What do you want to know about gynecological cancers?
It might be hard to believe today, but back in the ’80s, the public knew so little about breast cancer, how it forms, and how to treat it. But thanks to the annual breast cancer awareness efforts launched each October, when the country is awash with pink ribbons, many women are better aware of how to lower their risk of developing the disease and what they need to do to detect it. But gynecological cancers do not receive public attention. You might not know, for example, that September is Gynecological Cancer Awareness Month, designed to inform women and their loved ones about the seven major cancers that can develop in the female reproductive system. However, these cancers affect tens of thousands of women each year.
Gynecological cancers, in fact, are very common: More than 107,000 women will be diagnosed with one of these diseases in 2017, according to the American Cancer Society. Three of these cancers, cervical, ovarian/fallopian (as well as peritoneal) and endometrial (uterine) cancers, are more common than cancers of the vagina and vulva. Other related cancers include germ cell and ovarian cancers, stromal cell carcinomas, gestational trophoblastic carcinomas, and uterine sarcomas, all of which are also treated by a gynecological oncologist.
Although they are often discussed as a group, each type of gynecological cancer is different, with its own symptoms, risk factors, and treatments. “Gynecological cancers can be complex,” says Dr. Kelly Manahan, a gynecological oncologist at our hospital near Atlanta. “This is why it is so important to seek advice from a gynecological oncologist.”
It’s also important to know the signs, symptoms and risk factors for gynecological cancer: to provide women with the information they may need to reduce their risk and to seek medical attention if they develop certain symptoms.
Cervical cancer forms in the cells that line the lower part of the uterus, known as the cervix. The cervix contains two main types of cells: squamous cells and glands (glands). Abnormal changes in any of these types of cells can lead to cervical cancer. But only some women with cervical cancer will develop cancer.
Other common risk factors for cervical cancer are smoking, early sex, and multiple sexual partners. However, nearly all cervical cancers are caused by a persistent viral infection called human papillomavirus (HPV), a sexually transmitted disease that affects millions of Americans each year. But not all people infected with HPV will develop cancer. While there are more than 100 strains of HPV, two of them cause 70 percent of cervical cancers. The HPV vaccine is designed to protect against the most common strains of the virus that cause cancer. The Centers for Disease Control and Prevention recommends the vaccine for girls and boys 11 to 12 years old. If you are under 26 and have not been vaccinated, you can ask your doctor about a “catch-up” vaccine.
Cervical cancer is the only gynecological cancer that can be diagnosed or prevented by screening tests. Doctors can use a Pap test or an HPV test to look for abnormal cells in the cervix before cancer develops. “Regular screening tests can allow a patient to detect an abnormality early, even before it turns into cancer,” says Dr. Manahan.
Common symptoms of cervical cancer include:
- vaginal discharge
- Abnormal vaginal bleeding
- Vaginal odor
- Bleeding after intercourse.
Endometrial cancer is the most common type of cancer of the female reproductive organs. Because the endometrium (or endometrium) is part of the uterus, endometrial cancer is often called uterine cancer, but it is different from uterine sarcoma, a rare type of cancer that also forms in the uterus. The risk of uterine cancer increases with age: Three out of four cases are diagnosed in women 55 and older, including women who have gone through or have gone through menopause.
Other risk factors for endometrial cancer include obesity, high blood pressure, diabetes, tamoxifen use, and a family history of uterine, ovarian, or colon cancer. Women who took only estrogen without progesterone are also at greater risk.
Common symptoms of endometrial cancer include:
- Postmenopausal bleeding (including spotting) or very heavy periods before menopause
- Difficult or painful urination
- Pain during intercourse
- Pain or a lump in the pelvic area.
- Involuntary weight loss
“Endometrial cancer is often caught early because abnormal bleeding prompts patients to seek medical advice,” says Dr. Manahan. “Endometrial cancer is usually diagnosed with a biopsy, although ultrasound may be used to aid in the diagnosis.”
Ovarian cancer (fallopian tube/peritoneal cancer)
Ovarian cancer, fallopian tube cancer and peritoneal cancer are often called the silent killer because their symptoms usually don’t develop until after the disease has progressed. All women are at risk of developing ovarian cancer, but older women are more likely to develop the disease than younger women. The vast majority of women diagnosed with ovarian cancer are over the age of 40, and the highest proportion of cases occur in women age 50 and older. Women with ovarian cancer who have a mother, sister, grandmother, or aunt have an increased risk of developing this disease.
Having a personal history of breast, colorectal, or endometrial cancer is also a common risk factor, as is genetics. Women with BRCA1, BRCA2, Lynch syndrome, or Peutz-Jeghers syndrome are also at risk of developing ovarian cancer. “Knowing your family history is very helpful because it can help determine your or your family’s personal risk of developing certain types of cancer,” says Dr. Manahan.
Women who have given birth to at least one child, especially before age 30, have a lower risk of developing ovarian cancer, as do women who have used birth control pills for at least three months. “The general rule of thumb for contraceptive use to reduce ovarian cancer risk is that the risk drops by 10 percent for each year the pill is taken, to a maximum of 50 percent in five years,” says Dr. Manahan.
Common symptoms of ovarian cancer (as well as cancers of the fallopian tubes and peritoneum) include:
- persistent swelling
- Stomach ache
- Acid reflux / heartburn
- Change in frequency of urination
While mammograms detect breast cancer and a Pap test for cervical cancer, no test has been developed to detect ovarian cancer. Most ovarian cancers form in the cells that line the surface of the ovary. This is called epithelial ovarian cancer. s. Germ cell and stromal cell carcinomas (including granulosa cell tumors) make up less than 15 percent of ovarian cancers combined. These types of tumors usually affect young women and often appear in the early stages.
“Women who are diagnosed with early-stage ovarian cancer have a greater chance of getting a positive result than those diagnosed at its advanced stages,” says Dr. Manahan. “However, because there is no screening test for this disease, about 75 percent of women with ovarian cancer are diagnosed with stage III or IV disease, which means that the cancer has spread outside the pelvis. Seeking professional medical advice from a gynecological oncologist to treat these The condition is critical.” In general, the first line of treatment for ovarian cancer is cytoreductive surgery, which removes all visible ‘lumps or bumps’ related to cancer in the abdomen and pelvis. This surgery is usually followed by chemotherapy, says Dr. Manahan.
Vaginal cancer is the rarest of gynecological cancers. Fewer than 5,000 women are expected to be diagnosed with the disease in 2017. Women at increased risk of vaginal cancer are 60 years of age or older, have an HPV infection, or have a history of cervical, precancerous, or lymphocytic cancer Abnormalities on the cervix or were exposed to diethylstilbestrol (DES) before delivery.
Most vaginal cancers are squamous cell carcinomas. Other subtypes of the disease are particularly rare. Vaginal cancer in its early stages can cause abnormal spotting or bleeding.
Other common symptoms of vaginal cancer include:
- Pain during intercourse
- Pain in the pelvic area.
- A lump in the vagina
- pain when urinating
Vulvar cancer is a very rare cancer that appears on the outside of a woman’s external genitalia, called the vulva. Vulvar cancer usually forms as a lump or sore that often itches. Although it can affect women of any age, vulvar cancer is most often diagnosed in older women. This disease is also more common in women who smoke, have HPV infection, have a history of cervical cancer or abnormal cells in the cervix, are HIV positive, or have chronic itching or burning in the vulvar area.
Common symptoms of vulvar cancer include:
- Itching, burning or bleeding in the vulva that does not go away.
- The skin of the vulva changes color.
- Changes in the skin of the vulva, including rashes or warts.
- Sores, lumps, or sores on the vulva that do not go away.
- Pelvic pain, especially during sex or urination.
Like other gynecological cancers, when vulvar cancer is in its early stages, the disease is less likely to spread and easier to treat.
Research continues to improve our understanding of gynecological cancers. “New treatments and developments are frequently available,” says Dr. Manahan. “For example, the use of advanced molecular profiling to identify additional treatment options for gynecological cancers has helped improve patient outcomes. Sometimes, new treatments are also available in pill form that cause very few side effects to treat gynecological cancers.”
Learn more about advanced genomic testing.