What female cancers and cancers do we know? (symptoms + treatment)

Cancer refers to a wide variety of diseases of different parts of the body and organs. Its common feature is that the body's own cells go "crazy" and start to grow uncontrollably.

The cluster of cancer cells infiltrates the surrounding area, but can also spread to distant parts of the body - metastasise. Cancer can therefore occur in any part of a living organism.

Cancer most often occurs in places where the most proliferation of cells normally takes place (e.g. trachea, lungs, intestines) or in places where cells are stimulated by hormones (e.g. prostate, ovaries, breast).

Table of factors causing cell mutation and tumour growth

Differences in women's bodies also result in different types of cancer

The human body structure of women and men differs at certain points. Therefore, we know the types of cancer that occur exclusively in a particular sex due to anatomical specificities.

For example, only men can have prostate cancer, while women can have cancers of the female genital organs or the lesser-known placental cancer.

Breast cancer can also be considered a female cancer, given its high incidence in women, but it can affect both sexes.

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Cancer of the vulva

Vulvar cancer refers to a cancerous process affecting the external female genitalia.

These tumors are histologically divided into several subgroups depending on the specific tissue in which they form.

Histological classification of vulvar tumours:

• Epithelial tumours - account for up to 85% of all vulvar tumours. They are formed from dermal epithelium, squamous epithelium, glandular epithelium or dermal adnexa.
• Mesenchymal tumours - this group of tumours includes those originating from soft tissues (liposarcoma, angiomyxoma, leiomyoma...)
• melanocytic tumours - affecting on average between 2 and 10% of mostly elderly patients

How does vulvar cancer manifest itself?

Despite the variety of tissues from which vulvar tumours can grow, their manifestations have common features.

The typical symptom is prolonged itching of the external genital area. This symptom may initially be mistaken by the patient for another - usually infectious - disease, such as a yeast infection.

Less commonly, discharge is also a common symptom of many gynaecological diseases.

In some cases, there is also pain in the affected area or gynaecological bleeding outside the cycle.

Itching and subsequent scratching may cause infection and local swelling, resulting in urological problems and urinary problems.

Lesions with characteristic features

Swelling of the vulva may not occur only because of pruritus. It also occurs along with skin lesions.

Malignant lesions have characteristic features, namely leukoplakia, growths and local bleeding. Ulceration may also occur in the affected area.

It is usually found on large pimples, but can also be seen on small pimples, external genitalia or clitoris.

Have you noticed a neoplasm on your vulva?

If you have palpated a new formation on your vulva, you need to see your gynaecologist (unless it is a rash and injury).

A doctor who specialises in gynaecology can already judge a neoplasm from experience based on its appearance.

The basic examination is complemented by histology, which is the basis for the final diagnosis. A biopsy should be taken from any suspicious area in the external genital area.

What are the treatment options for vulvar cancer?

If the disease is diagnosed early and no metastases are present, surgical removal of the tumour is the most appropriate. This method increases the survival rate of patients to 60%.

Radiotherapy has proven to be effective in patients with inguinal nodes. Positivity of the nodes usually indicates metastases in this area.

Vaginal cancer

The vagina is a musculo-vascular tube, an organ connecting the uterus and the external genital organs of a woman.

Vaginal cancer with a cause directly in the vagina is very rare.
It accounts for only about 1.5% of all gynecologic cancers.
Cancer most commonly affects cells on the surface of the vaginal mucosa, the birth canal.

It is more often found together with cervical cancer, or as a tumour growing out of the uterus or vulva.
The risk of developing it increases with age or is caused by HPV.

The most common types of vaginal cancer:

• Vaginal squamous cell carcinoma (the most common type of vaginal cancer from epithelial cells).
• Vaginal adenocarcinoma (cancer of the glandular cells)
• vaginal melanoma (a tumour of pigment-producing cells - melanocytes)
• vaginal sarcoma (tumour from connective or muscle tissue)

Stages of vaginal cancer:

• Stage I - circumscribed cancer, affecting the vaginal wall
• Stage II - cancer that has spread into the surrounding tissues
• Stage III - cancer that has spread to the pelvis
• Stage IV.A - cancer extending into the surrounding organs (bladder, rectum)
• Stage IV.B - cancer growing outside the vagina (metastasis to distant organs such as the liver)

Treatment options for vaginal cancer depend on the specific type of tumor and stage of the disease!

Symptomatology of vaginal cancer

The early stages of the disease are asymptomatic. Therefore, regular gynaecological examinations play an important role in their early diagnosis.

Symptoms of vaginal cancer include specific symptoms such as pain in the vaginal area radiating to the lower abdomen, irregular menstruation, missed periods, off-cycle bleeding, bleeding after intercourse, menopausal bleeding and watery discharge.

Non-specific symptoms include problems with urination. Tumour growth causes pain on urination, pain in the abdomen and pelvic area, and often causes constipation.

What to do if you develop risk symptoms?

When symptoms indicate vaginal cancer, it is essential to see a gynaecologist.

The basis of the examination is to check not only the vagina, but also the cervix, from which the tumour in some cases descends into the vagina.

The gynaecological examination is supplemented by an ultrasound, sometimes by an X-ray. Laboratory results are equally important.

Cancer of the cervix and uterine body

Cancer of the cervix is a well-known disease. Cancer of the uterine body is not so much talked about. Both diseases are oncological diseases of the uterus. They differ according to the place where the tumour started.

Uterine cancers by site of origin:

• malignant tumour of the endocervix
• cancer of the exocervix
• malignant tumour of the isthmus
• endometrial cancer
• myometrial malignancy
• malignant tumour of the fundus of the uterus
• malignant tumour overlapping more than one region of the body of the uterus

Cervical cancer is caused by HPV

Cervical cancer (carcinoma cervix utheri) is a tumour arising in the tissue of the cervix. It affects younger ages, mainly in developed countries.

It is caused by infection of the epithelium in this area with the human papillomavirus, also known as HPV. In some cases, it heals spontaneously. In others, the infection turns into a carcinoma.

The risk of cancer increases when combined with other risk factors such as sexual promiscuity, poor hygiene, reduced immunity, multiple pregnancies, long-term or incorrect use of contraception, genetics, alcohol, smoking.

Interesting:
The number of deaths from cervical cancer is declining.
This is due to cytological screening, which detects precancers early, and HPV vaccination.
Subsequent treatment ensures that the disease does not progress to the stage of invasive cancer.

What are the causes of uterine cancer?

Cancer of the uterine body (carcinoma corpus uteri) is a tumour arising from the lining of the endometrium (the inner lining of the uterus). For this reason it is also called endometrial cancer. It affects older ages, mainly after the menopause.

It is caused by an excessive amount of oestrogen (similar to the effect of testosterone in prostate cancer). The risk groups of women are therefore post-menopausal patients with late onset, patients taking hormonal contraceptives, patients who have not yet given birth and patients who are infertile.

There is also a high risk for obese patients and those with high blood pressure or diabetes.

Ovarian and fallopian tube cancer

Ovarian and fallopian tube cancer affects women of all ages. However, the incidence of the disease increases with age. Up to 80% of these malignancies are diagnosed in patients over 50 years of age.

Distribution of tumour types according to localisation:

• ovarian cancer
• cancer of the broad ligament of the uterus
• malignant tumour of the rounded ligament of the uterus
• parametrial malignancy
• uterine adnexal malignancy
• malignant tumour of multiple areas of the fallopian tube

Classification of tumour types according to the tissue from which they arise:

• epithelial tumours - form from the superficial epithelium
• germ cell tumours - formed from cells involved in the formation of the foetus
• gonadostromal tumours - formed from a specialised middle layer of germ cells

Epithelial ovarian carcinoma is the most common type of ovarian cancer and includes ovarian cancer, fallopian tube cancer, and peritoneal cancer. It is a common cause of cancer mortality in women.

When should we think about ovarian and fallopian tube cancer?

This type of cancer can affect any of us. As mentioned, the risk of developing it increases with age. However, this is not the only risk factor.

Risk factors for ovarian and fallopian tube cancer:

• Age category
• genetic predisposition
• unhealthy lifestyle (smoking, alcohol, other)
• contraception (incorrect and repeated use)
• hormone replacement therapy

How does it manifest itself?

Ovarian and fallopian tube cancer, like most diseases, does not manifest itself right away. For this reason, it is often caught too late at an advanced stage.

Regular gynaecological examinations help to detect most of them at random.

Non-specific symptoms include fatigue, malaise, nausea, vomiting, bloating, lack of appetite, various digestive problems or difficulty urinating.

The first symptoms often indicate a high stage of the disease. These include abdominal, pelvic, and sacral pain, peritoneal irritation, irregularity of the menstrual cycle, bleeding after or during intercourse, and menopausal bleeding.

One of the symptoms, especially in ovarian cancer, is so-called virilization. This means male characteristics in a woman, such as male pubic hair, thickening of the voice, etc.

Can ovarian cancer be cured?

After diagnosis, i.e. after the tissue has been taken for histology with confirmation of cancer, partial resection of the affected part of the ovary is performed in young women to preserve fertility.

This is not always possible. There is a risk of infertility because complete removal of the ovaries is often necessary. If the tumour has grown into the uterus, the entire uterus must be removed (hysterectomy).

Except for borderline ovarian tumours, chemotherapy is always indicated.

Placental cancer

Pregnancy is considered the most beautiful period in a woman's life. The feeling of being a mother is indescribable.

Pregnancy has its downsides, however. It is associated with morning sickness, weight gain, swelling and leg pain. There are also various diseases such as high blood pressure, gestational diabetes, depression and lactation psychosis.

Few people would believe that during this wonderful period, the risk of cancer also rises. Specifically, placental cancer, which affects about one in 20 000 women.

It arises from different parts of the trophoblast, which is the basis for dividing it into three basic types of cancer:

1. choriocarcinoma (the most common).
2. placental bed tumour
3. epithelioid trophoblastic tumour

When the placenta kills

Placental cancer (choriocarcinoma) is a very rare type of cancer that affects women exclusively. It occurs during pregnancy or shortly after fertilisation.

Topographical occurrence: Choriocarcinoma is often found in Asia, Vietnam and South America. It is rarer in Europe. This topographical occurrence has not yet been clarified.

This type of cancer arises from the trophoblast. The trophoblast is a thin layer of flat and cuboidal epithelial cells of the blastocyst that develops by cell division from the morula on about day 5 after fertilisation of the egg.

It is an embryonic tissue which on the 14th day penetrates the uterine lining, musculature and blood vessels. Through the bloodstream it reaches the brain, lungs, liver and other organs. This process is called trophoblastic invasion.

It is during this process that the embryonic tissue is at risk of degenerating into cancerous tissue. Since trophoblast invasion occurs in the uterus, up to 80% of choriocarcinomas also occur there. However, trophoblastic invasion can also occur in other organs into which the trophoblast penetrates.

The risk of placental cancer persists throughout pregnancy. However, it most often forms early in pregnancy!

Can choriocarcinoma be diagnosed early?

Diagnosis of choriocarcinoma is based on a blood test, in which the pregnancy hormone hCG is present even after the end of pregnancy. This hormone continues to be produced by the tumour.

During pregnancy, bleeding or miscarriage may indicate cancer. Other possible methods of investigation include ultrasound or X-ray.

The abnormal morphology of the placenta is obvious. It is swollen and its villi are visible to the naked eye - normally they are microscopic.

Treatment options for chorionic carcinoma

In the past, a diagnosis of chorionic carcinoma was tantamount to the death of the patient. Today, most of these tumours are relatively well treatable.

There are several highly effective drugs that are chosen individually for each patient. The drug methotrexate, which blocks the folic acid that causes the tumour to grow, remains at the forefront.

Interesting:
Time plays a large role in the success of treatment. A correct diagnosis and initiation of treatment within three months of giving birth poses a low health risk. Diagnosis after six months and with high hCG levels indicates not only a large tumour but also the development of metastases and little chance of a cure. Each woman can monitor her hCG levels individually at home after giving birth with a pregnancy test and seek early medical help.

Breast cancer

Although we understandably mostly associate breast cancer with the female sex and pink ribbons, it also affects men.

In women, however, it is the second most common cancer. In the past, it has plagued older women. Today, an increasing number of younger patients between the ages of 25 and 45 are being diagnosed.

The outlook for breast cancer treatment is very favourable if the disease is caught early.

However, the disease often means the removal of a breast, which also has a psychological impact on the patient. Breasts have always been a symbol of femininity. The removal of one of them affects a woman's quality of life and can cause feelings of inferiority, loss of femininity, depression or other psychological problems.

Breast cancer affects different parts of the breast

The breast is a glandular organ located bilaterally on the front of the chest. It attaches to the pectoral muscle.

It is made up mainly of fat and milk glands resembling grapes. In men, the glands are ductless and stunted. They end at the front with the nipple and areola.

Breast cancer is a common name for several malignant tumours of the breast or for tumours of different parts of the breast.

The cancerous process affects different parts of the breast:

• cancer of the nipple and areola
• mid-breast cancer
• cancer of the upper inner quadrant of the breast
• malignant tumour of the lower inner quadrant of the breast
• malignant tumour of the upper outer quadrant of the breast
• malignant tumour of the lower outer quadrant of the breast
• malignant tumour of the axillary part of the breast
• malignant tumour overlapping more than one part of the breast

Interesting:
Not every lump in the breast is a cancer. However, every new lump must be examined by a doctor.
In the breast of a woman, variously sized nodules made up of connective tissue or cystic formations form.
These fibrocystic changes are caused by women's cycles. They usually disappear spontaneously, no later than the menopause.

Prevention and early detection of the disease

In breast cancer, it is important to educate patients about what the disease entails, how to catch it early and what the treatment options are. More women need to be disabused of the misconception that breast cancer is an incurable and necessarily fatal disease.

Breast cancer should be on the minds of all women, especially those in the high-risk group.

Women at risk:

• Women who have had breast cancer in the past
• patients who have a positive family history (i.e. a close blood relative has had breast cancer)
• patients who have not yet given birth or who have become pregnant for the first time after 30 years of age
• patients at high risk (> 50 years)

Regular gynaecological examinations and breast self-examination are also essential for prevention.
As part of the gynaecological examination, mammography is the most reliable diagnostic method for this disease.

Information that mammography and the X-rays it emits cause cancer is not proven. Therefore, fears of cancer after the examination are unfounded.

Breast self-examination:

• Home breast examinations should be performed at least once a month
• the best time is the first few days after the end of menstruation
• to observe, for example, lumps, bulges, changes in the size, shape and colour of the breasts and nipples that are visible to the naked eye
• it is best to perform the examination by palpation in the shower, as it is easier to palpate moist skin