The Ultimate Guide to Gynecological Cancer Symptoms and Treatments in the Philippines

#1 Cervical Cancer¹

When a woman’s cervical cells start to change or grow out of control, cervical cancer develops. The cervix is a low, narrow canal that connects the uterus and the vagina. Most cancer cells develop in either of the following:

• The squamous cells on the outer part of the cervix. In this case, squamous cell carcinoma occurs.
• The glandular cells inside the cervix. In this case, adenocarcinoma develops.

There are times both or none of these cells are involved in the development of cervical cancer.

Symptoms:

Unfortunately, most early-onset cervical cancers exhibit little to no symptoms. More advanced cancers involve the following:

• Abnormal vaginal bleeding
• Spotting in between periods
• Foul and heavy vaginal discharge, often including blood
• Pelvic and/or back pain
• Experiencing pain and bleeding during and after intercourse 

If you are experiencing any of these symptoms and suspect cervical cancer, consult your doctor immediately.

Causes and Risk Factors:

Like with all types of cancers, an overgrowth of abnormal cells causes cervical cancer.

However, the most common cause of cervical cancer is the  human papillomavirus (HPV). While this common sexually transmitted disease is usually harmless, it can lead to the growth of cancer cells. Then, this growth can lead to a tumor, which can spread the cancer to other cells in the body.

Unprotected, regular sexual activity with different partners is a definite risk factor for both cervical cancer and HPV. Other risk factors include the following:

• Contracting other sexually transmitted diseases
• Starting sexual activity at an early age
• Taking oral contraceptives, especially if done long-term (5+ years)
• Age, as younger women are less susceptible to cervical cancer
• Health conditions that lead to a weakened immune system
• Regular smoking
• Miscarriage prevention drugs such as diethylstilbestrol, which you could’ve been exposed to if your mother took them in her lifetime

Prevention:

Like with all illnesses, cervical cancer can be prevented! See some screening and prevention methods we recommend below:

Practicing Safe Sex

We recommend limiting the number of your sexual partners. No matter the number, however, an honest discussion about STIs must come up for your own protection. Ask your partner to take a test to reassure both of your health concerns.

We also recommend using condoms, dental dams, diaphragms, and other forms of contraception to reduce your risk.

Routine Pap Tests

Pap tests or smears are primarily for detecting early cervical cancer. The doctor collects cells from your cervix in conjunction with a pelvic exam.

Pap smears are recommended for people aged 21 and up every year. Start going to your doctor today — or don’t miss that next appointment!

HPV Tests  

Alongside pap smears, HPV tests are also the norm for cervical cancer screening. Just like pap smears, doctors collect cells and check them for HPV risk. With the strong link between HPV and cervical cancer, an HPV test can detect both the existence of HPV and possible cancer cells².

Visual Inspection

If, for some reason, both a pap smear and HPV test is unavailable, a visual inspection can be done instead. A white vinegar dilution is applied to the cervix. Your healthcare provider can detect abnormalities as they turn white after the vinegar is applied.

The HPV Vaccine

HPV vaccines are available for children, teens, and adults.

Preventing HPV is a strong start to preventing cervical cancer now and in the future. The cost of an HPV vaccine in the Philippines ranges from PHP 2,500 to PHP 7,500.³

If you’re a parent, you can start your children on the HPV vaccine as young as nine years old. It doesn’t hurt to get one for yourself, either!

Lifestyle Changes

If you’re smoking, we recommend quitting. If you’re not smoking, don’t start. A history of smoking is strongly linked to the development of cervical cancer.

Other lifestyle changes also include eating a balanced diet and leading an active lifestyle to make sure your body stays fit and healthy.

Treatments:

After screenings including pap smears and HPV tests, diagnosis can be done via biopsies and curettages.

Once cervical cancer is confirmed, imaging tests and visual examinations are done in order to determine the stage the cancer is in. There’s a chance that the cancer may have spread beyond the cervix.

For treatment, the following options are available:

• Surgery. This can be done on just the cancer, the cervix, or the cervix and uterus.
• Radiation therapy. High-powered radiation beams can target affected areas externally, or inside the vagina itself.
• Chemotherapy. Chemotherapy is usually done alongside radiation therapy for better results.
• Immunotherapy. The immune system needs all the help it can get! Immunotherapy helps your immune system fight against the growth of cancer cells.
• Supportive care. This type of care is done alongside all treatments to relieve symptoms and provide support with the help of doctors and loved ones.

#2 Ovarian Cancer⁴

Cancer beginning in each of the ova in the reproductive system is called ovarian cancer. As soon as mutations in the cells begin, cancer grows and spreads. Currently, there are three known types of ovarian cancer:

• Germ cell tumor. Known as a rare type of ovarian cancer and can occur at younger ages.
• Epithelial ovarian cancer.  The most common cancer with several subtypes.
• Stromal tumors. Rare tumors that can be diagnosed at an earlier stage.

To find out if you have ovarian cancer, keep an eye out for the symptoms below:

Symptoms:

These symptoms may seem like natural side-effects of a woman’s monthly cycle or other normal circumstances, but shouldn’t be taken lightly:

• Looking and feeling bloated
• Sudden weight loss
• Urgent and frequent urination
• Fatigue and exhaustion
• Back and pelvic pain
• Constipation
• Pain during intercourse

All sound familiar? Don’t panic – these symptoms are common with so many other diseases. However, what you should watch out for is the persistence and severity of such symptoms.

Causes and Risk Factors:

• Genes. Gene changes are inherited and are causes of ovarian cancer. At-risk genes include BRCA1, BRCA2,  BRIP1, RAD51C and RAD51D, the latter three being linked to Lynch syndrome. You can undergo genetic testing to know for sure⁵.
• Undergoing HRT (hormone replacement therapy). Hormonal replacement therapy increases the risk of ovarian cancer, especially when taken after menopause.
• Age. The older you are, the riskier it is.
• Never having been pregnant or never using oral contraceptive pills.
• Endometriosis. When uterine lining grows outside of your uterus, it is called endometriosis. If you have this, you are more at risk for ovarian cancer.
• Obesity. Heavier weight leads to a risk of ovarian cancer.

Prevention:

Aside from keeping your weight in check and leading a healthy, active lifestyle, there’s not much that can prevent ovarian cancer. To reduce your risk, speak to a doctor.

Together with a specialist, you can undergo pelvic exams, imaging, and tests. You can also go through genetic testing to determine your risk.

A doctor may suggest taking birth control pills to reduce ovarian cancer risk. Discuss if this is an option, or if fully removing your ovaries may be one as well.

Treatments:

There are multiple possible treatment options for ovarian cancer:

• Surgery. You can undergo surgery to remove one ovary, both ovaries, or both ovaries and your uterus. The last two surgery options are for extensive ovarian cancer. For removing only one ovary, the cancer is still early and hasn’t spread just yet.
• Chemotherapy and targeted therapy. Both these options target and kill cancer cells and weaknesses within them.
• Immunotherapy. This may or may not be an option for ovarian cancer, but it basically boosts your immune system to help fight cancer cells.
• Hormone therapy. Used greatly on slow-growing ovarian cancers, hormone therapy blocks the effects of estrogen and progesterone on the body to control cancer growth.
• Supportive care. Supportive care is done alongside all the other treatments to relieve pain and symptoms from both the treatments and the cancer itself.     

#3 Vaginal Cancer⁶

Just like cervical cancer, vaginal cancer is strongly associated with a HPV diagnosis. Most of the growth occurs in the vaginal surface, glandular cells, or in the muscles of the vaginal walls.

Symptoms:

Vaginal cancer would need to progress before the following symptoms occur:

• Abnormal vaginal bleeding. If you bleed during sex, between periods, or after menopause, count it as abnormal bleeding. Bloody, watery discharge is also counted as a symptom.
• Urination problems. Frequent or painful urination is a common symptom of vaginal cancer.
• Pelvic problems. Pelvic pain, back pain, and constipation are also common symptoms.
• A mass in your vagina. A lump or mass in your vagina is indicative of vaginal cancer.

Causes and Risk Factors:

There is no clear cause related to vaginal cancer. However, the following may contribute to your risk:

• HPV and HIV. Being infected with HPV and/or HPV increases your chances of contracting vaginal cancer. HPV is especially risky — it can cause vaginal intraepithelial neoplasia, which leads to vaginal, cervical, and even vulvar cancer.
• Age. The older you are, the higher your chances are of getting vaginal cancer.
• Exposure to miscarriage prevention drugs. Your mother may have taken diethylstilbestrol or DES, which increases your risks.
• Regular sexual activity. Having multiple partners can lead to HPV or HIV, which then increases your risk of vaginal cancer.
• Smoking. While not a direct cause, there has been an established link between smoking and developing vaginal cancer.

Prevention:

There is no direct prevention for vaginal cancer. However, you can take the steps below to reduce your risk:

Undergo Regular Pelvic Exams

Don’t miss a doctor’s appointment! Pelvic exams, including pap smears, can determine whether or not you’re at risk for vaginal and cervical cancer.

At the same time, you can undergo vaginal inspection, such as colposcopy. It’s a type of screening for vaginal cancer that uses a magnifying instrument.

Get the HPV Vaccine

The HPV vaccine can prevent future occurrence of vaginal and cervical cancer. Get it at your nearest clinic or local healthcare center — it’s available for children, teens, and adults.

Lead a Healthy Lifestyle

Quit smoking — it has a direct impact on your overall health and is linked to different gynecological cancers.  Eating clean and leading an active lifestyle also helps!

Treatments:

• Surgery. You may undergo surgery for the removal of small tumors, the vagina, or the majority of your pelvic organs if the cancer has already grown and spread. If you’re worried about the aftermath, don’t worry too much — there are options available for vaginal reconstruction.
• Radiation. Radiation therapy can target cancer cells either externally or internally. So, the radiation may be directed at your entire abdomen or inside your vagina.
• Clinical trials. New treatment methods are constantly explored with vaginal cancer. You can sign up for one if you feel like it — just remember that a cure isn’t guaranteed.
• Supportive care and chemotherapy. Like with all types of cancer, chemotherapy and supportive care to manage symptoms are options.

#4 Vulvar Cancer⁷

The vulva is the outer skin of the vagina, encompassing the urethra, clitoris, and labia. Vulvar cancer can happen at any age, and usually comes in the form of itchy lumps around the vulvar area. It can affect and inflame the labia.

Symptoms:

Aside from lumps, here are other tells to watch out for:

• Abnormal bleeding. Bleeding between periods, during intercourse, or after menopause is a cause for concern.
• Pain, tenderness, and itchiness. Your vulva may be uncomfortable during this point. When it reaches a level of persistence and severity, make sure to check with your doctor.
• Thickening and skin changes. You’ll notice the texture or color of the vulva becoming distinct.
• Open sores. Aside from lumps, vulvar cancer may take the form of open sores and wart-like bumps.

Causes and Risk Factors:

There are currently no known causes for vulvar cancer, but there are some risk factors to keep in mind:

• Age. Older people tend to get vulvar cancer more than any other age group.
• HPV. Exposure to HPV can lead to vaginal, cervical, and vulvar cancer.
• Skin conditions involving the vulva. Anything that causes the vulva to itch, become inflamed, or tender can lead to cancer — especially if the condition is lichen sclerosus.
• Precancerous conditions involving the vulva. Precancerous conditions, like vulvar intraepithelial neoplasia, can lead to cancer.
• Smoking. Smoking is directly linked to the development of numerous cancers.
• Weakened immune system. Any condition, medication, or circumstance that can weaken the immune system can lead to a higher risk of vulvar cancer.

Prevention:

Like with vaginal and cervical cancers, we suggest doing the following:

• Quit smoking. It’s highly linked to too many cancers to keep up the habit!
• Practice safe sex. Screen your partners, have an honest conversation about previous or present diseases, and use contraceptives. If either one of you suspects that you have an STD, get checked immediately.
• Go to your doctor for a pelvic exam. A routine check-up of your body and its reproductive system can save your life. They can catch signs of vulvar cancer early on!
• Get vaccinated. Get the HPV vaccine wherever it’s available.

Treatments:

The following treatments are possible for vulvar cancer:

• Surgery.
  • Laser surgery.  If the cancer is still non-invasive, this option can be explored. The cancer cells are cut out using lasers instead of making an incision.
  • Excision.  Here, both normal tissue and cancer cells are removed under surgery.
  • Vulvectomy.  The entire vulva is removed. This is usually done if the cancer is already extensive and could spread to other parts of the body.
  • Lymph node removal. If the cancer has spread to your lymph nodes, then it’s time for them to get the cut, too.
• Radiation therapy. Targeted beams can kill cancer of the vulva. It can shrink cancers and can be effective, especially when used in tandem with chemotherapy.

#5 Endometrial or Uterine Cancer⁸

Uterine cancer starts in the lining of the uterus, or the endometrium. You can have either endometrial cancer, which is more common, or uterine sarcoma, which is rarer. Unlike other gynecological cancers, uterine cancer can be detected early because of its exhibited symptoms:

Symptoms:

• Frequent abnormal bleeding
• Pelvic pain

Yes, there are only two symptoms, but it’s enough to cause alarm. If you’re experiencing both of these symptoms, look into the severity and persistence of the bleeding and pain.

Causes and Risk Factors:

• Hormonal conditions. Fluctuating hormones can put you at risk for endometrial cancer. Some of these conditions include polycystic ovarian syndrome, Lynch syndrome, or simply the habit of taking estrogen without any progesterone. Increased estrogen secretion is strongly linked to endometrial cancer.
• Obesity. Excess body fat also affects how your hormones are balanced. Obesity also leads to diabetes, another risk factor for cancer.
• Age. The older you are, the higher your likelihood to develop uterine cancer.
• Menstrual conditions. If you started your period early or your menopause late, you may be at risk. Never having been pregnant is a risk factor as well.

 

Prevention:

Uterine cancer prevention is pretty straightforward. Due to the nature of uterine cancer, you should maintain a healthy weight.

For those who have undergone menopause, check with your doctor if hormone therapy is a possibility. Taking birth control pills will also help.

Treatments:

• Surgery. With uterine cancer, you may have to undergo hysterectomy (uterine removal) or salpingo-oophorectomy (fallopian tube and ovary removal).
• Radiation therapy and hormone therapy. Hormones can either encourage more or lower hormones in the body, while radiation targets cancer cells with high-energy beams.
• Chemotherapy and immunotherapy. After surgery, chemotherapy can kill off more cancer cells, if there are any. Immunotherapy, meanwhile, helps with more advanced cancers.

After surgery, you may not be able to become pregnant. You may also experience menopause once your ovaries are removed.

Financial and Medical Assistance for Cancer in the Philippines

Where can you get financial and medical assistance for cancer in the Philippines?

Luckily, there are several financial assistance programs for cancer to choose from in the country:

• The Department of Health’s Medical Assistance Program
•  PCSO’s Individual Medical Assistance Program (IMAP)
• SSS Philippines Medical Assistance
• NGOs, such as Pink for Life or Soroptimist Ortigas Foundation

You can also apply for a PWD ID in the Philippines. For more information about financial assistance regarding cancer in the Philippines, read our article here.

How the NICCA Can Help

The National Integrated Cancer Care Act (NICCA) can help women affected by gynecological cancers. Among other provisions, the NICCA aims for the following:

• Alleviation of cancer treatment’s financial costs through instantaneous classification of cancer patients as persons with disabilities;
• Early detection efforts for would-be patients;
• Mandatory workplace policies regarding cancer patients; and
• Innovative cancer research that can treat or cure the disease, as well as improving the patient’s overall quality of life⁹.

However, the NICCA is yet to be fully implemented. You can view the petition for its full implementation along with the four provisions we’ve mentioned here.

In Conclusion

Gynecological cancers are concerning, but they’re all preventable and treatable. We hope this article helped you gain some insight — and helped you out regarding financial assistance in the Philippines, too!

Let us know if you enjoyed this article. We’ll see you in the next one!

References

1. Mayo Foundation for Medical Education and Research. (2021, June 17). Cervical cancer. Mayo Clinic. Retrieved July 11, 2022, from https://www.mayoclinic.org/diseases-conditions/cervical-cancer/symptoms-causes/
2. HPV and cancer. National Cancer Institute. (n.d.). Retrieved July 11, 2022, from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
3. Tacio, H. D. (2021, February 10). Cervical cancer: Second-most common cancer among women: Henrylito D. tacio. BusinessMirror. Retrieved July 14, 2022, from https://businessmirror.com.ph/2019/05/16/cervical-cancer-second-most-common-cancer- among-women/
4. NHS. (n.d.). NHS choices. Retrieved July 11, 2022, from https://www.nhs.uk/conditions/ovarian-cancer/
5. Centers for Disease Control and Prevention. (2019, June 10). Genetic testing for hereditary breast and ovarian cancer. Centers for Disease Control and Prevention. Retrieved July 11, 2022, from https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/testing.htm#
6. Mayo Foundation for Medical Education and Research. (2019, July 25). Vaginal cancer. Mayo Clinic. Retrieved July 16, 2022, from https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20 352447
7. Vulvar cancer. Johns Hopkins Medicine. (2021, August 8). Retrieved July 16, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/vulvar-cancer
8. Mayo Foundation for Medical Education and Research. (2021, May 20). Endometrial cancer. Mayo Clinic. Retrieved July 16, 2022, from https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/sy c-20352461#:~:text=Endometrial%20cancer%20is%20a%20type,is%20sometimes%20c alled%20uterine%20cancer.
9. Implementing rules for cancer act signed: Department of Health Website. IMPLEMENTING RULES FOR CANCER ACT SIGNED | Department of Health website. (n.d.). Retrieved July 16, 2022, from https://doh.gov.ph/press-release/implementing-rules-for-cancer-act-signed

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