutation relating to certain cancers 
• having had cancer previously 
• certain benign conditions 
• early or late menopause 
• exposure to hormones or certain chemicals 
• viral infection such as human papillomavirus (HPV) 
• lifestyle factors such as smoking, obesity or poor diet.

Depending on your personal and family history, you may need to have some screening tests or genetic tests to check your risk of developing gynaecological cancer. Screening tests can help detect cancer early when it is easier to treat. Genetic tests can help identify inherited mutations that increase the risk of certain cancers. 

Some of the tests that may be recommended for you are:

• Cervical Screening Test (CST) 
  This test checks for the presence of HPV, a virus that can cause cervical, vaginal and vulvar cancers. CST testing is recommended for all people with a cervix aged 25-75 every five years. CSTs can be performed by a health professional or by the patient themselves using a self-collect swab.  

• Pelvic exam 
  This external and internal exam involves the doctor feeling the uterus, ovaries and other pelvic organs for any abnormalities. It can help detect ovarian, uterine, vaginal and vulvar cancers.  

• Transvaginal ultrasound 
  This test uses sound waves to create images of the pelvic organs. It can help detect ovarian, uterine or fallopian tube cancers. It may be done if you have certain symptoms, abnormal pelvic exam results or a family history of ovarian cancer. 

• Endometrial biopsy 
  This test involves taking a small sample of tissue from the lining of the uterus (endometrium) and examining it under a microscope. It can help diagnose endometrial cancer or precancerous changes. It may be done if you have abnormal vaginal bleeding, especially after menopause. 

• CA-125 blood test 
  This test measures the level of a protein called CA-125 in the blood. CA-125 is often elevated in women with ovarian cancer but can also be affected by other conditions. The test may be done to monitor ovarian cancer treatment, check for recurrence or screen high-risk women. 

• BRCA1 and BRCA2 gene tests 
  These tests look for mutations in the BRCA1 and BRCA2 genes, which produce proteins that help repair damaged DNA and prevent tumour growth. Women who inherit these mutations have a higher risk of developing breast, ovarian and fallopian tube cancers. These tests may be done if you have a strong family history of these cancers or if you belong to certain ethnic groups, such as Ashkenazi Jews. 

• Lynch syndrome gene tests 
  These tests look for mutations in genes involved in DNA mismatch repair. People who inherit these mutations have a higher risk of developing colorectal, endometrial, ovarian and other cancers. These tests may be done if you have a family history of these cancers, or if you have endometrial cancer at a young age.