The cancer of female reproductive system is called as gynecology cancer. It can occur in any part of female reproductive system. The cancer cells of such type of cancer invade the nearby tissues or organs or sometimes spread through lymphatic system and bloodstream in different parts of body. In this article we will try to concentrate on the three most common cancer of female reproductive system.

A) Cancer of the uterus:

Cancer Of The Uterus

The uterus is a hormone regulating muscular sex organ situated in the pelvic region. This organ holds pregnancy and bleeds every menstrual period. In the uterine cancer, changes occur in the cells of endometrium. These cells multiply very rapidly and there also occurs change in their arrangement. The number of cells increases so rapidly that they spread in the muscles of the uterus, cervix and other parts of the body through blood stream.

Symptoms:

Unfortunately, there appear no symptoms externally in the primary stage of this cancer. If the histopathological examination is done of the endometrium cells of the uterus, then the cancer cells might be detected. The main symptom of the uterine cancer is abnormal vaginal bleeding after menopause. In younger women, if the bleeding is heavier than usual periods or bleeding occurs during intercourse than there are higher chances of occurring of cancer.

Risk factors of uterine cancer:

1) This type of cancer occurs mostly in woman having no child.

2) If the woman have menopause at the age of 55.

3) If the menstrual period begins before the age of 12 and menopause occurs at a higher age.

4) If there is a heredity of cancer in the family.

5) If the pelvis is exposed to radiation due to some reasons.

6) If the drug called tamoxifen is for longer duration for treatment of breast cancer.

Treatment:

 The treatment of uterine cancer depends on the stage and grade of the cancer. Following are the stages of cancer:

Stage I:

In this stage the cancer remains limited to the uterus only.

Stage II:

In this stage the cancer cells start spreading from uterus to cervix.

Stage III:

The spreading of cancer cells continues in this stage and extends up to pelvic region.

Stage IV:

The cancer invades the urinary bladder in this stage. This is said to be the last stage of uterine cancer.

 The age of the patient also determines the treatment type of uterine cancer. The type of the treatment is different if the patient is suffering from any other chronic disease. However, the treatment mainly depends on the stage of the cancer.

Following treatments are made depending upon the patient:

1) Surgery:

The most common surgery includes removal of uterus and ovaries.

2) Radiotherapy:

Depending upon the stage of the cancer, radiation therapy is done. If the cancer has spread to a large area then extended beam therapy is carried out and if it is confined to a small area then brachytherapy is used.

3) Chemotherapy:

The chemotherapy uses high power drugs to kill cancer and it is carried out a higher stage of cancer.

Tests for diagnosis of uterine cancer:

At the very primary stage the patient should immediately consult a gynecologist. The concerned doctors then carry out following test for detection of cancer:

a) Pap smear test:

In this test the cells of the cervix are examined for cancer detection.

b) Pelvic Sonography:

This is the most easiest and useful way for cancer diagnosis.

C) Endometrial biopsy:

In this test, a sample of the inner tissues of the uterus is examined under microscope.

d) Hysteroscopy:

A hysteroscope is used to view inside the uterus to find out the cancer affected part.

e) Magnetic Resonance Imaging (MRI):

MRI is done to determine the exact stage of cancer.

Other tests like X-ray are done if the cancer is spread over a large area.

 B) Ovarian Tumor:

Ovarian tumor

The ovaries of female reproductive system have ovules in them since birth. This ovum then causes the development of fetus. Besides ovum, there are many cells present in the ovaries and the uncontrolled division of these cells can cause many critical diseases. The external symptoms and treatment of these diseases changes according to the type of cell. There is an increased chance of having different types of tumor in various stages of age of a woman. The different types of tumor are as follows:

1) Ovarian cyst:

If the tumor has fluid accumulated in it then it is called as ovarian cyst. The cysts are of different types. When the size of the cyst is more than 5 centimeters then they have to be removed by surgery.

2) Solid tumors:

When the tumor does not include fluid due to increase in the number of cells and only cells exists in the tumor then solid tumors are formed.

3) Mixed tumors:

When the ovarian cyst and the solid tumors exist together then they are called as mixed tumors.

One thing that should be remembered is that 80% of the tumors are not cancerous. But if they are of size more than 5 centimeters or mixed tumors, then they should be treated immediately.

Causes of tumors:

There is no definite cause of tumors. But following situations increases the possibilities of tumor:

1) Menopause

2) Smoking

3) Obesity

4) Intake of contraceptive pills at a smaller age and continuing it for a longer duration.

5) Undergoing hormonal treatment for pregnancy.

6) Intake of hormone tablets after menopause.

7) Positive maternal family history.

Symptoms:

Unfortunately there occur no external symptoms for tumors. Because the ovaries are present inside the pelvis and there is a lot of space surrounding the ovaries. So, the tumor cannot be detected until it grows to a certain size. Many times the tumor is detected if the patient undergoes Sonography or any such test for some other disease. In some patients, the tumor is detected after it has grown to a size like that of a fetus of 5-6 months. In some women following symptoms may be seen:

1) Pain in the pelvic region

2) Pain in the waist

3) Having painful intercourse

4) Some women might feel the tumor by hand.

5) Frequent urination sensation

6) Swelling on legs

7) Irregular periods

8) Accumulation of water in stomach

Bursting of tumor:

The blood vessels which provide blood supply to the ovarian tumor are so sensitive that they get twisted due to some rapid body movements. Such twisting of the blood vessels restricts the blood supply to the ovarian tumor and causes some changes in the tumor. Due to this the patient suffers from extreme stomach pain. Sometimes internal bleeding occurs in the tumor and the outer covering of the tumor bursts. The chances of bursting of tumor are more in case of Hemorrhagic ovarian cyst. Immediate treatment of the patient is must in such case. The death of the patient may occur so, it is required to treat the patient before his condition becomes critical.

Ovarian tumor marks:

Many type of tumor can become cancerous. Probably in all types of tumor this possibility should be assumed.  For this, the blood sample is tested to see the levels of tumor marks of particular type of tumor. If this level is found higher than the probability of such tumor of being cancerous increases. This test also detects, whether the tumor has spread to other body parts and the response of the patient to the treatment.

Ovarian cancer:

Ovarian cancer

The growth of ovarian cancer occurs sometimes in the ovary or in the other organs like breast, uterus. The type of cells in the cancer determines its type of treatment. In some cases chemotherapy is more effective while in other cases radiotherapy proves effective. The cancer can be detected at an early stage if all the proper treatments are done after menopause. So, it is essential to do all the post menopausal screening regularly.

C) Cervical cancer:

Cervical cancer

Any type of cancer can be easily avoided by doing regular check-up. Such type of cancer can be easily detected by biopsy and can be treated easily. So, regular check-up should be done to avoid further complications. The cervix of the uterus is easily visible by the examination done by a gynecologist.

The cells present in the inner and outer portion of the uterus are different from each other. The place where these two types of cells come together is called as transformation zone.  Sometimes the cells in the inner portion of the uterus start multiplying in the outer area. If there occurs no change in the nucleus of the cell than it is called as metaplasia and it is said to be a normal condition.  But if there begins a change in the nucleus then it is called as dysplasia and if the changes occurs on a large scale then it is the beginning of the cancer.

Diagnosis of cancer at primary stage:

In the world, there are near about 4, 60,000 patients of cervical cancer. Out of them, 16% are Indians but cancer of only 5% patients is detected at the primary stage. If routine check-up is done regularly and if the dysplastic cells are treated immediately then the cancer can be prevented on time and the patient can be cured completely. This procedure of diagnosis is called as down staging of cervical cancer. According to a survey made by the World Health Organization, this type of diagnosis has many benefits and India this procedure of down staging is used in Mental and child health program. The methods used for diagnosis of cervical cancer are:

1) Pap Smear Test:

This test was initiated by Papanicolaou and Traut in 1943. The cells present on the cervix of the uterus are taken on a glass slide and examined by using Papanicolaou stains. This is called as Pap test or surface biopsy. This test can be easily done in the annual medical check-up every year after the age of 45. Nearly 95% of the patient’s cancer can be detected and 70 % of the women suffering from cancer of the uterus can be easily diagnosed. If the result of this appears to be normal in the first three years of check-up then this test can be done after every five years. Different types of virus infections like Herpes, Condyloma, and Acuminate etc can also be detected by this test. By treating this infection the further changes in the cells can be prevented.

2) Colposcopy:

Colposcopy

This is a very effective test. This test is done if there appears a wound or tumor on the cervix of the uterus or if the Pap smear test is not clear. This test can be done within 10 minutes in the outdoor patient department without giving any anesthesia. Special equipment is used to test the cervix of the uterus and by applying various types of medicines, the exactly affected area can be found out. The biopsy of this area can be done later.

3) Cervical Intraepithelial Neoplasia:

In this stage of cancer, the changes began to appear in the cells but it has not spread deep inside the cervix and is limited up to the cervix only. The cervical cancer can be controlled without any major surgery if it is detected in this stage.  The affected area can be removed by a minor surgery or it can be burnt by using laser therapy or cryotherapy. Due to this the cancer can be treated at stage zero.

4) Invasive Cancer:

This is the next stage of cancer. If the cancer is not detected at stage zero then the changes in the cell increases and start spreading in the surrounding area. The cancer cells can spread through blood or lymphatic in the liver. The cancer can spread in the uterus and vagina. The next stage of cancer depends upon the limit of spreading of the cancer cells.

5) Human Papiloma Virus Infection:

This virus infection can cause cervical cancer. HPV16 and HPV 18 are the two types of virus responsible for 70% of cervical cancer and 60% of vaginal cancer. This cancer can be controlled by a giving a vaccine to the girls aging from 9-25 years.

Even today in India, the girls are married at a minor age. In the metro cities the percentage of sexual intercourse with more than one person is also increasing. Due to this the probability of Herpes, HPV and HIV infection increases resulting in cancer at higher age. This problem can be avoided by adopting proper lifestyle, doing regular check-up and having proper treatment immediately after the diagnosis of cancer.