How long has my cancer been there?
A commonly asked question is “How long can you have cancer without knowing about it?”
Usually, symptoms of cancer will present when the cancerous tumour or mass has increased in size large enough that it begins to push against nearby organs and tissue, blood vessels, and/or nerves.
If a mass has reached a certain size, it can cause pain, and/or changes in how the nearby organs function. For e.g. if a large growth presses against the bladder this may cause more frequent urination. The time this takes can vary for different cancers.
Cancers are diagnosed mostly after symptoms develop because symptoms trigger patients attending to medical appointments and checks. But many types of cancers can be diagnosed early, before symptoms form. When diagnosed and treated early this has the best prognosis.
In general, for cervical cancer, the World Health Organization reports it takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. This is the time it takes for the cells in the cervix to begin to undergo abnormal changes, turn precancerous, then cancerous. This is why we conduct HPV testing every 5 years, as it takes a long time for the cancer to develop.
However, if women have a weakened immune system, such as those with untreated HIV infection, a HPV infection can develop quicker than 5 to 10 years. Some sub-types can also be more aggressive. Small cell cancers (a rare cervical cancer type) tend to grow very fast and are the most aggressive type of cervical cancer. Although, they account for less than 1% of all cervical cancer.
For ovarian cancer, the time cancer takes to develop also varies. Ovarian cancers develop and grow at varying rates over time. Some types of ovarian cancer may grow slowly over years while others can progress very quickly within months. Low-grade and borderline epithelial ovarian cancers tend to grow slowly. Type I tumours tend to grow slowly and cause fewer symptoms, while Type II (high-grade serous cancers) grow fast. Many ovarian cancers are not found until after they have grown and/or spread, which is why it’s sometimes termed the “silent” killer.
For endometrial cancer, which originates in the lining of the uterus, type 1 endometrial cancers (low-grade endometrioid cancers)_are less aggressive, more slow growing and they typically don't spread to other areas of the body quickly. Type 2 endometrial cancer types are more aggressive, although much less common.
Vulvar cancer begins on the surface of the vulva and most of these cancers grow slowly, remaining on the surface for years. Precancerous lesions usually develop first and are caught and diagnosed as abnormal cell growth before they turn into vulvar cancer. These precancerous lesions are called vulvar intraepithelial neoplasia (VIN).
However, some forms (for example, melanomas on the vulva) grow quickly. If left untreated for years, vulvar cancer can invade the vagina, the urethra, or the anus and spread into groin lymph nodes and later also into the pelvis and abdomen and into the bloodstream.
Similar to vulvar cancer, when vaginal cancer first forms, it develops very slowly, over a period of several years. Most vaginal cancers are squamous cell carcinomas, which means the cancer originated from skin cells. Generally, vaginal cancer is a secondary cancer, which means cancer cells have spread to the vagina from elsewhere in the body, such as the cervix or vulva.
So how long has my gynaecological cancer been there? While there’s no simple answer, some cancers can be present for months or even years before they are detected. Others are more aggressive, and invade the body quicker making them more challenging to treat. The immune system and genetic conditions (such as Lynch Syndrome) also may cause cancer to grow more quickly than in the general population.
To increase your chances of catching potential gynaecological cancers early, keep up with your recommended HPV screening (screens for cervical cancer only), and report any signs or symptoms such as abnormal vaginal bleeding as soon as you can to your doctor.
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