A Cancer-Prone System
Starting from the outside, the key elements in the female reproductive system are the vulva (or outer lips), the vagina (or birth canal), the cervix (a doughnut-shaped structure that is at the entrance to the uterus), the uterus, or womb (inside which a baby grows before birth), the fallopian tubes (along which fertilised eggs travel to the uterus) and the ovaries (where the eggs and various hormones are made). Not all of these organs and tissues are equally liable to cancer. For example, cancer attacks the fallopian tubes rarely; the vulva and vagina, more often; and the ovaries, the walls of the uterus (the endometricum) and the cervix most frequently. Each type of cancer requires specific diagnosis and treatment. Uterine cancer accounts for about four percent of all cancers in women; cervical cancer, for about three percent. Thanks to increased public awareness, early detection the death rate for cervical and uterine cancer has declined in recent decades.
It is not unusual for a serious disease to share the same symptoms with a relatively unimportant problem. This is especially true of cervical cancer and other cancers of the reproductive system. For example, two common symptoms of cancer of the vulva are itching and a burning pain, conditions that can also be caused by vulvar infections. A change in a vulvar mole or freckle, or any bump, growth or ulcer that does not heal within two weeks, may or may not, signal cancer. Cervical cancer is often symptomless, at least in its early stages, but in time, it causes abnormal vaginal bleeding or increased vaginal discharge. The discharge may begin as a watery discharge streaked with blood, but eventually the discharge will contain greater quantities of blood.
Having a symptom of gynaecological cancer does not necessarily mean that you have cancer. It does mean that you should see a doctor for a complete pelvic examination and further tests to rule out the possibility of cancer. Age seems to be the main factor that affects a woman’s chances of developing cervical cancer or any other cancer of her reproductive organs. The danger years vary, but fall within the 40-65 year old age span. The years of greatest risk for cervical cancer appear to be between 40 and 49. The odds that a woman will develop any type of gynaecological cancer increase after menopause.
Each reproductive organ also has its own specific risk factors. Studies reveal that cancer of the cervix occurs more often in women who become sexually active early in life, who have contracted a sexually transmitted disease such as genital warts, who have had many sexual partners, whose sexual partners have had many sexual contacts, or who smoke. More cases of cervical cancer also occur among women who use oral contraceptives than among those who rely on a diaphragm, condoms or an intrauterine device (IUD).
Two routine screening examinations are available for women, the cervical smear test (Pap smear test) and the pelvic examination, which may detect gynaecological cancer – or conditions that may lead to it – long before a woman notices anything wrong. In the cervical smear test, a metal instrument called a speculum is used to open up the vagina and examine the cervix. With the speculum in place, the doctor uses a wooden spatula or cotton wool swab to rub off a sample of cells from the surface of the cervix; the sample is transferred onto a glass slide and sent to the laboratory for examination under the a microscope. The test is designed to detect the presence of abnormal (precancer) cells that in some cases may develop into cervical cancer. Even if such cells are found, it does not mean that you have cancer or will get it later; it does mean, though, that more tests and possibly treatment are necessary. If the cervix shows inflammatory changes or if you have had an abnormal smear, the doctor may also examine the cervix with a magnifying instrument called a colposcope. After examining the cervix, the doctor will do a pelvic examination by passing a gloved finger up inside the vagina while pressing down on the abdomen with the other hand. In this way he may be able to detect abnormalities in the uterus, fallopian tubes and ovaries. Depending on your age, your past and present sexual habits, whether you are at high risk for developing cervical cancer, will determine how often you should be examined. Generally, any factor that increases the risk of developing cancer increases the need for regular check-ups. Cervical cancer detected early can usually be cured without affecting a woman’s ability to have children, but a more advanced cancer might require a hysterectomy – the surgical removal of the uterus and the cervix, which makes it impossible for her to have children.