Gynecologic Oncology (Cancer) Surgery

Cancer of the External Genital Area (Vulvar Cancer)

These cancers usually cause no symptoms. The most common complaint is itching. Unfortunately, because it is often treated with simple creams for itching, diagnosis and therefore treatment are delayed. It often starts with a change in color or a painless swelling that may not seem very important. Raised white, gray, red or brown growths are usually seen. Before cancer develops, there are early precancerous stages called VIN. Vulvar cancer, that is, cancer of the external genital organs, ranks fourth among female genital cancers, after cervical, endometrial and ovarian cancers. It is generally thought to be caused by the human papillomavirus. Human papillomavirus is a type of virus that causes cancer of the cervix and also causes warts in the external genital area. HPV (human papillomavirus) types 16, 18, 31, 33 and 51 are commonly seen as cancer-causing strains. Factors such as chronic itching, moist skin in the external genital area, synthetic underwear and the dyes and detergents used on clothing, deodorants applied to the area, poor local hygiene and certain diseases of the external genital area (syphilis) are thought to play a role. Conditions such as diabetes, obesity and high blood pressure are considered to be diseases common at the age when this cancer appears, rather than causes of cancer in the external genital area. In these cancers, surgery is the preferred treatment, especially in the early stages. Advanced cases are treated with chemotherapy and radiation therapy.

Vaginal Cancers

The vagina (birth canal) is a muscular organ 8–10 cm long. Vaginal cancers may arise directly from the vagina or spread to the vagina from other organs (metastatic). Metastatic cancers, that is, cancers that spread to the vagina from other organs, are more common than primary vaginal cancers. For this reason, before a cancer seen in the vagina can be attributed to the vagina, other organs that could be the source of metastasis must be investigated. Radiation therapy is the preferred first-line treatment.

Cervical Cancers

Precancerous lesions of the cervix;

The widespread use of Pap smears, HPV screening and colposcopy in screening for cervical cancer has made it much easier to diagnose the precancerous stages that lead to cervical cancer, and allows this difficult and common disease to be detected at an early stage. What matters here is that treatment at the precancerous stages is 100% effective. With appropriate treatment and follow-up, there is not even any loss of fertility. This is a great advantage, especially for young people who have not yet completed their families.

Cervical cancer

Unfortunately, this is a type of cancer that can affect women who neglect Pap smear and HPV screening, which are now widely performed and easily accessible. Cervical cancer should not be confused with uterine cancer, because they are tumors with completely different characteristics. Cervical cancer is almost entirely caused by the HPV virus. Mild lower back and groin pain and brownish or pinkish discharge are its first symptoms. Diagnosis is made by taking a tissue sample (biopsy). The earlier the diagnosis, the smaller the treatment (surgery) needed and the higher its success.

When diagnosed early, simply removing part of the cervix (conization) may be enough. This is important because it preserves fertility, especially in young women. Otherwise, a simple hysterectomy or an extended hysterectomy (radical hysterectomy) may be needed. In advanced cases where surgery is no longer an option, treatment is given as a combination of radiation (radiotherapy) and medication (chemotherapy).

Uterine Cancer

Uterine cancer is the most common female genital cancer worldwide and in Türkiye. Its first and most important clinical sign is usually abnormal bleeding. Bleeding after menopause is especially significant and must always be investigated. Bleeding may also appear as a brownish discharge. If diagnosed early, uterine cancer is one of the cancers with the most encouraging results after appropriate surgery. Even in advanced cases, survival and quality of life can be greatly improved.

Ovarian Cancers

This is the most feared of the female genital cancers, because the disease is usually diagnosed at an advanced stage. No method for screening for ovarian cancer has been found yet. The most common complaints are abdominal bloating and groin and lower back pain. For now, the most useful approach is to advise women with such complaints to have a routine examination without delay. Unfortunately, because women in Türkiye often dismiss such complaints as “normal” and “it will pass,” ovarian cancer remains a very serious problem. Ovarian cancer is more common in women who have never married, given birth or become pregnant. Early diagnosis is especially important in these groups, because with early diagnosis the woman's fertility can be preserved.

In addition, the risk of ovarian cancer is higher in people with a family history of breast, bowel or uterine cancer. It is especially important for such individuals to be more vigilant. Treatment consists of appropriate, that is complete, surgery combined with chemotherapy.

Fallopian Tube Cancers

These account for 3 in 1,000 of all female genital cancers. They usually behave like ovarian cancer. The most common sign is bloody discharge and bleeding. They may also present with abdominal bloating and groin and lower back pain. Intermittent, cramping pain is typical of tubal cancers. The most common finding on examination is a mass. Treatment again consists of complete surgery combined with chemotherapy.