COMMON FEMALE

CARCINOMA

OVARIAN CANCER
Cancer begins in cells, the building blocks that make
up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as
the body needs them. When cells grow old, they die,
and new cells take their place.
Sometimes, this orderly process goes wrong. New cells
form when the body does not need them, and old cells
do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor.
 The Ovaries
The ovaries are part of a woman's
reproductive system. They are in the pelvis.
Each ovary is about the size of an almond.
The ovaries make the female hormones --
estrogen and progesterone. They also
release eggs. An egg travels from an ovary
through a fallopian tube to the womb
(uterus).
When a woman goes through her "change of
life" (menopause), her ovaries stop
releasing eggs and make far lower levels of
hormones.

 
 OVARIAN CANCER
Ovarian cancer is a frustrating disease to
patients and health care providers because of
its silent onset and lack of warning symptoms
usually result in advanced disease by the time
of diagnosis.
• A woman with ovarian cancer has a threefold
and fourfold increased risk of breast cancer
and woman with breast cancer have an
increased risk of ovarian cancer.
Ovarian cancer
Ovarian cancer can invade, shed, or spread
to other organs:
Invade: A malignant ovarian tumor can
grow and invade organs next to the ovaries,
such as the fallopian tubes and uterus.
 
Shed: Cancer cells can shed (break off) from the main
ovarian tumor. Shedding into the abdomen may lead to
new tumors forming on the surface of nearby organs
and tissues. The doctor may call these seeds or
implants.
Spread: Cancer cells can spread through the lymphatic
system to lymph nodes in the pelvis, abdomen, and
chest. Cancer cells may also spread through the
bloodstream to organs such as the liver and lungs.
 
When cancer spreads from its original place
to another part of the body, the new tumor
has the same kind of abnormal cells and the
same name as the original tumor. For
example, if ovarian cancer spreads to the
liver, the cancer cells in the liver are actually
ovarian cancer cells.
The disease is metastatic ovarian cancer,
not liver cancer. For that reason, it is treated
as ovarian cancer, not liver cancer.
Doctors call the new tumor "distant" or
metastatic disease.
 Risk factors
A risk factor is something that may increase the
chance of developing a disease.

1.Family history of cancer: Women who have a mother,

daughter, or sister with ovarian cancer have an
increased risk of the disease. Also, women with a
family history of cancer of the breast, uterus, colon, or
rectum may also have an increased risk of ovarian
cancer.
If several women in a family have ovarian or
breast cancer, especially at a young age, this
is considered a strong family history. If you
have a strong family history of ovarian or 
breast cancer.
Genetic tests can sometimes show the
presence of specific gene changes that
increase the risk of ovarian cancer.
2. Personal history of cancer: Women who
have had cancer of the breast, uterus, colon,
or rectum have a higher risk of ovarian cancer.
3. Age over 55: Most women are over age 55
when diagnosed with ovarian cancer.
4. Never pregnant(Nulliparity): Older women
who have never been pregnant have an
increased risk of ovarian cancer.
5. Menopausal hormone therapy: Some
studies have suggested that women who
take estrogen by itself (estrogen without
progesterone) for 10 or more years may
have an increased risk of ovarian cancer.
6. Other Factors include the following:
 taking certain fertility drugs
 using talcum powder perineally
Being obese (high – fat diet).
 Smoking
 Alcoholism

° Having a risk factor does not mean that a

woman will get ovarian cancer.
Most women who have risk factors do not
get ovarian cancer. On the other hand,
women who do get the disease often have no
known risk factors, except for growing older.
Women who think they may be at risk of
ovarian cancer should talk with their doctor.
Benign and malignant cysts
An ovarian cyst may be found on the surface
of an ovary or inside it. A cyst contains fluid.
Sometimes it contains solid tissue too. Most
ovarian cysts are benign (not cancer).
Most ovarian cysts go away with time.
Sometimes, a doctor will find a cyst that does
not go away or that gets larger.
• These may be simply pathologic
enlargements of normal ovarian
constituents, the graafian follicle, or the
corpus luteum, or they may arise from
abnormal growth of the ovarian epithelium.
• These are tumors that are believed to arise
from parts of the ovum that disappear
normally as ripening (maturation)
takes place. Because their origin is
undefined, all that can be said is that they
are tumors made up of undifferentiated
embryonal cells.

The doctor may order tests to make sure

that the cyst is not cancer.
 SYMPTOMS
Symptoms
Early ovarian cancer may not cause obvious
symptoms. But, as the cancer grows,
symptoms may include:
1. Pressure or pain in the abdomen, pelvis, 
back, or legs.
2. A swollen or bloated abdomen.
3. Irregular menses and increasing
premenstrual tension.
4. Menorrhagia with breast tenderness.
5. Early menopause
6. Pelvic pressure
7. Dypepsia
8. Urinary frequency
9. Nausea, indigestion, gas, constipation, or 
diarrhea
10. Feeling very tired all the time.
11. Shortness of breath.
COMMON FEMALE
CARCINOMA
CERVICAL CANCER
 The Cervix
The cervix is part of a woman's reproductive
system. It's in the pelvis. The cervix is the lower,
narrow part of the uterus (womb).
The cervix is a passageway:
°The cervix connects the uterus to the
vagina. During a menstrual period, blood
flows from the uterus through the cervix into
the vagina. The vagina leads to the outside of
the body.
 ° The cervix makes mucus. During sex,
mucus helps sperm move from the vagina
through the cervix into the uterus.
° During pregnancy, the cervix is tightly
closed to help keep the baby inside the
uterus. During childbirth, the cervix opens
to allow the baby to pass through the
vagina.
 Risk Factors
1. Early age of first intercourse.
2. Early child bearing.
3. Multiple partners
4. Exposure to HPV.
5. Smoking
6. Exposure to diethylstilbesterol (DES) in
utero.
Diethylstilbestrol (Stilboestrol®), which is also
commonly called Stilboestrol®. It is used to treat 
prostate cancer.
Stilboestrol reduces the level of testosterone in the
body by making the brain think there are too many
sex hormones circulating in the body. When this
occurs, production of testosterone is 'switched off'.
This reduced level of testosterone can help to slow
down the growth of the cancer cells and may cause
the cancer to shrink in size.
7.Using birth control pills for a long time:
Using birth control pills for a long time (5 or
more years) may slightly increase the risk of
cervical cancer among women with HPV
infection. However, the risk decreases
quickly when women stop using birth
control pills.
 Incidence
One of the most common reproductive
cancer in women.
It occurs most commonly between 30-45
years of age, but can occur as early as 18
years of age.
Sexual activity has a relationship to the
incidence of cancer of the cervix.
It is more prevalent in those who have had
multiple sexual partners and several early
pregnancies.
It is believed that this type of cancer is an
STD.
 Symptoms
Early cervical cancers usually don't cause
symptoms. When the cancer grows larger,
women may notice one or more of these
symptoms:
1. Abnormal vaginal bleeding
° Bleeding after sexual
intercourse,douching, defecation or a 
pelvic exam.
°Bleeding that occurs between regular 
menstrual periods(metrorrhagia).
•Metrorrhagia refers to vaginal
bleeding unrelated to monthly
bleeding/menstruation.
It may be very slight, just enough to
spot the undergarments (“spotting”)
 and it is noted usually after some form of
trauma (intercourse, douching or
defecation). As the disease progresses, the
bleeding may become constant and may
increase in amount.
Menstrual periods that last longer and are
heavier than before.
Bleeding after going through menopause.
Increased vaginal discharge (Leukorrhea).
•Leukorrhea refers to whitish discharge
from the womb.
•Pelvic pain 
•Pain during sex
 Staging
To plan the best treatment, your doctor
needs to know the grade of the tumor and
the extent (stage) of the disease. The stage is
based on whether the tumor has invaded
nearby tissues, whether the cancer has
spread, and if so, to what parts of the body.
Usually, surgery is needed before staging
can be complete. The surgeon takes many
samples of tissue from the pelvis and
abdomen to look for cancer.
Your doctor may order tests to find out
whether the cancer has spread:
CT scan: Doctors often use CT scans to make
pictures of organs and tissues in the pelvis or
abdomen. An x-ray machine linked to a
computer takes several pictures. You may
receive contrast material by mouth and by
injection into your arm or hand. The contrast
material helps the organs or tissues show up
more clearly. Abdominal fluid or a tumor may
show up on the CT scan.
Chest x-ray: X-rays of the chest can show
tumors or fluid.
Barium enema X-ray: The barium outlines
the intestine on the x-rays. Areas blocked by
cancer may show up on the X-rays.
 Colonoscopy: This exam can help tell if
cancer has spread to the colon or rectum.
 
STAGES OF OVARIAN CANCER
These are the stages of ovarian cancer:
Stage I: Cancer cells are found in one or both
ovaries. Cancer cells may be found on the surface of
the ovaries or in fluid collected from the abdomen.
Stage II: Cancer cells have spread from one or both
ovaries to other tissues in the pelvis. Cancer cells
are found on the fallopian tubes, the uterus, or
other tissues in the pelvis. Cancer cells may be
found in fluid collected from the abdomen.
Stage III: Cancer cells have spread to tissues
outside the pelvis or to the regional lymph
nodes. Cancer cells may be found on the outside
of the liver.
Stage IV: Cancer cells have spread to tissues
outside the abdomen and pelvis. Cancer cells
may be found inside the liver, in the lungs, or in
other organs.
 
STAGES OF CERVICAL CANCER
The stage is based on where cancer is
found. These are the stages of invasive
cervical cancer:
Stage I: The tumor has invaded the cervix
beneath the top layer of cells. Cancer cells
are found only in the cervix.
Stage II: The tumor extends to the upper
part of the vagina.
It may extend beyond the cervix into nearby
tissues toward the pelvic wall (the lining of the
part of the body between the hips). The tumor
does not invade the lower third of the vagina or
the pelvic wall.
Stage III: The tumor extends to the lower part
of the vagina. It may also have invaded the pelvic
wall. If the tumor blocks the flow of urine, one
or both kidneys may not be working well.
Stage IV: The tumor invades the bladder or
rectum. Or the cancer has spread to other
parts of the body.
Recurrent cancer: The cancer was treated,
but has returned after a period of time
during which it could not be detected. The
cancer may show up again in the cervix or in
other parts of the body.
 TREATMENT
Local therapy: Surgery and radiation
therapy are local therapies. They remove or
destroy ovarian cancer in the pelvis. When
ovarian cancer has spread to other parts of
the body, local therapy may be used to
control the disease in those specific areas.
Local therapy: Surgery and radiation
therapy are local therapies. They remove or
destroy ovarian cancer in the pelvis. When
ovarian cancer has spread to other parts of
the body, local therapy may be used to
control the disease in those specific areas.
Because cancer treatments often damage
healthy cells and tissues, side effects are
common. Side effects depend mainly on the
type and extent of the treatment. Side effects
may not be the same for each woman, and
they may change from one treatment session
to the next.
Surgery
The surgeon makes a long cut in the wall of
the abdomen. This type of surgery is called a
laparotomy. If ovarian cancer is found, the
surgeon removes:
both ovaries and fallopian tubes (
salpingo-oophorectomy)
the uterus (hysterectomy)
 
the omentum (the thin, fatty pad of tissue
that covers the intestines) 
nearby lymph nodes
samples of tissue from the pelvis and
abdomen
 
 
If the cancer has spread, the surgeon removes
as much cancer as possible. This is called
"debulking" surgery.
If you have early Stage I ovarian cancer, the
extent of surgery may depend on whether you
want to get pregnant and have children. Some
women with very early ovarian cancer may
decide with their doctor to have only one ovary,
one fallopian tube, and the omentum removed.
If you haven't gone through menopause yet,
surgery may cause hot flashes, 
vaginal dryness, and night sweats. These
symptoms are caused by the sudden loss of
female hormones.
Chemotherapy
Chemotherapy uses anticancer drugs to kill
cancer cells. Most women have
chemotherapy for ovarian cancer after
surgery. Some women have chemotherapy
before surgery.
Usually, more than one drug is given. Drugs
for ovarian cancer can be given in different
ways:
By vein (IV): The drugs can be given through
a thin tube inserted into a vein.
By vein and directly into the abdomen:
Some women get IV chemotherapy along with
intraperitoneal (IP) chemotherapy. For IP
chemotherapy, the drugs are given through a
thin tube inserted into the abdomen.
 
By mouth: Some drugs for ovarian cancer
can be given by mouth.
SIDE EFFECTS:
The side effects depend mainly on which
drugs are given and how much.
Chemotherapy kills fast-growing cancer
cells, but the drugs can also harm normal
cells that divide rapidly:
 1. Blood cells: When chemotherapy
lowers the levels of healthy blood cells, the
patient is more likely to get infections,
bruise or bleed easily, and feel very weak
and tired.
• If levels are low, the physician may stop
the chemotherapy for a while or reduce
the dose of drug.
There are also medicines that can help your
body make new blood cells.
Cells in hair roots: Chemotherapy may
cause hair loss. If you lose your hair, it will
grow back, but it may change in color and
texture.
Cells that line the digestive tract:
Chemotherapy can cause a poor appetite,
nausea and vomiting, diarrhea, or mouth
and lip sores.
Other side effects include skin rash,
tingling or numbness in your hands and
feet, hearing problems, loss of balance, 
joint pain, or swollen legs and feet.
Radiation therapy
Radiation therapy (also called
radiotherapy) uses high-energy rays to kill
cancer cells. A large machine directs
radiation at the body.
Radiation therapy is rarely used in the
initial treatment of ovarian cancer, but it
may be used to relieve pain and other
problems caused by the disease.
Cervical Cancer: 2 Types of RT
External radiation therapy: A large
machine directs radiation at the pelvis or
other tissues where the cancer has spread.
The treatment usually is given in a hospital or
clinic. The patient may receive external radiation 5
days a week for several weeks. Each treatment
takes only a few minutes.
Internal radiation therapy: A thin tube is placed
inside the vagina. A radioactive substance is loaded
into the tube. You may need to stay in the hospital
while the
radioactive source is in place (up to 3 days). Or the
treatment session may last a few minutes, and you
can go home afterward. Once the radioactive
substance is removed, no radioactivity is left in
your body. Internal radiation may be repeated two
or more times over several weeks.
COMMON FEMALE
CARCINOMA

UTERINE CANCER
 The Uterus
The uterus is part of a woman's
reproductive system. It is the hollow, pear-
shaped organ where a baby grows. The
uterus is in the pelvis between the bladder
and the rectum.
The narrow, lower portion of the uterus is
the cervix.
The broad, middle part of the uterus is the
body, or corpus. The dome-shaped top of the
uterus is the fundus. The fallopian tubes
extend from either side of the top of the uterus
to the ovaries.
The wall of the uterus has two layers of tissue.
•The inner layer, or lining, is the
endometrium.
 The outer layer is muscle tissue called the
myometrium.
In women of childbearing age, the lining of the
uterus grows and thickens each month to
prepare for pregnancy. If a woman does not
become pregnant, the thick, bloody lining flows
out of the body through the vagina. This flow is
called menstruation.
 
Benign conditions of the uterus
1. Fibroids are common benign tumors that
grow in the muscle of the uterus. They occur
mainly in women in their forties. Women
may have many fibroids at the same time.
Fibroids do not develop into cancer. As a
woman reaches menopause, fibroids are
likely to become smaller, and sometimes
they disappear. 
It arise from the muscle tissue of the uterus.
They develop slowly between the ages 25 and
40 years and often become large in size after
this period.
Usually, fibroids cause no symptoms and
need no treatment. But depending on their
size and location, fibroids can cause bleeding,
vaginal discharge, and frequent urination.
Other symptoms are due to pressure on the
surrounding organs: pain, backache,
constipation and urinary symptoms.
In addition, such tumors often cause
metrorrhagia and even sterility.
If fibroids cause heavy bleeding, or if they
press against nearby organs and cause pain, the
doctor may suggest surgery or other treatment.
2. Endometriosis is another benign condition
that affects the uterus. It is most common in
women in their thirties and forties,
especially in women who have never been
pregnant.
It occurs when endometrial tissue begins to
grow on the outside of the uterus and on
nearby organs.
This condition may cause painful menstrual
periods, abnormal vaginal bleeding, and
sometimes loss of fertility (ability to get
pregnant), but it does not cause cancer.
Women with endometriosis may be treated
with hormones or surgery.
3.Endometrial hyperplasia is an increase in
the number of cells in the lining of the uterus.
It is not cancer. Sometimes it develops into
cancer. Heavy menstrual periods, bleeding
between periods, and bleeding after
menopause are common symptoms of
hyperplasia.
• It is most common after age 40.
To prevent endometrial hyperplasia from
developing into cancer, the doctor may
recommend surgery to remove the uterus (
hysterectomy) or treatment with hormones
 (progesterone) and regular follow up
exams.
Malignant Tumors of the Cervix
Malignant tumors. They are generally
more serious and may be life threatening.
Cancer cells can invade and damage nearby
tissues and organs. Also, cancer cells can
break away from a malignant tumor and
enter the bloodstream or lymphatic system.
The most common type of cancer of the
uterus begins in the lining (endometrium).
It is called endometrial cancer, uterine
cancer, or cancer of the uterus.
The term uterine cancer or cancer of the
uterus is used to refer to cancer that begins
in the endometrium.
 Risk Factors
Age. Cancer of the uterus occurs mostly in women
over age 50.
Endometrial hyperplasia. The risk of uterine cancer
is higher if a woman has endometrial hyperplasia.
Hormone replacement therapy (HRT). HRT is used
to control the symptoms of menopause, to prevent 
osteoporosis(thinning of the bones), and to reduce the
risk of heart disease or stroke.
Women who use estrogen without
progesterone have an increased risk of
uterine cancer. Long-term use and large
doses of estrogen seem to increase this risk.
Women who use a combination of estrogen
and progesterone have a lower risk of
uterine cancer than women who use
estrogen alone. The progesterone protects
the uterus.
Obesity and related conditions. The body makes
some of its estrogen in fatty tissue. That's why
obese women are more likely than thin women to
have higher levels of estrogen in their bodies. High
levels of estrogen may be the reason thatobese
 women have an increased risk of developing
uterine cancer. The risk of this disease is also
higher in women with diabetes or 
high blood pressure (conditions that occur in many
obese women).
Tamoxifen. Women taking the drug 
tamoxifen to prevent or treat breast cancer
have an increased risk of uterine cancer. This
risk appears to be related to the estrogen-
like effect of this drug on the uterus. Doctors
monitor women taking tamoxifen for
possible signs or symptoms of uterine
cancer.
Colorectal cancer. Women who have had
an inherited form of colorectal cancerhave a
higher risk of developing uterine cancer
than other women.
 
 Symptoms
Uterine cancer usually occurs after menopause.
But it may also occur around the time that
menopause begins. Abnormal vaginal bleeding
is the most common symptom of uterine cancer.
Bleeding may start as a watery, blood-streaked
flow that gradually contains more blood.
Women should not assume that abnormal
vaginal bleeding is part of menopause.
A woman should see her doctor if she has
any of the following symptoms:
Unusual vaginal bleeding or discharge
Difficult or painful urination
Pain during intercourse
Pain in the pelvic area
 Staging Uterine Cancer

These are the main features of each stage of the
disease:

Stage I -- The cancer is only in the body of the
uterus. It is not in the cervix.

Stage II -- The cancer has spread from the body of
the uterus to the cervix.


 
Stage III -- The cancer has spread outside the
uterus, but not outside the pelvis (and not to the
bladder or rectum). Lymph nodes in the pelvis
may contain cancer cells.

Stage IV -- The cancer has spread into the

bladder or rectum. Or it has spread beyond the
pelvis to other body parts.
 
 DIAGNOSIS
Physical exam: Your doctor checks general
signs of health. Your doctor may press on
your abdomen to check for tumors or an
abnormal buildup of fluid (ascites). A
sample of fluid can be taken for ovarian
cancer cells analysis.
I t is indicated in ovarian cancer.
Pelvic exam: Your doctor feels the ovaries and
nearby organs for lumps or other changes in their
shape or size.
 A Pap test is part of a normal pelvic exam, but it is
not used to collect ovarian cells. The Pap test
detects cervical cancer. The Pap test is not used to
diagnose ovarian cancer.
Blood tests: Your doctor may order blood tests.
The lab may check the level of several substances,
including CA-125. CA-125 is a substance found on
the surface of ovarian cancer cells and on some
normal tissues.
A high CA-125 level could be a sign of cancer or
other conditions. The CA-125 test is not used alone
to diagnose ovarian cancer.
and on some normal tissues for monitoring a
woman's response to ovarian cancer treatment and
for detecting its return after treatment.
Ultrasound: The ultrasound device uses sound
waves that people cannot hear. The device aims
sound waves at organs inside the pelvis. The waves
bounce off the organs. A computer creates a
picture from the echoes.
The picture may show an ovarian tumor. For
a better view of the ovaries, the device may
be inserted into the vagina (transvaginal
ultrasound).
Biopsy: A biopsy is the removal of tissue or
fluid to look for cancer cells. Based on the
results of the blood tests and ultrasound,
your doctor may suggest surgery (
laparotomy) to remove tissue and fluid
from the pelvis and abdomen. Surgery is
usually needed to diagnose ovarian cancer.
Laparoscopy may be used to remove a
small, benign cyst or an early ovarian cancer.
It may also be used to learn whether cancer
has spread.
Colposcopy: The doctor uses a colposcope
to view the cervix. The colposcope combines
a bright light with a magnifying lens to make
tissue easier to see. It is not inserted into the
vagina. A colposcopy is usually done in the
doctor's office or clinic.
Although most women have a laparotomy
for diagnosis, some women have a
procedure known as laparoscopy. The
doctor inserts a thin, lighted tube (a
laparoscope) through a small incision in the
abdomen. Laparoscopy may be used to
remove a small, benign cyst or an early
ovarian cancer.
Biopsy: Most women have tissue removed
in the doctor's office with local anesthesia. A
pathologist checks the tissue under a
microscope for abnormal cells.
 Endocervical curettage: The doctor
uses a curette to scrape a small sample of
tissue from the cervix. Some doctors may
use a thin, soft brush instead of a curette.