Gynaecological Cancer

Screening and prevention

Regular gynaecological screening plays a vital role in the early detection of cancer and pre-cancerous conditions. The most important screening tools include:

• Cervical smear test (Pap test) — recommended every 3 years from age 25, following two normal annual tests. From age 30, HPV testing every 5 years is now the preferred strategy
• HPV vaccination — protects against the high-risk human papillomavirus strains responsible for the vast majority of cervical cancers. Recommended for girls and boys from age 11
• Pelvic ultrasound — used to evaluate abnormal bleeding, ovarian cysts, or endometrial thickening
• Endometrial biopsy — indicated for postmenopausal bleeding or abnormal endometrial appearance on imaging

Cervical cancer

Cervical cancer develops from persistent infection with high-risk HPV strains. It progresses through identifiable pre-cancerous stages (CIN — cervical intraepithelial neoplasia), offering a window for early intervention.

• Pre-cancerous lesions (CIN) — detected by cervical smear and colposcopy. Low-grade lesions are monitored; high-grade lesions (CIN 2–3) are treated by LLETZ (loop excision) or conisation to remove the abnormal tissue while preserving the cervix
• Early-stage cervical cancer — may be treated with conisation alone (for very early microinvasive disease) or radical hysterectomy with lymph node assessment
• Advanced disease — managed with chemoradiotherapy, with surgery reserved for specific indications

Fertility-sparing options such as trachelectomy (removal of the cervix while preserving the uterus) can be discussed in selected early-stage cases in women wishing to conceive.

Endometrial cancer

Cancer of the uterine lining is the most common gynaecological cancer in developed countries. It typically presents with abnormal vaginal bleeding, making early diagnosis possible in the majority of cases.

• Risk factors — obesity, diabetes, prolonged unopposed oestrogen exposure, polycystic ovary syndrome, tamoxifen use, and a family history of endometrial or colorectal cancer (Lynch syndrome)
• Diagnosis — transvaginal ultrasound to measure endometrial thickness, followed by hysteroscopy and endometrial biopsy for histological confirmation
• Surgical treatment — total hysterectomy with bilateral salpingo-oophorectomy (removal of uterus, tubes, and ovaries) is the standard treatment. Sentinel lymph node biopsy helps determine whether the cancer has spread, avoiding unnecessary extensive lymph node dissection
• Adjuvant therapy — radiotherapy, chemotherapy, or hormone therapy may be recommended depending on the stage and grade of the tumour

Ovarian cancer

Ovarian cancer is often called the “silent killer” because its symptoms are vague and nonspecific in early stages. It is frequently diagnosed at an advanced stage, which makes awareness and prompt investigation critical.

• Symptoms to watch for — persistent bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, urinary frequency or urgency. While common, these symptoms should be investigated if new, persistent, and unusual for you
• Diagnosis — pelvic ultrasound, CA-125 blood test, and CT or MRI imaging to assess the extent of disease
• Surgical treatment — optimal debulking surgery aims to remove all visible tumour. This may include hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and peritoneal biopsies
• Chemotherapy — platinum-based chemotherapy is the standard adjuvant treatment, sometimes given before surgery (neoadjuvant) to reduce tumour burden
• Genetic testing — BRCA1/2 testing is recommended for all ovarian cancer patients, as it influences treatment choices (e.g., PARP inhibitors) and has implications for family screening

Multidisciplinary care

Every gynaecological cancer case is reviewed at a multidisciplinary tumour board meeting (RCP — Réunion de Concertation Pluridisciplinaire), bringing together gynaecological surgeons, medical oncologists, radiation oncologists, pathologists, and radiologists. This collaborative approach ensures that each patient receives an evidence-based, individually tailored treatment plan.

Dr. Maazouzi is committed to providing compassionate care throughout the cancer journey — from initial investigation and diagnosis, through surgical treatment, to long-term follow-up and survivorship support.