Ovarian cancer is a silent killer, rarely displaying symptoms until the cancer is advanced. Cervical cancer, however, can present early with abnormal vaginal bleeding. Both ovarian and cervical cancers are among the top 10 most common women cancers in Singapore. When it comes to these cancers, early detection is your best chance of recovery.

Dr Francis Chin, Senior Consultant from the Department of Radiation Oncology at National Cancer Centre Singapore, gives detailed answers to your questions.


Question by ireneneo

Dear Dr Chin,

What are the chances of recurring ovarian cysts after its being removed? And also what are the percentiles for these cysts to be cancerous?

Answered by Dr Francis Chin, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore

Ovarian cysts are relatively common among women. The treatment may be dependent on the following factors such as size of the cysts, the age of the patient, menopausal status and the patient’s own specific medical conditions and risks.

Most ovarian cysts are benign or functional cysts. The risks of small cysts (less than 5 cm) on a single ovary found in a premenopausal woman being cancerous are usually low. Half of functional cysts disappear upon follow up ultrasound scans done once every 4 months. Larger cysts may require closer follow up until they are gone.

Do consult your doctor if the earlier cysts removed have any borderline or malignant potential. If so, then there is a possibility of further surgery and even chemotherapy for patients with higher risk.


Question by mylenetan

Dear Dr Chin,

May I have your advice on the following on Endometriosis Cyst:

  1. For Endometric cyst of about going 3cm, what is your advice if it is being left alone and any danger if done so? Is a yearly review with doctor good enough for this case?
  2. Is surgery recommended now, if not when is it good for surgery? What is the chance of it growing back if an ops is done to remove it?
  3. What are the food/things we need to eat or do when such cyst is found?
  4. Any other advice please.

Thank you for your time.

Answered by Dr Francis Chin, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore

Thank you for your questions. Pls see reply above to similar questions asked by member ireneneo.


Reposted by administrator

I took hormone replacement therapy for about 5 years. What impact on my risk of gynae cancer? If any impact, is it like cigarette and lung cancer, eg does my risk return to normal after stopping a few years?

Annie L

Answered by Dr Francis Chin, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore

There are many different types of hormone replacement therapy (HRT), some contain estrogen alone while others may have a combination of estrogen with progesterone. In a recent study conducted in UK a few years ago involving over 700,000 woman, there appears to be a slightly increased risk for endometrial cancer in women with estrogen alone HRT as compared with women who have never used any HRT. There is also no increase in breast cancers for the above treatment.

Whereas in women who took the combination estrogen and progesterone, there was a protective effect, meaning a lower number of endometrial cancer than expected. However, the combination of estrogen and progesterone may result in a greater increase in breast cancer, strokes, blood clots and heart diseases. Despite all these, HRT can also be considered in healthy women because the benefits of HRT include treating menopausal symptoms and the benefits may outweigh its risks. Please do consult your doctor for your individual treatment analysis before engaging in such treatments.


Reposted by administrator

My cousin had cancer of the cervix. Is this cancer genetic?

Answered by Dr Francis Chin, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore

Cancer of the cervix can be genetic in Peutz -Jeghers syndrome (PJS), which is a rare condition that can be passed from affected parents to their children. People with PJS develop different coloured spots on their lips, mouths and hands and feet. PJS also is characterised by benign polyps in the stomach and colon and maybe on the cervix too. Some of these polyps may turn cancerous. But in Singapore, cervical cancer is mainly caused by the human papilloma virus (HPV) infection. The good news is that a vaccine is now available against HPV. Do check with your doctors if you are suitable for the vaccination.


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I am a 23 year old lady who is sexually active and would like to take the vaccination. But when i read more about the vaccination it is stated that the vaccination should be takn before becoming sexually acitve, before 26. I would like to know if i do it now, will it still be effective and if i only have one sex partner are there chances to be infected with HPV?

Answered by Dr Francis Chin, Senior Consultant, Department of Radiation Oncology, National Cancer Centre Singapore

Ideally, we do recommend our patients to receive the vaccine before they become sexually active. However, if you are already sexually active, the vaccination may result in a lesser degree of protection against HPV. This is because you may have already been exposed to one or more of the HPV types targeted by the vaccines. As there are multiple types of HPV which you may not get exposed to, you may still get protection by getting vaccinated.

There are currently two types of vaccine on the market - one covers HPV 6, 11, 16, 18. (Including coverage for HPV causing genital warts) while another covers HPV 16 and 18. Both vaccinations will need to be carried out over three injections and can be paid using CPF Medisave, up to SGD400 a year from 1 November 2010. Do consult your doctor for suitability of such vaccinations.


Ref: S13 ​