Gynaecological Cancer | Surgical Menopause Prevention
Early detection of gynae cancers changes lives!
In 2014, Dafina Malovska was living a normal life, doing all the things that young people do; building a career, working long hours, travelling, making friends and generally enjoying life.
But while she was planning her future, she didn’t know that her life was in danger. She had no idea that she had a tumour growing that would eventually weigh 500g, lead to her losing uterus and ovaries and send her straight into surgical menopause.
Dafina shares her experience of the cancer surgery that lead to surgical menopause and her plans to shake up women’s health screening in the UK.
PP: What were the early signs that something was wrong?
DM: In July 2014 I started becoming very bloated, which was unusual for me. I saw my GP almost 4 months in a row, but she didn’t touch or examine my abdomen once. She sent me to see a gastroenterologist who failed to find anything and recommended I take Activia Yogurt.
After a few months of constant bloating, I started bleeding between my periods. I knew that something wasn’t right. I went to see a different GP who referred me to a gynaecologist.
PP: How did a pelvic floor examination change your life?
DM: Before the UK appointment came through I ended up seeing a private gynaecologist on a visit home to North Macedonia. At the first appointment, I had a complete pelvic examination, including a transvaginal ultrasound, where a huge 14cm-long tumour was discovered on my uterus. I was immediately booked in for an operation that I hoped would save my uterus, so that one day, I could still have children
On waking up from the operation, I was devastated to be told that I had stage 2 womb cancer and it had spread to my ovaries. I would need immediate surgery to remove my uterus and ovaries to prevent the cancer from spreading and, to ultimately save my life. I discussed all options with the surgeon and asked if I could freeze my eggs. As I had a very rare type of cancer, Leiomyosarcoma which is oestrogen receptive, this option was out of the question.
That evening I had a total hysterectomy. My plans of having my own big family had completely disappeared. Not only would I not be able to have my own children, after the operation I went into immediate surgical menopause.
PP: How has surgery affected you?.
DM: It’s been 5 years since the operation. Every day I deal with the consequences of early menopause - hot flushes, night sweats, vaginal dryness, loss of libido, mood swings, and osteopenia (lower bone density). I am only 40 years old.
But I’m happy that I’m still alive and I can share my story. I wouldn’t want what happened to me to happen to anyone else, especially as it may have been prevented, simply by being detected earlier. Sadly, all too often we hear how women in the UK are diagnosed with gynaecological cancer, too late.
PP: Do you think screening for gynaecological cancer is effective?
DM: Did you know that women in the UK are only tested for 1 out of the 5 gynaecological cancers?
Cervical screening, the preventative smear test, is the only reproductive health test available, yet it only detects the likelihood of one type of gynaecological cancer, cervical cancer. Whilst 3,000 women are diagnosed every year with cervical cancer, over 18,000 are diagnosed with the other 4 types of cancers for which there is no screening at all. I wonder how many of these women are diagnosed too late?
According to Cancer Research UK, over 21,000 women are diagnosed every year - that’s 58 per day - with one of the 5 gynaecological cancers:
Womb - 9,300
Ovarian - 7,300
Cervical - 3,000
Vulval - 1,300
Vaginal – 240
On average, 21 women in the UK die each day because of late diagnosis of gynaecological cancer.
Only a few months before my own diagnosis of womb cancer, I had a smear test which showed that everything was normal. Had I had the chance to see a specialist in women’s health at least ONCE in the previous years and had a full check-up including pelvic examination, my tumour which grew to 14cm long and weighed 500g, would have been discovered much earlier. I would have had a chance to remove it before it spread to my other organs.
PP: What changes would you like to see in women’s health ?
DM: The UK’s current approach to healthcare is reactive rather than preventative, with a symptom-driven system that relies on us discovering an issue ourselves and then going to the GP. But unfortunately, by the time we get the symptoms, the issue has already developed, and it can as in my case, be too late for any preventative measures.
In the early stages, these cancers are often asymptomatic, or present with non-specific symptoms but we are still told to wait for our symptoms to develop before seeing our GP. This is wrong!
Women in the UK suffer, or die, from conditions which would have been diagnosed and treated much earlier in other countries. Regular women’s health check-ups are common practice in many countries including France, Germany, Belgium, Finland, Sweden, the US, the Philippines and even North Macedonia! So why not in the UK?
PP: What are the benefits of women’s health check-ups?
JD: Making women’s health check-ups become part of normal health policy in the UK would save many lives. By diagnosing gynaecological cancers not picked up by screening programmes, and a range gynaecological complications like endometriosis and fibroids, that significantly affect a women’s quality of life.
Offering annual women’s health check-ups from the age of 18 onwards would help educate women about their gynaecological health, help break the taboos around this subject and bring essential, positive change to the cultural and social attitudes towards women’s reproductive health.
It would also give girls and women the chance to openly discuss any gynaecological concerns with a specialist, in confidence, such as: periods, sex, contraception, fertility, pregnancy & menopause. Going for a women’s health check-up could become just as normal as going to the dentist.
PP: What are you doing to make this happen?
DM: I’ve launched a petition for Yearly Women’s Health Check Ups in the UK for all women. I want this petition to help bring about much needed change to help reduce the deaths of over 7,600 women each year.
Although the petition has gained support from MPs, GPs and gynaecologists, all support will help to achieve the required number of signatures and make the biggest difference - #checkMEup.
September 2021
