Gynaecological Cancers

The Gynaecology Cancer Service in the Belfast Health and Social Care Trust is provided at Belfast City Hospital. For information on the pathway patients follow when they are referred with suspected Gynae cancer, please follow the links on the right hand side of this page.

Please note that this section details services provided to adult patients of Belfast Trust. Please follow the link for information on Children’s Cancers.


  • There are 5 main Gynaecological cancers.

    Ovarian

    Most ovarian cancer are epithelial cancers. This term means that the cancer has started in the cells that cover the surface of the ovary.

    There are two common epithelial cancers of the ovaries :

    • Serous
    • Endometriod

    Less common types of epithelial ovarian cancer are:

    • Mucinous
    • Germ Cell Tumours (Ovarian Teratomas)
    • Clear cell
    • Undifferentiated or unclassifiable
    Vulval

    There are six types of vulval cancer:

    • Squamous Cell Carcinoma: This is the most common type of vulval cancer. It develops in the skin of the vulva from cells called squamous cells. This type of cancer usually takes years to develop.
    • Verrucous Carcinoma: This is a slow growing of squamous cell carcinoma which often looks like a large wart.
    • Vulval Melanoma: This develops from the pigment-producing cells that give the skin its colour. This is the second most common type of vulval cancer.
    • Adenocarcinoma: This develops from cells that line the glands in the vulval skin.
    • Basal Cell Carcinoma: This is found in the deepest layer of the skin of the vulva. It is generally slow growing and almost never spreads from the vulva.
    • Sarcomas: This develops from cells in tissue such as muscle or fat under the skin. They tend to grow more quickly than other types of vulval cancer.
    Cervical

    There are two main types of cervical cancer:

    • Squamous cell carcinoma: This is the most common type of cervical cancer. It develops from the flat cells which cover the outer surface of the cervix at the top of the vagina.
    • Adenocarcinoma: This type develops from the glandular cells which line the cervical canal (endocervix). As adenocarcinoma starts in the cervical canal it can be more difficult to detect with cervical screening tests.

    There are other, less common types of cancer of the cervix known as:

    • Adenosquamous carcinoma
    • Clear-cell carcinoma
    • Small-cell carcinoma
    Womb

    Womb cancer is also known as endometrial cancer and arises in the lining of the womb.

    There are four main types of womb cancer:

    • Endometrioid
    • Serous
    • Sarcomas
    • Clear cell
    Vaginal

    There are two main types of primary vaginal cancers and they are named after the cells from which they develop:

    Squamous cell: The most common type of vaginal cancer is called squamous cell. This is usually found in the upper part of the vagina, and most commonly affects women between the aged 50–70.

    Adenocarcinoma: This type of vaginal cancer usually affects women under 20, but may occasionally occur in other age groups.

    Other very rare types of vaginal cancer include:

    • Melanoma
    • Small cell carcinoma
    • Sarcoma
    • Lymphoma
  • Referral

    If a GP feels a patient has symptoms which may indicate a Gynaecological cancer, they will refer the patient to a Gynaecologist or a Gynae-oncologist (a specialist in Gynaecological cancers). Depending on what type of Gynaecological cancer is suspected the referral process might vary slightly. Some patients with suspected cervical or vulval cancer may be referred to a colposcopy clinic for a biopsy while other patients will be referred to an outpatient appointment at a gynae clinic.

  • Investigations and diagnosis

    Patients may be referred for a number investigations and scans in order to determine whether they have cancer. These investigations also allow doctors to make a diagnosis and see the extent of any disease.

    Some investigations are used for all types of Gynaecological cancer, while others are used only for specific types. Please follow the links below for more information:

  • Multi-disciplinary team

    In order to ensure the highest quality of care possible, patients diagnosed with cancer will be treated by a group of experienced Gynae-oncology specialists. This group is known as a multi-disciplinary team (MDT). The team includes:

    • Specialist surgeons
    • Clinical Oncologists
    • Medical Oncologists
    • Radiologists
    • Pathologists
    • Clinical Nurse Specialists
    • Palliative Care Team
    • Administration Staff

    The Gynae-Oncology MDT discusses patient cases during weekly meetings on Wednesday mornings in Belfast City Hospital. These discussions are important for diagnosing patients and deciding on the best treatment plan. Outcomes of these discussion will be sent to patient’s GP.

  • Treatment

    There are a number of treatments that can be used to treat Gynaecological cancers. For more information on the various types, please follow one of the links below:

    • Chemotherapy
    • Radiotherapy
    • Brachytherapy (Womb and Cervical cancer only)
    • Surgery
    • Specialist palliative care

    Before any sort of treatment is given by a doctor, patients must give their consent. This is an important process to make sure patients understand their treatment.

  • Follow up

    Patients who have had treatment for a Gynae cancer will have regular follow up appointments with their surgeon or oncologist. Patients should be aware of their follow up plan prior to leaving hospital after their treatment or results appointment.

    Patients who are not aware of their follow up program should contact their key worker, clinical nurse specialist or consultant to find out when they will be reviewed following treatment.

    Patients experiencing worrying symptoms that they think may be related to their cancer should get in touch with their GP, Clinical Nurse Specialist or Consultant as soon as possible.

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