Obstetrics and Gynecology Specialist Op.Dr.Esra Demir Yüzer gave important information about the subject. While cancer remains the second leading cause of death in the world, gynecological cancers are increasing. It is recommended to consult an obstetrician and obstetrician once a year and have a test done in order to be protected from gynecological cancers, which consist of cancers of the cervix, uterus, ovaries, vagina, vulva and tubes. There is no common cause in gynecological cancers. It is stated that risk factors vary according to cancer types.
Cervical cancer: Smoking, sexually transmitted diseases, especially human papilloma virus infection (HPV), sexual intercourse at an early age, polygamous women with husbands, and low socio-economic status are considered risk factors.
Uterine cancer: Obesity, diabetes history, late menopause age, infertility, use of estrogen alone without progesterone increases the risk.
Ovarian cancer: No obvious cause has been identified. However, it is thought that environmental and genetic factors such as age, familial factors, diet containing high animal fat, powder use are effective in ovarian cancer. For example, while a woman's lifetime risk of developing ovarian cancer is 1.4 percent, it rises to 5 percent for women with a first-degree relative with ovarian cancer and up to 7 percent for women with two first-degree relatives.
What are the symptoms?
Symptoms of gynecological cancers differ according to the involved organ. The symptom of cervical cancer is vaginal bleeding in the form of spotting after sexual intercourse, an increase in the amount or duration of menstruation, and brown vaginal discharge. In advanced stages, low back and groin pain, difficulty in urination or leg edema may be seen. Uterine cancer is an early symptomatic cancer, it presents with abnormal bleeding before or during menopause. Unfortunately, ovarian cancer presents late and its findings are not specific. Abdominal swelling, pain, indigestion, increase in abdominal circumference, abnormal vaginal bleeding are the most common symptoms. Because of its late finding, 70 percent of ovarian cancer cases are diagnosed at stages 3 and 4. The most common findings of vulvar cancer are chronic itching, palpable mass in the vulva, pain, bleeding and ulcers.
Gynecological cancers can lead to death!
The mortality rates of gynecological cancers in general vary depending on the stage of the disease, histological type and degree, the general age of the patient and the surgery performed. It is emphasized that the cancer with the worst life expectancy is ovarian cancer due to its late finding. The average life expectancy after diagnosis is 35 percent. Uterine cancer, on the other hand, has a better life expectancy than ovarian cancer, since it gives symptoms earlier. The survival rates for all stages are as follows: Stage I 75 percent, stage II 60 percent, stage 30 percent, and stage 4 10 percent. The average life expectancy in cervical cancer, whose early diagnosis is increased by Pap smear method, is around 80 percent. Stage I is 90 percent, stage 2 is 65 percent, and stage 4 is 15 percent.
Methods used in diagnosis
Thanks to the methods developed for the early diagnosis of gynecological cancers, the success rate of treatment is increasing. Among the gynecological cancers, cervical cancer is considered as the type of cancer with the highest increase in early diagnosis in recent years. In this cancer, cellular changes that have the potential to become cancerous in the future are recognized at an early stage with the screening method, which is called Pap smear test, which is performed by cytological examination of cells shed from the cervix. With the destruction of these lesions, a significant decrease in the mortality rate in cervical cancer was detected. So much so that a single negative Pap smear test reduces the risk of cervical cancer by 45 percent. Nine negative Pap smear tests for life reduce this risk by 99 percent. The Pap smear test, which is the most effective screening method for cervical cancer, is recommended once a year to every sexually active woman over the age of 18.
Treatment in gynecological cancers
Success in the treatment of gynecological cancers differs according to the stages of the disease. It is noted that the effective treatment is usually surgery. Surgery is performed in all stages of ovarian cancer. Generally, these cases present in the advanced stage because they present in the late period. Complete surgical staging should be performed on patients and tumor mass should be minimized. Surgical staging means not only removing the uterus and ovaries, but also investigating the extent of the cancer in the entire abdomen and cleaning the areas determined to have spread. Thus, the patient will get the maximum benefit from the chemotherapy he will receive in the future. Usually, after the first post-chemotherapy of ovarian cancer, an operation called “second-look surgery” is performed. As a result of this surgery, chemotherapy is given again if necessary. While surgery is performed in the early stages of cervical cancer, radiation therapy is the main treatment option in advanced stages. In uterine cancer, surgery is the first treatment option. Afterwards, radiotherapy and, if necessary, chemotherapy can be applied. In cases with gynecological cancer, treatment and follow-up should be multidisciplinary. More than one treatment can be used in combination in the recurrence of diseases.