Gynaecological

Gynaecological cancer

The main function of the female reproductive system is to produce eggs to be fertilised and to provide a safe environment for a baby to develop. The female reproductive system is very complex and produces and controls its own hormones released both by the brain and by the ovaries. The combination of all these hormones gives women their reproductive cycle.

There are five different types of gynaecological cancers, with some of them having similarities in symptoms. It is important to know about the different types of gynaecological cancers, to spot the signs and identify suitable treatment options. You can learn more about this below.

Rutherford Treatment Options

Proton Beam Therapy Available
Radiotherapy Available
Chemotherapy Available
Immunotherapy Available

Vulval cancer

Vulval cancer affects the vulval area of the vagina, this includes the labia, urethra, birth canal, clitoris and lymph nodes in the groin. Cancer of the vulva is rare, with just over 1,300 women in the UK diagnosed with it each year. The most common area of the vulva where cancer develops is the labia, but it can occur in any part of the external female sex organs.

Common types of vulval cancer:

Squamous cell carcinoma – affects the outer skin layers of the vulva. It accounts for 90% of all vulval cancers
Melanoma – the second most common of vulval cancers, it develops from the pigment-producing cells that give your skin its colour
Rare types of vulval cancer:
Basal cell carcinoma – develops in the basal cells that are in the deepest skin layer of the vulva
Sarcoma – develops in the muscle tissue, blood or fat vessels
Adenocarcinoma - develops from cells in the glands of the vulval
Bartholin’s glands cancer – occurs in the glands at the opening of the vagina

Symptoms

Symptoms caused by vulval cancer can depend on where in the vulva it is situated and the rate at which it is growing. Some people may have symptoms, whereas others may not experience any.

Here are some common symptoms that may be experienced:

Persistent itching, burning or soreness of the vulva (including during urination)
A lump, swelling or wart-like growth
Raised, red, white or dark patches on the skin of the vulva
Bleeding, or a blood-stained vaginal discharge (not related to periods)
Tenderness or pain in the area of the vulva
A mole on the vulva that changes shape or colour
A lump in the groin

If you experience any of the above symptoms, please don’t hesitate to book an appointment with your GP.

Diagnosis

Your GP will discuss your symptoms and give you a thorough physical examination. Further tests to diagnose vulval cancer may include:

A biopsy – where a sample of cells will be taken
Blood tests
Colposcopy using a microscope to check for abnormal cells
CT or MRI scan
Cystoscopy to examine the bladder
Proctoscopy to examine the bladder
X-ray

Cervical cancer

The cervix sits at the bottom part of the womb (uterus) and joins up to the top of the vagina. Cancer that occurs in the cervix is called cervical cancer and it mainly affects women between the ages of 30 - 45 years.

Cervical cancer originates from abnormal cell changes within the cervix, sometimes this type of cancer can be caught early from cervical screening tests, women in the UK have these carried out annually from the age of 25. These tests are also referred to as smear tests. Any abnormal cells that are caught through screening can be treated before they develop into cancerous cells.

Types of cervical cancer

There are various types of cervical cancer, with some being more common than others. These include:

Squamous cell cancer – this type accounts for 70-80% of cervical cancer cases
Adenocarcinoma- cancer that starts in the gland cells that produce mucus and accounts for 20% of cervical cancer cases
Adenosquamous carcinoma – a very rare type of tumour that consists of both glandular and squamous cancer cells
Small cell – a very rare type of cervical cancer that occurs on 3% of cases
Sarcoma –a very rare type that develops in the muscle tissue, blood or fat vessels

Symptoms

Abnormal cells that are not yet cancerous, may not cause any symptoms. However, if these abnormal cells continue to develop into cervical cancer, common symptoms may include:

Bleeding from the vagina between periods, after sex, or after the menopause
Bleeding in between periods or heavier periods than usual

If you experience any of the above symptoms between cervical screening appointments, please don’t hesitate to book an appointment with GP.

Diagnosis

Your GP will discuss your symptoms and give you a thorough physical examination. Further tests to diagnose cervical cancer may include:

An internal examination
Blood tests
Colposcopy: a cervix examination where a sample of cells may be taken
Cone biopsy: a procedure where a cone shape of tissue is taken from the womb
CT, pelvis, MRI, and PET-CT scans

Vaginal cancer

Vaginal cancer is very rare, with fewer than 300 women diagnosed in the UK each year. When referring to vaginal cancer, it concerns areas of the opening of the vagina, up to where the cervix starts.

There are different types of vaginal cancer, but the most common are:

Squamous cell carcinoma – the most common of vaginal cancers, it occurs in the squamous cells in the lining of the vagina

Rare types of vaginal cancer:

Adenocarcinoma - develops from cells in the glands of the vagina
Small cell carcinoma –very rare
Sarcoma – develops in the muscle tissue, blood or fat vessels
Melanoma – develops from the pigment-producing (only 3% of vaginal cancers are melanomas)
Lymphoma –lymphoma cells that can spread to the vagina via the bloodstream
Clear cell cancers

Symptoms

Bleeding after the menopause (most common symptom)
Bleeding after the menopause, between periods or after sex
Bleeding in between periods or heavier periods than usual
Feeling the need to empty the bowel, even after emptying it
Blood-stained vaginal discharge
Bloody or pink and watery vaginal discharge
Constipation
Pain when urinating, needing to pee often, or blood in your pee
Swollen legs
Pain in the pelvic area

If you experience any of the above symptoms, please don’t hesitate to book an appointment with your GP.

Diagnosis

Your GP will discuss your symptoms and give you a thorough physical examination. Further tests to diagnose vaginal cancer may include:

A biopsy – where a small sample of cells will be taken
Blood tests
Colposcopy- to examine the vagina
Scans including CT, MRI, PET-CT and ultrasound,
Chest X-ray (to check if the cancer has spread)

Uterine (womb) cancer

Uterine cancer also referred to as sometimes womb or endometrial cancer. In the UK, uterine cancer is the 4th most common cancers of all women’s cancers. It mostly occurs in women over 40 years of age. Around 95% of womb cancers affect the endometrial lining or the glandular cells of the womb.

Types of uterine cancer:

Uterine cancers mainly develop from cells in the lining of the womb, these are known as endometrial cancer. These are different types of endometrial cancer:

Endometrioid cancer - Approximately 75% of uterine cancer are endometrioid cancers
Serous endometrial carcinoma (also referred to as uterine serous carcinoma)
Carcinosarcoma
Mucinous carcinoma
Mixed cell endometrial cancer
Clear cell carcinoma

Symptoms

Symptoms caused by uterine cancer can depend on where in the womb it is situated and the rate at which it is growing. Some people may have symptoms, whereas others may not experience any.

Here are some common symptoms that may be experienced:

Bleeding after the menopause (most common symptom)
Bleeding in between periods or heavier periods than usual
Bloody or pink and watery vaginal discharge

If you experience any of the above symptoms, please don’t hesitate to book an appointment with your GP.

Diagnosis

Your GP will discuss your symptoms and give you a thorough physical examination. Further tests to diagnose uterine cancer may include:

Physical examination (including internal)
Blood tests
Ultrasound scan
A biopsy – where a sample of cells will be taken (there are various ways to carry this out)

Treating gynaecological cancer with proton beam therapy

Treatment for gynaecological cancer will often involve different treatment options, such as surgery, chemotherapy, immunotherapy, or radiotherapy. The earlier it is diagnosed, then surgery or a combination of radiotherapy and chemotherapy are viable options. If the cancer has advanced and spread to other parts of the body (such as the lungs), immunotherapy (targeted therapy) may also be used.

Proton beam therapy treatment for gynaecological cancer can be used before or after surgery, or following chemotherapy, depending on the specific case. The use of proton beam therapy will aim to shrink a tumour before removal, or after surgery, to kill any remaining local cancer cells that may have been left behind. A consultant oncologist at the Rutherford will be able to discuss with you if your case of gynaecological cancer will benefit from proton beam therapy.

DOWNLOAD GENERAL INFO - PROTON THERAPY (PDF)

The benefits of using proton beam therapy treatment for gynaecological cancer

As gynaecological cancer can be situated near other sensitive areas of the body and vital organs, proton beam therapy can be an effective treatment choice, as it aims to deliver minimal radiation dose to healthy tissues surrounding the tumour, while precisely targeting the cancer. Sensitive areas near the female reproductive system may include bladder, bowel, kidneys, rectum and other parts of the female reproductive system, such as ovaries, cervix, uterus, vagina and vulva.

If proton beam therapy is recommended for your type of gynaecological cancer, you may experience fewer side effects to your urinary and bowel functions, as healthy tissue exposed to radiation is lower than if you were treated with conventional radiotherapy. Fertility of often a concern for younger women diagnosed with gynaecological cancer but proton beam therapy may help to maintain the function of your hormones, your consultant will be able to advise you if this is possible. Proton beam therapy is also particularly useful for younger women who have previously received conventional radiotherapy around the abdomen or pelvis, or if a tumour has come back (reoccurring cancer). Conventional radiotherapy wouldn’t generally be offered as a repeat treatment for the same area of the body, as it has already been exposed to radiation, in these cases proton beam therapy may be a viable option.

Watch Video

An overview of how proton beam therapy works

Proton beam therapy is highly accurate in targeting a treatment area. It can be used to treat hard-to-reach tumours in the female reproductive system, while lowering radiation exposure to surrounding healthy tissue and vital organs.

Watch the video

Further information & support

Being diagnosed with gynaecological cancer and deciding on the best treatment can be daunting, for full details on gynaecological treatment options or to discuss a diagnosis, please contact our enquiries team. Our enquiries team will endeavour to help you assess your treatment options and advise which consultants could be best placed to plan your treatment pathway.

Macmillan Cancer Support offers a wide range of information and support, as well as help with your practical, emotional, and financial needs. All telephone helplines are free and confidential, and interpreting services are also available.

Freephone: 0808 808 0000

(Monday to Friday, 9.00am – 8.00pm)

Website: www.macmillan.org.uk

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Treating gynaecological cancer with proton beam therapy

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