Cancer and Pre-cancer

01
Endometrial Cancer
02
Ovarian Cancer
03
Cervical Cancer
04
Vulvar Cancer
05
Oncofertility Services
06
Pre-cancer Services
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01  Endometrial Cancer

Most endometrial cancers present with abnormal vaginal bleeding or bleeding after menopause. Fortunately, most endometrial cancers are diagnosed early due to their early warning signs. Majority of endometrial cancers can be operated laparoscopically (keyhole surgery). The organs that need to be removed will be the uterus, cervix, both fallopian tubes and ovaries, and some lymph nodes. If presumed early stage, removal of the sentinel node instead of removing all the pelvic lymph nodes can be done. This will reduce the risk of swelling in the lower limbs after surgery. The sentinel node is the most important node because it’s the first node that the cancer will spread to. If that node is tested negative for cancer, we can be rest assured that the rest of the lymph nodes in the pelvis are negative for cancer.

02  Ovarian Cancer

Unfortunately, ovarian cancer presents late due to the lack of specific symptoms. The main goal of surgery is to resect all the tumour, leaving no visible tumour in the abdomen and pelvis. The surgery includes removal of the uterus, cervix, both fallopian tubes and ovaries, lymph nodes, omentum, possibly the bowel if there is any involvement, and peritoneum (the lining tissue of the abdomen and pelvis) if there is any spread of disease. Numerous research studies have proven that optimal debulking surgery (surgery that leaves no visible tumour behind) will greatly enhance the chance of survival and even cure.

03  Cervical Cancer

In early stages, cervical cancer is mainly treated by surgery. Usually called a radical hysterectomy, the uterus, cervix, tissues at the side of the cervix called the parametrium, and a cuff of vagina, is removed. Lymph nodes will also need to be removed together with the specimen.

04  Vulvar Cancer

Vulval cancers can be treated by a radical vulvectomy together with removal of the inguinal lymph nodes. This surgery is commonly done together with a plastic surgeon to achieve good and adequate cosmesis to retain one’s dignity and self-esteem.

05  Oncofertility Services

Up till recently, oncology and fertility were seldom used in the same sentence. But increasingly, more and more women are being diagnosed with cancers at a young age when fertility is an important consideration. Management requires counselling by both oncologic surgeons and reproductive medicine specialists as treatment is individualized. It requires careful coordination of care to achieve the best possible oncologic outcomes at the same time preserving fertility.

06  Pre-cancer Services

Pre-cancers of the cervix are detected through screening either through HPV testing, PAP smear or both. Once pre-cancers are detected, a small procedure done to the cervix to either excise or ablate the lesion can be offered. The difference between the two procedures should be discussed with your gynaecologist as fertility concerns have to be considered.