The cervix is the lowest part of the uterus or womb; it connects the uterus to the vagina. The Pap test can detect early or precancerous changes to the cells of the cervix and with appropriate treatment, cervical cancer can be prevented. Cervical screening programs are operated provincially and screening is recommended every one to two years, depending on the province. The most common cause of cervical cancer is the human papillomavirus (HPV), which is passed from person to person during sexual intercourse. The HPV vaccine is now available to help protect against the majority of these types of viruses. Cervical cancer is most common in developing countries. Due to the introduction of Pap test, the number of women with cervical cancer in Canada has decreased by 50% and the number of women who have died of the disease has gone down by 60% since 1977.
The fallopian tubes connect the ovaries to the uterus (womb). A woman’s eggs (ova) travel from the ovaries, through the fallopian tubes to the uterus. Primary cancer of the fallopian tubes is the rarest of all gynecologic cancers. While the disease is most common among women in their early 60s, it can be diagnosed into a woman’s early 80s. This disease can be difficult to diagnose and surgery is typically used to confirm fallopian tube cancer. The most common symptoms of fallopian tube cancer include vaginal bleeding, vaginal discharge and/or pelvic pain.
Gestational Trophoblastic Disease (GTD) is a group of diseases that begin when abnormal placental cells grow in the uterus after conception. GTD can develop from a normal or abnormal pregnancy but is usually the result of an abnormal joining of the sperm and egg. Symptoms can include unusual vaginal bleeding during pregnancy, anemia, unusual abdominal swelling and severe vomiting. Ultrasound is used in the diagnosis of GTD and other tests may follow. Treatment can include chemotherapy and surgery.
A rare disease, primary peritoneal cancer is cancer of the peritoneum, the membrane that lines the inside of the abdominal cavity and the surface of all organs in the abdomen. It is closely related to epithelial ovarian cancer, the most common type of malignancy affecting the ovaries. It is possible to have primary peritoneal cancer even if the ovaries have been removed. Because of the vague nature of its symptoms, this disease is often detected in the late stages when it is difficult to achieve a cure. Ovarian and peritoneal cancers behave and are treated similarly – usually with surgery and chemotherapy. Risk factors include aging and a family history of breast, ovarian and primary peritoneal cancers. The cause of primary peritoneal cancer is unknown; symptoms are vague and similar to those of ovarian cancer: abdominal bloating, loss of appetite, indigestion, unexplained weight gain, changes in bowel or bladder habits, nausea and vomiting.
Cancer of the uterus or womb begins in the cells lining the uterus called the endometrium. Uterine cancer (or endometrial carcinoma) is most common in postmenopausal women although it can occur in younger women. Several factors are believed to increase risk for uterine cancer including a family history of the disease, taking estrogen replacement therapy alone after menopause, obesity, beginning menstruation at a young age, reaching menopause later than usual, and never having given birth. There is no effective screening test at this time. Fortunately, many uterine cancers are caught early because they cause bleeding, which is highly abnormal in postmenopausal women. Other symptoms include abnormal bleeding between periods, heavier/longer lasting menstruation, blood in the stool or urine, abnormal vaginal discharge, and pelvic or back pain.
Cancer of the vagina or birth canal is a rare disease representing about 2% of all gynecologic cancers. It typically affects women over 65 but some of the more rare forms can be found in women under 20. Most vaginal cancers begin in the lining (epithelium) of the vagina and are called vaginal squamous cell carcinomas. There are other even more rare types of vaginal cancers including adenocarcinomas, which arise from the glandular tissues; malignant melanomas, which often affect the lower or outer parts of the vagina; sarcomas, which develop deep in the vaginal wall; and others such as lymphoma, which can spread to the vagina. Risk factors include increasing age, certain high risk strains of human papillomavirus, having a diagnosis of cervical cancer, being of a young age at first intercourse and having a large number of sexual partners over a lifetime.
Vulvar cancer is the abnormal growth of malignant cells in the vulva, the female external genetalia/reproductive system. A relatively rare disease, vulvar cancer represents about 4% of all gynecologic cancers. Diagnosed and treated early, this cancer is highly curable. Most women diagnosed with vulvar cancer are over the age of 50 while half are over 70. The most common symptom is vulvar itching; there can also be pain, bleeding, vaginal discharge and/or pain during urination. Risk factors include being older, and having a history of infection with certain human papillomaviruses (HPV), multiple sexual partners or sexual transmitted diseases, cervical cancer, immunodeficiency, chronic vaginal and vulvar irritation and smoking.
Contact the Canadian Cancer Society’s Cancer Information Service toll free at 1-888-939-3333 or email info@cis.cancer.ca
Canadian Cancer Society
Womens Health Matters
Society of Gynecologic Oncologists of Canada
Oncolink – Gynecologic Cancers
Women’s Cancer Network / Gynecologic Cancer Foundation