This Gynaecological Cancer Awareness Month (September) the Public Health Agency (PHA) is raising awareness of the signs and symptoms of cancers relating to the female reproductive system including endometrial, ovarian, cervical, vulval and vaginal cancers. 

Dr Tracy Owen, Deputy Director of Public Health at the PHA, said: “It’s important to be aware of the signs and symptoms of gynaecological cancers, for women to notice changes in their bodies, and to speak to your GP if something doesn’t feel right. Talking about symptoms can feel embarrassing but it’s extremely important to talk to your GP and get the help you need. 

“The earlier a cancer is picked up, the easier it is to treat it and the more likely it is to be successful.”

Gynaecological cancers can affect women of all ages. 

Ovarian cancer

Ovarian cancer is more common in women who have been through the menopause, usually in those over the age of 50, but it can also affect younger women. Unfortunately, many women don’t know the signs and symptoms of ovarian cancer and this can lead to delays in them contacting their GP. No matter what age you are, it is so important to be aware of the signs and symptoms of ovarian cancer as the earlier it is detected, the easier it can be to treat and the better chance of survival.

Signs and symptoms:

• persistent pelvic or abdominal pain (that’s your tummy and below);
• increased abdominal size/persistent bloating – not bloating that comes and goes;
• difficulty eating or feeling full quickly;
• urinary symptoms (needing to wee more urgently or more often than usual);
• changes in bowel habits;
• extreme fatigue (feeling very tired);
• unexplained weight loss;
• vaginal bleeding after menopause.

Cervical cancer 

Nearly all cervical cancers are caused by persistent infection with human papillomavirus, known as HPV. It is a very common virus – about 8 out of 10 people catch it at some point in their lives. The virus usually causes no symptoms and is mainly spread by skin-to-skin contact during sexual activity. In most cases, the body’s immune system will clear the virus and it doesn’t cause any problems, but in some people the virus can stay in the body for many years. 

In Northern Ireland we have two very effective ways of helping to reduce cervical cancer – HPV vaccination and cervical screening. 

The HPV vaccine will help protect you against HPV infection and associated cancers, including over 90% of cervical cancers in women.

Cervical screening is available to all women aged 25-64, as this is the age group where screening is of most benefit. Screening is offered every three years if you are aged 25-49, and every five years if you are aged 50-64. It is really important to attend for cervical screening when invited, as it could help save your life. Screening checks a sample of cells for certain types of HPV which can cause abnormal changes to the cells in your cervix and are referred to as ‘high risk HPV’. If high risk HPV is detected during screening, the sample of cells will also be checked for abnormal cell changes under a microscope. If abnormal cells are found, they can be treated so they do not get a chance to turn into cervical cancer.

However, it’s important to remember that the cervical screening programme is for women who have no symptoms of disease. If you have any cervical cancer signs or symptoms, contact your GP practice for an appointment – do not wait until your next cervical screening invite or appointment.

It is also important to remember that cervical screening will not check for other types of cancer.

Signs and symptoms:

• vaginal bleeding after sex, between periods or after the menopause;
• vaginal discharge that is not normal for you;
• persistent back or tummy pains;
• pain during sex.

Endometrial cancer

Cancer of the womb (uterus) is the most commonly occurring cancer of the female reproductive system, and the fourth most common cancer affecting women. This cancer is also called uterine cancer, or endometrial cancer. Most cases develop in women aged in their 50s or 60s. If endometrial cancer is diagnosed at an early stage, there is a good change of successful treatment. 

Signs and symptoms:

The most common symptom is abnormal vaginal bleeding:

• bleeding between periods;
• bleeding after having sex;
• periods that are heavier than usual;
• any vaginal bleeding in women past the menopause.

Early symptoms that occur in some cases are:

• pain during or after having sex;
• vaginal discharge;
• pain in the lower abdomen.

If womb cancer reaches a more advanced stage, it may cause additional symptoms. These include:

• pain in the back, legs or pelvis;
• loss of appetite;
• tiredness;
• nausea.

Vulval cancer 

Symptoms of vulval cancer can affect any part of your vulva, but they’re most common on the inner and outer lips (labia) around the opening of your vagina. 

Signs and symptoms:

• a lump, sore, growth (this may look and feel like a wart) or ulcer;
• bleeding from your vulva, or blood-stained vaginal discharge, that is not related to your periods;
• itching that does not get better;
• changes to your skin, such as red, white or dark patches;
• a mole that changes shape or colour;
• burning pain when you pee.

Vaginal cancer

Vaginal cancer is a rare cancer that’s found anywhere in the vagina. Its most common in women aged 75 and over. Vaginal cancer is nearly always caused by infection from certain types of HPV.

Signs and symptoms:

• a lump in the vagina;
• ulcers and other skin changes in or around the vagina.

Other symptoms of vaginal cancer include:

• bleeding from the vagina after the menopause;
• bleeding after sex or pain during sex;
• smelly or bloodstained vaginal discharge;
• bleeding between periods;
• an itch in your vagina that will not go away;
• pain when you pee, or needing to pee a lot.

Dr Owen concluded: “If you do experience any of these symptoms, it may not be anything serious, but it’s very important to contact your GP because finding cancer early improves the chances of successful treatment.”

For more information on the signs and symptoms of gynaecological cancers visit: www.BeCancerAwareNI.info