Frequently asked questions about the gynae cancer

Cervical cancer

What are the symptoms of cervical cancer?

Foul smelling persistent vaginal discharge, any abnormal bleeding like-postcoital bleeding/ intermenstrual bleeding or post menopausal bleeding are the most common symptoms of cervical cancer.

What are the causes of cancer cervix ?

HPV ( Human Papilloma virus) infection is responsible for 80-90 % of the cervical cancer cases worldwide.

Who are prone to get cervical cancer?

Patients with multiple sexual partners, patients with early age at first coitus, early child birth, husband with multiple sexual partners, patients with sexually transmitted disease are more prone to get infection with HPV virus and later cervical cancer.

Can cervical cancer be prevented?

Yes it can be prevented by regular screening of married women and by vaccinating  girls before starting sexual activity.

How screening is helpful in prevention of cervical cancer?

Cervical cancer has a long natural history. Firstly, precancer changes occur in cervix which later develop into cervical cancer.

Screening can detect the precancer stage of cervical cancer and with the different modes of treatment it can be cured in precancer stage, so we can stop the progression of precancer into the cancer

What are the different methods of screening of cervical cancer?

PAPS smear, LBC, ( both are cytology tests where superficial scrapings of cervix are taken and sent for testing)

HPV DNA testing ( it detects presence of HPV infection) VIA, VILI and colposcopy which detect abnormal changes in cervix and help in biopsy site identification.

Do genetics play a role in cervical cancer ?

No genetics does not play any role in this cancer.

What are the treatment modalities of cervical cancer?

Surgery (Radical hysterectomy with B/l pelvic lymphadenectomy) is the treatment of choice for early stage of cancer cervix.

In advanced stage, radiotherapy along with chemotherapy is given.

What are the chances of recurrence?

If treated in early stage recurrence is rare but in advanced stage recurrence risk is high.

Endometrial Cancer

What are the symptoms of endometrial cancer?

Abnormal vaginal bleeding like heavy menstrual bleeding or postmenopausal bleeding are the most common early symptoms.

Which females are at risk for endometrial cancer?

Patients who are obese, hypertensive or diabetic.

Patients with history of Polycystic ovaries, postmenopausal patients on long term estrogen therapy, patients of carcinoma breast on hormonal therapy are at risk of endometrial cancer.Patients with family history of ovarian/ breast/ enometrium or colon cancer.

Do genetics play a role in endometrial cancer?

Yes 5-10% of cases of carcinoma endometrium are familial, they have some genetic mutations which are predisposing factor for endometrial, colon,ovarian and breast cancer.

Does HRT increases the risk of endometrial cancer?

Yes, unopposed estrogen therapy without progesterone therapy can increase the risk of endometrial cancer.

What are the ways for prevention or early detection of endometrial cancer?

Do not neglect the abnormal vaginal bleeding in perimenopausal age group,

Do not start any blind hormone therapy without D&C and biopsy report in case of abnormal bleeding in this age group.

Annual ultrasonography after age of 40 years in patients with family history of endometrial, colon, and breast or ovarian cancer.

What is the treatment of endometrial cancer?

Surgery is the treatment of choice in early stage endometrial cancer. Post operative management like observation/adjuvant radiotherapy and /or chemotherapy is decided according to the final histopathology report.

In advansed stage, only chemotherapy may be given.

Is follow-up needed after completion of the treatment?

Yes, every cancer needs followup because there is always chance of recurrence even after completion of the treatment. Regular follow up helps in detecting recurrence early.

So all patient needs regular checkups once in every three months for 2 years, once in every 6 months after 2 years till 5 years and then annually for life long.

Ovarian cancer

What are the symptoms of carcinoma ovary?

In early stages there are usually no symptoms or very vague complaints like abdominal fullness, heaviness, bloating after eating food or loss of appetite. In late stages, there may be abdominal distension or urinary complaints or altered bowel habits. Sometimes ovarian tumor is an accidental finding on ultrasound.

Which females are at risk of ovarian cancer?

Females with family history of ovarian and breast cancer are at risk of having some genetic mutations responsible for these cancer.

Females with early menarche, late menopause, unmarried women, women with no child, late childbirth with multiple treatment of infertility with ovulation induction drugs are at risk.

How can we reduce the risk of ovarian cancer?

Use of oral contraceptives for 5 years reduces the risk of ovarian cancer by 50%, pregnancy, childbirth also reduces the risk of ovarian cancer.

Do genetics play a role in ovarian cancer?

Females with family history of ovarian and breast cancer are at risk of having some genetic mutations BRCA1 and BRCA2 which are responsible for these cancer.

How to detect ovarian cancer in early stage?

As symptoms are vague and usually diagnosed in advanced stage, regular screening with annual ultrasound abdomen after age of 40 in general population and 10 years before the age of the patient in family in cases of family history of breast or ovary cancer or patient who is BRCA gene mutation positive, helps in early detection of ovarian cancer. There is no single specific test to screen ovarian cancer.

Is there any relation between cancer breast and cancer ovary?

Some patients who have BRCA mutation, are at risk of both cancers ovary and breast.

What is the treatment of cancer ovary?

Treatment of cancer ovary involves combination of surgery and chemotherapy. Depending on stage of disease, their sequence is decided. In early stage, surgery is done, which may be followed by chemotherapy. In advansed stage , both the methods are used, depending on general condition of patient to tolerate the treatment.

Can young girl be affected by ovarian cancer?

Yes, ovarian cancer can occur in young girl, most common ovarian cancer in this age group is germ cell tumor of ovary.