A diagnosis of cancer in a woman’s reproductive organs can lead to fears about losing her femininity and her ability to bear children.
But according to gynecologic oncologist Robert DeBernardo, M.D., gynecological cancers aren’t common, and most can be easily treated.
“Gynecological cancers are rare in the grand scheme when compared to lung or colon cancer,” says DeBernardo, director of minimally invasive surgery in Cleveland Clinic’s Ob/Gyn & Women’s Health Institute. “But they’re scarier because they affect a woman’s genitals.”
In all gynecological cancer cases, most women should consult a specialist. General obstetrician/gynecologists are not trained to treat these diseases, and women will heal better with access to the right treatments, clinical trials and medications, he says.
There are four main types of gynecological cancers that women should discuss with their doctors.
1. Endometrial cancer
Endometrial cancer develops in the lining of the uterus, the endometrium. According to the American Cancer Society, it’s one of the most common. Between 80 percent and 90 percent of women fare well, because it’s frequently caught early, DeBernardo says.
Endometrial cancer’s cause is unknown, but it is linked to several risk factors. Many are associated with the balance between estrogen and progesterone.
Its main symptom is the reason this cancer is most often diagnosed early, DeBernardo says. “Ninety percent of women who have endometrial cancer present with abnormal bleeding. This is usually after menopause,” he explains. “They’ll have breakthrough bleeding or a pink tinge on their underwear, and they’ll go in to the doctor.”
Several tests, both invasive and noninvasive, can identify endometrial cancer.
Surgery, including a hysterectomy, is the main treatment for endometrial cancer, but radiation therapy, hormone therapy and chemotherapy may sometimes be used for therapy. Women can reduce their risk by using oral contraceptives, controlling their weight and managing their diabetes, DeBernardo says.
2. Ovarian cancer
The deadliest gynecological cancer, ovarian cancer, is rare. Annually, about 20,000 U.S. cases are diagnosed. When discovered early, up to 95 percent of cases can be easily cured. But 70 percent of these cancers are diagnosed in advanced stages.
Ovarian cancer most commonly occurs in women in their 50s, but it can strike women younger than 35.
Ovarian cancer’s underlying cause remains unknown, but women with a genetic predisposition to it could consider a hysterectomy as a precaution, DeBernardo says.
Women taking oral contraceptives are at a slightly lower risk, as are those who have undergone tubal ligation. Eating a low-fat diet may also decrease your risk.
Ovarian cancer frequently goes unnoticed because its symptoms mimic other, less serious conditions. With no ovarian cancer screening exam, DeBernardo says, signs can lead to a misdiagnosis of irritable bowel syndrome, Crohn’s disease or malfunctioning gallbladder.
After identifying an enlarged ovary during a pelvic exam, your doctor will likely order a blood test, ultrasound or more invasive testing.
The main treatment for ovarian cancer is removal of the ovaries and any visible tumor followed by other cancer-fighting treatments.
Remember: It’s important to report any irregular bleeding, abdominal pain or symptoms that concern you to your doctor. He or she may order additional tests as needed.
3. Cervical cancer
Once a leading cause of death among women in the U.S., cervical cancer is one of the least common gynecological cancers, in large part, due to sophisticated screening and vaccines. Appropriate screening with Pap smears — and HPV vaccines in younger women ages 9 to 26 — means fewer than 10,000 cervical cancers cases appear annually, DeBernardo says.
“As long as women are being screened, they’re at an increasingly low risk because of our ability to identify and treat lesions before they become cancerous,” he says. “Most problems are diagnosed as pre-cancerous and are eradicated easily.”
Women should have their first Pap smear by age 21. Those with no history of abnormal tests can be screened every three years, and after age 30 with no abnormal tests, they can be screened every five years. After age 65, women with three normal Pap smears in a row and no abnormal tests in the last 20 years can stop cervical screenings.
When invasive cervical cancer is found early, more than 90 percent of women have a 5-year survival rate.
There are many risk factors associated with cervical cancer, such as HPV infection, smoking and HIV infection.
Early-stage cervical cancer is painless and without symptoms. As the disease progresses, though, you can experience irregularities in vaginal bleeding.
Most cervical cancers are diagnosed through pelvic exams and Pap smears. If cancer is diagnosed, you might have additional tests.
Cervical cancer treatment is based on how advanced the disease is, the patient’s age and general health, and any desire for child-bearing. Radiation, chemotherapy and surgery are the main therapies.
4. Vulvar cancer
The labia, the external portion of a woman’s genitalia, can also develop cancer. Vulvar cancer is rare — one of the least recognized gynecological cancers — but if detected early, it is easily treated and cured. Advanced disease can occur in elderly women as they do not undergo regular gynecological exams. According to the American Cancer Society, vulvar cancer accounts for 4 percent of gynecological cancers.
Women in their 70s and 80s are most at risk, but younger women can develop vulvar cancer. Risk factors include HPV infection or a history of genital warts or abnormal Pap smears.
Vulvar cancer most frequently exists without symptoms, but the most common one is itching that won’t go away. Most vulvar cancer signs are associated with other conditions, so be sure to consult your gynecologist, DeBernardo says.
(A Wellness Update is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at www.awellnessupdate.com.)