Recurrences of gynaecological tumours

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Gynaecological tumours are neoplasms of the female reproductive tract that can begin in different places within a woman's reproductive system, including:

• Uterus
• Uterine cervix
• Ovaries
• Vulva
• Vagina
• Fallopian tubes
• Peritoneum

The main gynaecological malignancies can be divided into:

• Endometrial cancer (also called uterine cancer)
• Cervical cancer (also called invasive carcinoma of the uterine cervix)
• Ovarian cancer
• Melanomas of the uterine cervix and vagina (also called melanomas of the female genital tract)
• Adenoid cystic carcinoma of Bartholin's gland

Gynaecological tumours can be benign or malignant in nature and can develop as primary or secondary tumours.
Tumours of the female reproductive system can affect women of all ages; however, each gynaecological neoplasm has a different time frame of higher incidence.
Gynaecological tumours can be diagnosed early (and therefore more treatable) by regular visits to the gynaecologist and diagnostic tests such as Pap and HPV tests.

Causes of gynaecological tumours

The causes of gynaecological malignancies vary according to the type of tumour, but in general, the following conditions are considered risk factors:

• Genital tract infections, such as the infection of human papillomavirus (HPV)
• Debilitated immune system
• Cases of gynaecological cancer in the family
• Age
• Cigarette smoke
• A diet poor in fruit and vegetables, but rich in calories and fats
• Obesity
• Oestrogen dominance
• Diabetes
• Exposure to radiation, for instance, in previous radiation therapies
• Hereditary genetic alterations

Symptoms of gynaecological tumours

The symptoms of gynaecological malignancies may also vary depending on the nature of the tumour. In addition, in some cases these types of tumours are asymptomatic, especially at their early stages.
The following symptoms may be generally present in gynaecological tumours:

• Vaginal bleeding between periods
• Vaginal bleeding after menopause
• Vaginal bleeding after intercourse
• Unusual vaginal discharge
• Pelvic pain
• Abdominal pain
• Back pain
• Pain during sexual intercourses
• Swollen abdomen
• Frequent urination
• Aerophagia

Diagnosis of gynaecological tumours

In case a gynaecological tumour is suspected, an in-depth gynaecological exam is required to define a correct patient's medical history.
A series of tests must follow to reach an accurate diagnosis. These may include:

• Ultrasound scan 
• X-rays
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• A positron-emission tomography (PET) scan

After these tests, a biopsy is essential to confirm the diagnosis.

After a gynaecological tumour is diagnosed, its nature has to be evaluated. The staging system varies from one tumour to another, but in general these neoplasms are classified into four different levels, from the initial one (Stage I) to the most advanced one (Stage VI).

Treatment of recurrences of gynaecological tumours

The treatment of gynaecological malignancies varies according to a series of factors such as the nature, location and size of the tumour but without neglecting the patient's general medical condition.

In recurrences of gynaecological tumours, hadrontherapy is a potentially effective therapeutic option that permits, thanks to its greater biological efficacy, treating radio-resistant neoplasms as well, sparing the surrounding healthy structures.