Cancer Screening / Diagnostics
Screening is the process of testing, reliably and accurately, for early signs of a disease such as cancer, before any symptoms develop. It works on the concept that prevention is better than cure. Screening and early cancer detection are largely dependent on the skills and experience of the examiner.
Of all gynaecological cancers, cervical cancer is the main condition with an established screening programme. Since it was introduced in 1964, cervical cancer has become largely preventable. Additionally, research has led to the development of a primary preventative vaccine in 2006. A colposcopy is a simple procedure offered by our clinic, it is aimed to look at the cervix, the lower part of the womb at the top of the vagina. It is indicated if cervical screening finds abnormal cells in the cervix. These cells often go away on their own, but sometimes there is a risk they could eventually turn into cervical cancer if not treated. A colposcopy can confirm whether the cells in the cervix are abnormal and determine whether you need treatment to remove them.
There are three types of ovarian cysts: benign, borderline and cancerous. Accuracy in diagnosis often result in better management. The most important risk factor for the development of ovarian cancer is a family history of the disease. Screening for ovarian cancer is a service we offer for members of families with current or past history of ovarian cancer. This involves offering high resolution Pelvic Ultrasound, blood tests and close collaboration with clinical genetics specialists. Ultrasound can detect the majority of early stage ovarian cancers. If an ovarian cyst is found, this does not necessarily mean there is a serious problem. As often these cysts can simply be monitored without intervention. However, should an ovarian cyst be detected, with features suggestive of an early cancer, then surgery with an accredited surgeon trained in gynaecological oncology would be advised and facilitated.
Abnormal Uterine Bleeding (AUB) can occur before or after the menopause. The menopause is defined as the ending of menstrual periods for greater than one year. In the United Kingdom, the average age of the menopause is 52 years. In the majority of cases with AUB the examination findings are not worrying, and any pathologies detected can be easily treated. However, in a small minority of women AUB may be due to underlying changes within the lining of the uterus (endometrium) which could be more concerning such as endometrial hyperplasia (pre-cancerous changes) or cancer. Should you develop AUB, it is important to carry out the appropriate investigations in a step-wise approach. The first step is Pelvic Ultrasound, this is considered essential in detecting abnormalities causing AUB, such as polyp, fibroid, hyperplasia or cancer. The ultrasound accuracy is largely operator dependant, hence the importance of having it with highly experienced examiner. Should ultrasound raise the suspicion of an endometrial pathology, then Diagnostic Hysteroscopy is indicated as the next step. It is a procedure that allows your consultant to diagnose and often treat causes of AUB. It is done using a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus, with the aim to obtain a small tissue sample from the endometrium, called Endometrial Biopsy. This will be sent to the laboratory so it can be examined under a microscope to see if the cells are cancerous, and the results will be communicated with you by Mr Naji at a follow up appointment.
Vaginal / Vulval health
Vulval intraepithelial neoplasia (VIN) is a disease of the vulval skin (this is the skin surrounding the vaginal opening). It may also be associated with similar changes in the cervix, vagina and around the bottom. VIN may occur anywhere on the vulval skin and may occur at more than one site. VIN is not cancer. In some women it may disappear without treatment, in other women, if the changes are more severe, there is a chance that cancer could develop. This is why it is called a pre-cancerous condition. The symptoms of VIN vary, some women have no symptoms, other women may experience some or all of the following symptoms: - Itching - Pain - Changes to the vulval tissues, such as thickened, raised, red or white patches of skin - Discomfort or pain during sex If VIN is suspected, we will examine your vulva and may use a special microscope (Colposcope). This magnifies the area so that any changes can be clearly seen. We may also take a clinical photograph for your medical record. We will then take a small sample of cells from the affected area (Biopsy). Before taking the biopsy, we we will numb the area using a local anaesthetic injection, this is to ease any discomfort that may be experienced. The biopsy will be sent to the laboratory so it can be examined under a microscope to see if the cells are cancerous, and the results will be communicated with you at a follow up appointment.