Gynaecological Cancers: the facts, signs and symptoms

Sadly, gynaecological cancers have some of the worst outcomes for women with a devastating mortality rate of 37%. 21 women will die of a gynaecological cancer today, and 57 women will be diagnosed.* 

Here‘s the lowdown on the 5 types of gynaecological cancers. Remember, for more information always ask a healthcare professional. And if you’re ever worried about something, get it checked; embarrassment isn’t life threatening, but cancer is.

1. Vulva cancer 

Vulva cancer (also called vulval cancer) is a rare form of gynaecological cancer that affects the vulva, aka the outside parts of the female genitals. Around 1,200 cases are diagnosed in the UK each year. It’s more common in older women and many cases are diagnosed in women aged 65 or over.

Symptoms:

Symptoms of vulval cancer can include:

A lasting itch, pain or soreness and thickened, raised, red, white or dark patches on the skin of the vulva

Open sore or growth visible on the skin 

Burning pain when you pass urine

Vaginal discharge or bleeding

A mole on the vulva that changes shape or colour (appears like a skin tag)

Lump or swelling in the vulva

If you have any of the symptoms listed above, be sure to visit your doctor for a check up, particularly if:

They are not normal for you

They are persistent

There are repeated episodes

They do not go away

Most women with symptoms like these do not have cancer, but being aware of what the symptoms are means you’re more likely to spot if something’s amiss - and early diagnosis saves lives.

Risk factors:

The risk of developing vulval cancer increases with age. 

Human papillomavirus (HPV) is thought to be responsible for four out of 10 vulval cancers. But  ost women who have HPV infection do not go on to develop vulval cancer.

 Vulval intraepithelial neoplasia (VIN) means there are precancerous changes in the skin of the vulva. In some women VIN develops into vulval cancer. The most common symptom of VIN is a lasting itch that does not get better or go away.

Other risk factors include a weakened immune system, genital herpes infection, smoking and some chronic skin conditions.

2. Cervical cancer

Cervical cancer is cancer of the cervix (also known as the neck of the womb), which connects the womb and vagina. Around 3,100 women are diagnosed with cervical cancer in the UK each year and it’s the most common cancer in women under 35 years old*

Upsettingly, cervical smears are at an all-time low**, a sad fact only exacerbated by COVID. 62% of women under 25 have put off going to the doctor about an intimate issue because of COVID (vs av 33% u44yrs). 6 in 10 women under 25 don’t know how often to get a cervical smear (vs av 30% of u44yrs) and 1 in 3 women are missing their cervical smear citing ‘embarrassment’***

We must all work to change this - let’s start by talking to each other and educating ourselves about the risks.

Symptoms:

Some symptoms of cervical cancer are not obvious, so it’s vital to get your cervical smear as that’ll pick up on any abnormalities. 

The most common symptom of cervical cancer is bleeding from the vagina at times other than when you are having a period. For example between periods, after or during sex, or at any time if you are past your menopause. 

Some women also experience:

Vaginal discharge that smells unpleasant

Discomfort or pain during sex.

If you have any of the symptoms listed above, be sure to see your doctor – particularly if:

They are not normal for you

They are persistent

There are repeated episodes

They do not go away

Most women with symptoms like these do not have cancer, but being aware of what the symptoms are means you’re more likely to spot if something’s amiss - and early diagnosis saves lives.

Risk factors:

Cervical cancer is commonly caused by a transmitted infection called human papillomavirus (HPV) which is transferred through skin-to-skin sexual contact, and common for nearly all women to come into contact with at some stage during their adult life. Cervical screening is essential for early diagnosis of cervical cancer and the NHS cervical screening programme offers testing to women between the ages of 25 and 64. More than four million women are invited for cervical screening each year in England.  

Women with a weakened immune system and those who have had a large number of children are also more likely to get cervical cancer. All girls aged 12 or 13 in the UK are routinely offered the HPV vaccine at school. These vaccines protect against the strains of HPV that are most likely to cause cervical cancer.

3. Ovarian cancer

Cancer of the ovary affects over 7,000 women in the UK each year. 

This makes ovarian cancer the 5th most common cancer in women, after breast, lung, bowel and womb cancer. More than eight out of 10 ovarian cancers occur in women over the age of 50.

There are many types of ovarian cancer, with epithelial ovarian cancer being by far the most common form. Germ cell and stromal ovarian cancers are much less common.

Symptoms:

Many women with a very early stage of ovarian cancer often don’t have any symptoms at all. The symptoms may be very vague and difficult to recognise. They can include:

Feeling bloated (having a swollen, uncomfortable tummy)

Feeling full quickly and / or loss of appetite

Pain or discomfort in the lower tummy area and / or back

Needing to pass urine more often or more urgently

Changes in bowel habits

Constipation

Weight gain or weight loss

Unexplained or extreme tiredness

If you have any of the symptoms listed above see your doctor, particularly if:

They are not normal for you

They are persistent

There are repeated episodes

They do not go away

Most women with symptoms like these do not have cancer, but being aware of what the symptoms are means you’re more likely to spot if something’s amiss - and early diagnosis saves lives.

Risk factors:

About nine out of 10 tumours of the ovary are diagnosed as epithelial ovarian cancer.

In these cases, the cancer may have started in the surface layer covering the ovary. Cancers may have started development in the fallopian tube. The risk of ovarian cancer may be increased by the following factors:

Getting Older

As with most cancers, the risk of developing ovarian cancer increases as you get older. Most cases are in women who have had their menopause.

Inherited Faulty Genes

Most ovarian cancers are due to gene changes that develop during a woman’s life and are not inherited. About one to two in ten ovarian cancers are caused by an inherited faulty gene. Faulty inherited genes (mutations) that increase the risk of ovarian cancer include BRCA1 and BRCA2. These genes also increase the risk of breast cancer. Tests can now check for faulty BRCA1 or BRCA2 genes.

History of breast cancer 

Breast cancer and ovarian cancer can sometimes be due to the same faulty genes. Women who’ve had breast cancer have up to double the risk of developing ovarian cancer compared to other women in the population, and if their breast cancer was diagnosed before the age of 40, their risk is around four times higher.

Other possible risk factors include infertility, long-term use of hormone replacement therapy (HRT), being overweight, a diet high in animal fats, and having endometriosis.

4. Uterine (womb) cancer

Cancer of the womb is the fourth most common cancer in women in the UK, with around five out of every 100 cancers diagnosed in women each year being womb cancers. It‘s known by several different names including uterine cancer (the medical name for the womb), or endometrial cancer (a cancer within the lining of the womb) and this is by far the most common type of cancer of the womb.

Symptoms:

The most common symptoms of womb cancer include: 

Abnormal bleeding from the vagina – especially in women who have had their menopause and stopped having periods. About 90 out of 100 cases of womb cancer are picked up because of post-menopausal or irregular vaginal bleeding. Irregular bleeding can be vaginal bleeding after the menopause, bleeding that is unusually heavy or happens between periods or vaginal discharge – from pink and watery to dark and foul smelling.

Less common symptoms can include:

Pain or discomfort in the lower abdomen

Pain during sex

Your womb is enlarged, or feels swollen – this will be something which your doctor will be able to see

Advanced womb cancer can cause more symptoms, especially if the cancer has spread to other parts of the body. These are less common and can include:

Loss of appetite and weight

Tiredness or weakness

Feeling or being sick

Constipation

Feeling breathless

Passing urine more often than usual

If you have any of the symptoms listed above, be sure to visit your doctor for a check-up, particularly if:

They are not normal for you

They are persistent

There are repeated episodes

They do not go away

Most women with symptoms like these do not have cancer, but being aware of what the symptoms are means you’re more likely to spot if something’s amiss - and early diagnosis saves lives.

Risk factors:

Getting older

Womb (endometrial) cancer is most often diagnosed in women aged between 60 and 79. Over a 1/3 of uterine cancers in the UK are linked to lifestyle factors. 

Other factors

Most endometrial cancers are driven by the female hormone, oestrogen. Overweight or obese women are more likely to develop endometrial cancer than women of a normal weight. Having oestrogen-only Hormone Replacement Therapy (HRT) or taking Tamoxifen can also increase the risk of womb cancer. Women with diabetes are more likely to develop endometrial cancer.

5. Vaginal cancer

Vaginal cancer is rare, with just under 260 new cases diagnosed in the UK each year. That is less than one out of every 600 cancers diagnosed in women.

Symptoms:

It is rare to have symptoms if you have very early-stage vaginal cancer.

The most common symptoms of vaginal cancer are:

Blood-stained vaginal discharge

Bleeding after sexual intercourse and pain

Problems with passing urine (such as blood in the urine, the need to pass urine frequently and the need to pass urine at night)

Pain in the back passage (rectum)

Vaginal itch that won’t go away

Lump or growth in the vagina that you or your doctor can feel

If you have any of the symptoms listed above, be sure to visit your doctor for a check up, particularly if:

They are not normal for you

They are persistent

There are repeated episodes

They do not go away

Most women with symptoms like these do not have cancer, but being aware of what the symptoms are means you’re more likely to spot if something’s amiss - and early diagnosis saves lives.

Risk factors:

Getting Older

One of the risk factors is age – as women get older their risk of vaginal cancer increases. More than 70% of cases occur in women aged 60 and over. 

Pre-existing conditions

A condition called vaginal intraepithelial neoplasia (VAIN) can mean you are more at risk of getting vaginal cancer.  Women who have had genital warts caused by the human papilloma virus (HPV) may have a slightly higher risk of developing vaginal cancer. Women who have had radiotherapy to the pelvic area may also have a very slightly increased risk.

Luna Daily and The Lady Garden will be uniting to raise awareness of the importance of cervical smears, increasing uptake year-on-year, and increasing early detection and diagnosis - to inevitably reduce the detrimental outcomes of gynaecological cancers for women.

All information sourced from The Lady Garden Foundation

*The Lady Garden Foundation

**https://digital.nhs.uk/news/latest-news/decrease-in-number-of-people-having-cervical-screening-tests-in-2020-21-new-statistics-show

***1000 women of all ages, stages and ethnicities the UK

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