Welcome to week four of Gynaecological Cancer awareness month!
What is a hysterectomy?
Endometrium refers to the columnar glandular cells described previously in weeks two and three. Endometrial cancer starts when cells in the endometrium start to grow out of control.
A hysterectomy can be performed for benign reasons, such as prolapse, adenomyosis or fibroid complications. Due to the anatomical location of the uterus pressure can be put on the bowel or bladder, possibly causing symptoms such as incontinence. The same applies for malignant tumours of the uterus. If malignant tumours of the uterus are not removed, they are anatomically well placed in the peritoneal cavity to invade surrounding organs, causing multiple complications for a patient.There are varying degrees of hysterectomy procedures, partial, total and radical being the largest with removal of the cervix, uterus, fallopian tubes and ovaries. Additional surrounding tissue for example a section of bowel and lymph nodes can also be removed if the cancer has invaded, termed pelvic exenteration. Many factors will help decide the degree of hysterectomy taken, not least the clinical stage of disease but also considerations such as the age of the patient.
Would removal of the ovaries cause the patient to undergo early menopause? Has the patient started/finished her family?
Ultimately decisions are made by information from imaging techniques (CT/MRI), discussions with several clinicians at multidisciplinary team meetings and the patient.
Gynaecological cancers are staged using the FIGO staging system. Broadly speaking, the higher the stage the worse the prognosis for the patient. Considering uterine cancers have the highest incidence, the associated mortality rate is lower than that of ovarian cancer. This is likely to be due to uterine cancers producing symptoms of bleeding, and ovarian cancers having non-specific systemic symptoms.
Gynaecological Cancer Awareness Month
This month we have explored gynaecological cancers including incidence rates, symptoms, the cervical screening program, minor and major operations performed to remove lesions and tumours. By raising the awareness of these points, we hope to reduce the associated mortality rates. If you or someone you know is suffering with unusual symptoms, it is best to see your G.P and never miss a smear appointment! The earlier a diagnosis is made, the sooner treatment can be provided and lives can be saved.
