Gynaecological Cancers in Malaysia

Female Reproductive System

Breast cancer is the world’s most ‘famous’ cancer, receiving four times more funding than the top 2 killer cancers (lung cancer and colon cancer) despite both cumulatively killing 5 times more people. Thus, whenever the word “women” and “cancer” are in the same sentence, people inevitably think of breast cancer. However, Dr. Christina Lai of Sunway Medical Group warns of the ignorance of rarely talked about cancers that plague women, especially as early detection can save lives.


Gynaecological Cancers in Malaysia

What are gynaecological cancers?

In short, they are cancers that affect a woman’s reproductive system. This includes ovarian, cervical, uterine, vaginal and vulval caners.

What is an ovarian cancer?

Tumours that form on or in the lining of the ovaries, which includes the fallopian tubes are ovarian cancers. Cancers very rarely developed within the ovary itself.

What is uterine cancer?

Cancer that develops in the uterus, commonly from the lining of the uterus, or rarely, in the muscles of the uterus.

What is cervical cancer?

The most common type of cancer ‘down there’, cervical cancer occurs when abnormal cells on the cervix grow out of control, linked to the HPV virus. It is also one of the cancers that can be treated quite successfully if detected early (via a Pap smear). The cervix is the lower part of the uterus that opens into the vagina.

What are the signs and symptoms of these types of cancer?

Ovarian cancer: Early-stage rarely shows symptoms. Advanced-stage may be abdominal swelling, weight loss or bowel discomfort.

Uterine cancer: Abnormal bleeding from the vagina which may start as light bleeding accompanied by a watery discharge. This can be hard to tell for women who aren’t menopausal. Advanced-stage cancer may include back pains.

Cervical cancer: Usually asymptomatic (no symptoms). Abnormal bleeding may also be a sign, or pain during sexual intercourse may also be a symptom.

What are the risk factors of these cancers?

  • Age:
    • Women over 50 are more likely to develop cancer.
  • Genetics:
    • Risk increases by about 15% if two or more close relatives have been diagnosed with these cancers.  A mutation in the BRCA1 or BRCA2 gene (known for causing breastcancer) is also associated with an increased risk of ovarian cancer.
  • Hormone Therapy:
    • Hormone Replacement Therapy (HRT), oral birth contraceptives, and other hormone based interceptors have been known to raise risk factors in varying degrees.
  • Obesity:
    • Women who were obese in early adulthood are 50% more likely to develop ovarian cancer.
  • Exposure to virus:
    • Exposure to the human papillomavirus (HPV) or anything that causes immune deficiency.

What can I do to reduce the risk of these cancers?

  • Regular health checks, includes pap smears, pelvic exams, and checking the uterus and ovaries for size, shape and consistency.
  • Being physically fit and active
  • Have protected sex

How are these cancers diagnosed?

  • Genetic testing
  • Ultrasounds
  • CT scans / MRI
  • Blood Studies
  • Genetic testing
  • Pelvic exam
  • Pap smear

What is the treatment procedure for these cancers?

  • Surgery:
    • Removal of tumour or if needed, removal of organs.
  • Chemotherapy
  • Radiation therapy
  • Drugs
  • Combination of the above

Will fertility or reproductive ability be affected?

Yes, if not physically, then mentally. In come cancers, for example in ovarian cancer that only affects one ovary, a woman may still be able to get pregnant after the treatment process is stopped. Some cervical cancer treatments can adversely affect fertility, and the removal of organs in a hysterectomy will mean total inability to become pregnant. Chemotherapy or radiation therapy can also cause infertility right away by inducing early menopause. It is thus important to fully discuss the implications with your healthcare provider.

What are the statistics for cervical cancer in Malaysia?

Cervical cancer remains the second most common cancer among women in Malaysia and the fourth leading cause of death in women aged between 15 and 44. According to Globocan statistics (2012), there are about 2,145 new cases and 621 die from the disease in Malaysia every year.

What are the statistics for ovarian cancer in Malaysia?

Ovarian cancer is the fifth most common cancer among Malaysian women. Approximately 500 women are diagnosed with ovarian cancer every year in our country; of these, 90% are classified as epithelial ovarian cancer. Based on a preliminary study on the level of awareness of the risk factors of ovarian cancer among Malaysian women, they do not always seek help in a timelymanner where the gaps in awareness may influence screening uptake and presentation. This study was reported from the School of Health Sciences of University Sains Malaysia. It was found that 71.3% out of 87 women surveyed had a low level of awareness of ovarian cancer risk factors.

What are the common misconceptions on women’s cancer that in Malaysia?

  • Lack of urgency:
    • Women tend to delay seeing a doctor, and remain a state of hopeful denial, i.e out of sight, out mind. Even worse if after a diagnose is made, they dither on a treatment decision in fear of side effects, which may or may not be true.
  • Cultural influence:
    • Women don’t talk about these subjects, and many are shy to see doctors about anything related to genital and sexual health.

Dr. Lai emphasises that early detection saves lives, and women must act quickly and proactively in order to protect themselves from a cancer that can be treated successful with early detection.