These two separate systems of the body have been grouped together here for the convenience of description. Genito pertains to reproduction and urinary to formation and excretion of urine.
Cancer of the female genitals particularly the uterus and its cervix is very common in India, in fact, one of the commonest in the females.
Cancer of the Uterine Cervix
Cervix is the last part of the uterus which protrudes slightly into the vagina.
Cancer of the uterine cervix is common in Indian women, accounting for 25 to 50 per cent of all cancers in women seen in hospitals in different parts of India. Figures published in 1980 showed that in Guntur (Andhra Pradesh), cervical cancer accounted for 61.5 per cent, in Vishakhapatnam (Andhra Pradesh) 71.8 per cent, in Vellore (Tamil Nadu) 54.5 per cent, and in Calcutta 23.3 per cent, of all cancers in females. Cancer cervix is also widely present in countries of the South East Asia region.
Incidence of and mortality from cervical cancer has declined in Western countries considerably in recent decades. Hygienic measures, early detection by cervical cytology and effective treatment have contributed to this significantly.
Causes
Cervical cervix may have multiple causes. Important risk factors include poor genital hygiene, early marriage, early coitus, multiple sexual contacts and repeated childbirth. It is rare in nuns. On the other hand, prostitutes have a very high incidence of cancer cervix. Another observation is that cancer cervix is more common in the lower socio-economic groups than in the higher socio-economic groups, reflecting probably poor genital hygiene.
Symptoms
· Vaginal discharge mixed with blood.
· Bleeding in between periods or after the sexual act.
Diagnosis
· Routine: Physical check-up of the local part
· Blood: Hb may be low. TLC may show rise.
· DLC may show increase in polymorphs; this is due to infection.
· ESR is raised.
· Special: PAP smear test of the surface of the cervix is a must. This by itself can make the diagnosis of cancer. It can also detect the impending cancer, by seeing cells, which though not cancerous, yet are likely to become so.
A biopsy of the cervix is done and examined to confirm the diagnosis.
Treatment
It depends on the stage of the disease at the time of presentation to the doctor.
Surgery: If cancer has involved only the surface of the cervix, surgical removal of the cervix and the uterus provides complete cure. If the cancer has infiltrated the wall of cervix, either surgery or radiation is done. Mostly, either of them provide a cure. If the cancer has spread beyond the cervix, into the surrounding tissue or organs, surgery has no role.
Radiation: It is done in stage II, III, and IV of the cervical cancer. Radiation is given both externally as well as internally, by implantation of the radium needles into the cancerous area.
Radiation has many side-effects, such as infertility and early menopause, scarring and drying of the vagina, causing difficulty during intercourse and irritation of the bladder.
Chemotherapy: It has not proved very effective.
Prognosis
Detected and removed surgically in the earliest stage, it can be cured.
Prevention
PAP test in all women going to a gynaecologist is a must.
Early Detection
Signs & Symptoms
· Vaginal discharge mixed with blood.
· Bleeding in between periods or after the sexual act.
Investigations
· PAP smear test from the surface of the cervix.
· Biopsy examination of the involved part of the cervix.