Gynaecological Cancer

What is gynaecological cancer?

Cervical cancer is the second most common cancer worldwide in women under 45. About 2,800 women are diagnosed with this form of cancer in the UK each year. The major cause of the main types of cervical cancer is the Human Papilloma Virus (HPV) and there are over 100 different types of HPV, many of which cause no harm. However certain types are considered ‘high risk’ for cervical cancer and these are transmitted through sexual contact. So, even if you have only had one sexual relationship you could be at risk of developing it – whatever your age or family history.

Fortunately, great progress has been made in the prevention, diagnosis and treatment of this form of gynaecological cancer. What is certain, is that regular smear tests, in women aged 25-65, play a vital role in minimising this cancer. Similarly, the new vaccination against HPV, which prevents infection with the virus and therefore prevents the changes HPV causes which lead to cervical cancer, is of great benefit.

What is HPV?

HPV is a common virus that causes infection in the skin of the vulva, vagina and cervix. Most of these infections clear naturally through the body’s own defences but for some women the infection persists and causes problems, especially precancerous cells on the cervix (abnormal smear test) or cervical cancer.

How is the HPV virus spread?

HPV is very common and easily transmitted through sexual contact or even sometimes during intimate genital skin-to-skin contact without penetration. So any woman who has ever had sex, regardless of her age, is at risk of catching it.

In fact over 75% of sexually active women will be infected with HPV at some time in their lives. Most women who have an HPV infection have no symptoms and only discover that they have been infected when they have an abnormal smear test result.

How does the HPV virus cause cancer?

Fortunately, in most women who become infected with HPV, the body’s immune system manages to fight off any infection. However when HPV manages to remain in the cervix, abnormal cells can develop and these can progress to cause cervical cancer.

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Treatment of gynaecological cancer

Cervical screening with smear tests is designed to detect abnormal cells on the cervix that are caused by HPV before they become cancerous. When these changes are found, treatment is usually successful in eradicating the problem. Commonly, treatment involves a visit to a colposcopy clinic and a minor surgical procedure, usually in the outpatient clinic. In this way cervical smear testing and colposcopy have made a very big reduction in the number of cases of cervical cancer that we now see.

HPV vaccination

Recently, vaccines have been developed to prevent HPV infection. From September 2008, GPs now offer this vaccine to all 12 year old girls in the UK. From September 2009, 14-18 year old girls will also be included in the programme.

Women over 18 are not included in the NHS programme but can benefit from the vaccination. Gynaechoice is able to offer Gardasil vaccination now at a fixed cost of £438 for the three vaccinations.

The course of three vaccinations is given over a six-month period. HPV vaccines have been tested in many thousands of women and have been shown to be very safe and effective, with few side effects. Some patients get a little redness at the injection site but this quickly goes away.

The vaccination is given by one of our Consultant Gynaecologists giving you the opportunity to discuss sexual health issues, cervical cancer and screening.

Why should you have a HPV vaccination?

Although smear tests and colposcopy treatments have been very successful in reducing the number of cervical cancer cases caused by HPV infection we still see over 3000 cases of cervical cancer every year in the UK. Cervical cancer remains the second most common cancer in women under the age of 45 and three women die of it every day in the UK.

Vaccination against HPV will prevent infection with the virus and therefore prevent the changes HPV causes which lead to cervical cancer.

How effective is HPV vaccination?

The vaccines are very effective and will prevent over 70% of all cervical cancer. This is a very big advance, but HPV vaccines will not prevent all cases of cervical cancer so it is still essential to continue with cervical smear tests after vaccination.

Do condoms protect against HPV?

No. Condoms offer limited protection against HPV because the skin around the genital area can also carry the virus and a condom will not cover this area.

Does HPV cause any other problems?

Yes.

Warts

Some HPV types cause genital warts and vaccination against HPV can prevent these.

VIN

VIN is a precancerous change in the skin of the vulva (similar to the precancerous change on the cervix that smear tests are used to detect). VIN can progress to vulval skin cancer.

Most (80%) VIN is caused by HPV infection.

HPV vaccination can prevent VIN.

VAIN

VAIN is a precancerous change in the skin of the vagina. VAIN can progress to vaginal cancer.

HPV vaccination can prevent VAIN.

Is there an age limit?

Ideally HPV vaccination will be done before a woman is ever exposed to HPV infection, so young women before any sexual activity will benefit the most.

However, previous exposure to HPV infection does not always provide enough immunity to prevent another infection so vaccination can be valuable for women of any age.

Should boys be vaccinated?

Undoubtedly the major benefits of HPV vaccination are for girls but there are also significant advantages for boys, who should be vaccinated if possible. The vaccination for boys will not be offered on the NHS.

What should you do?

Consider having an HPV vaccination

Vaccination against the HPV virus will stop the virus causing the changes that can develop into cancer in the majority of cases.

Continue with regular cervical smear tests

Regular testing is the best way of detecting abnormal cells on the cervix, which may be the early signs of cancer.  When these cells are found, treatment can be given before cervical cancer develops. As HPV vaccination is not 100% effective in preventing cervical cancer it is still vital to continue with smear tests.

Lifestyle changes

Smoking cigarettes is a major risk factor for developing cervical cancer and you should try and stop.

Further advice

Gynaechoice encourage you to contact us for an appointment to discuss cervical screening, colposcopy, HPV vaccination or questions about any of the above issues.  This will give you the opportunity to address your queries and concerns and decide on the best option for you.

Refer to www.BSCCP.org.uk for further information.

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