Gynecologic cancers include cancer of the uterus, ovaries, cervix, vagina, vulva and Fallopian tubes.
- According to the American Cancer Society, nearly 83,000 women per year are diagnosed with some form of gynecologic or GYN cancer.
- The most common gynecologic cancer is uterine cancer with more than 40,000 cases diagnosed each year.
- Every year, more than 28,000 women die from a type of gynecologic cancer.
- Widespread screening with the Pap test has allowed doctors to find pre-cancerous changes in the cervix and vagina. This has helped prevent the development of some invasive cancers.
Risk Factors for Gynecologic Cancers
While all women are at risk for gynecologic cancer, some factors can increase a woman’s chances of developing the disease.
- Uterine cancer: Never pregnant, beginning menstruation early, late menopause, diabetes, use of estrogen alone (called unopposed estrogen) for hormone replacement therapy, family history of uterine cancer, high blood pressure and complex atypical hyperplasia. Tamoxifen, a drug frequently used to treat breast cancer, increases the risk of uterine cancer slightly. A genetic syndrome called hereditary nonpolyposis colon cancer (HNPCC) may also increase a woman’s risk.
- Cervical cancer: Strongly associated with sexually transmitted diseases, especially several strains of human papilloma virus (HPV), sexual activity at an early age, multiple sexual partners, smoking and obesity.
- Ovarian cancer: Obesity, never pregnant, unopposed estrogen, personal or family history of breast or ovarian cancer, genetic mutations in the BRCA1 or BRCA2 gene, HNPCC.
- Vaginal cancer: History of genital warts or an abnormal Pap test. There is an increased risk of clear cell carcinoma in women whose mothers took the drug diethylstilbestrol (DES) while pregnant. Women previously treated for carcinoma in-situ or invasive cervical cancer also have a higher risk of developing vaginal cancer.
Signs and Symptoms of Gynecologic Cancers
There are often no outward signs of gynecologic cancers. However, some common symptoms include:
- Unusual bleeding, such as postmenopausal bleeding, bleeding after intercourse or bleeding between periods.
- A sore in the genital area that doesn’t heal or chronic itching of the vulva.
- Pain or pressure in the pelvis.
- Persistent vaginal discharge.
Screening for Gynecologic Cancers
Gynecologic cancers are often detected through a series of screening exams.
- Your doctor will first perform a pelvic exam to evaluate your vulva, vagina, cervix, uterus, Fallopian tubes, ovaries and rectum.
- During the pelvic exam, your doctor will gently scrape some cells from the cervix and vagina to examine under a microscope. This is called a Pap test.
- If the Pap test is abnormal, your doctor may perform a test called a colposcopy to closely examine the cervix. Scraping cells from the cervical canal (endocervical curettage) may also be necessary.
- A small sample of tissue may be taken from any suspicious area. This test is called a biopsy.
- Occasionally, doctors need to examine a larger sample of cervical tissue. It is obtained during a procedure called conization or cone biopsy.
- In some situations, your doctor may recommend an exam under anesthesia to better evaluate the extent of a cancer. Tests requiring anesthesia include examination of the bladder (cystoscopy) and rectum (sigmoidoscopy).
- Abnormal uterine bleeding, a common symptom of uterine cancer, is usually evaluated by performing a dilatation and curettage, also called a D and C.
- Your doctor may also ask for MRI, CT, PET or ultrasound scans of the abdomen and pelvis to better evaluate areas that cannot be directly viewed, such as the ovaries.
Treatment Options for Gynecologic Cancers
Treatment for gynecologic cancer depends on several factors, including the type of cancer, its extent (stage), its location and your overall health. It is important to talk with several cancer specialists before deciding on the best treatment for you, your cancer and your lifestyle.
- A gynecologic oncologist is a doctor who specializes in surgically removing gynecologic cancers.
- A radiation oncologist is a doctor specially trained to treat cancer with radiation therapy.
- A medical oncologist is a doctor who specializes in treating cancer with drugs (chemotherapy).
Sometimes, your cancer may be cured by using only one type of treatment. In other cases, your cancer may be best cured using a combination of surgery, radiation therapy and chemotherapy.