What women should know about gynecologic cancer
By Pamela Della Valle, M.D.
Pardee UNC Health Care
While we have good screening exams and guidelines for early breast cancer detection, unfortunately, there aren’t recommended screenings for most types of gynecologic cancer (cancer that affects a woman’s reproductive system). Here’s what women need to know about early warning signs of gynecologic cancer and when to seek medical care.
Pamela Della Valle, M.D.
Pardee OB/GYN Associates
Cervical cancer begins in the cervix, which is found at the end of the uterus. It is almost always caused by human papillomavirus (HPV), which is a sexually transmitted infection. HPV is very common and usually goes away on its own. But in some cases, it can cause changes to a woman’s cervix that leads to cancer.
Having HIV, smoking, and having multiple sexual partners can also increase your risk of cervical cancer.
One of the best ways to reduce your risk of cervical, vaginal and vulvar cancer is to get the HPV vaccine early. It’s recommended for preteens ages 11 to 12 and can be given as early as age 9. It’s also recommended for females 9 to 45 and males 9 to 26 if they haven’t gotten it before.
It’s important to discuss your risk factors with your gynecologist and get a pelvic exam and Pap test as recommended. You can also reduce your risk by not smoking, using condoms during sex and limiting how many sexual partners you have.
Cervical cancer often doesn’t cause symptoms until it’s in more advanced stages. These symptoms include unusual vaginal bleeding or discharge.
Ovarian cancer starts in the ovaries, which are located on either side of the uterus. We do know that women who have been on birth control for more than 10 years have an 80 percent risk reduction.
Most women who get ovarian cancer aren’t high-risk. However, the following factors may increase a woman’s risk: being middle-aged or older; having the BRCA1 or BRCA2 gene or a genetic mutation associated with Lynch syndrome; having had breast, colorectal or uterine cancer; having a mother, sister, grandmother or aunt with ovarian cancer; having endometriosis; and never giving birth.
The following factors are associated with a lower risk of ovarian cancer: having given birth, breastfeeding, getting your tubes tied or a hysterectomy, having both ovaries removed, and using birth control for five or more years. Keep in mind that these things aren’t recommended for every woman, so talk to your gynecologist about what is right for you.
Ovarian cancer symptoms include feeling full very quickly during a meal, bloating, abdominal or back pain, pain or pressure in the pelvic region, vaginal bleeding or discharge that isn’t normal for you, a more frequent or urgent need to urinate, and constipation.
Uterine cancer begins in the uterus, where a baby grows during pregnancy. The following risk factors may increase your chances of uterine cancer: being older than 50, taking estrogen by itself as a hormone replacement, having obesity, having trouble getting pregnant, having less than five periods in a year before menopause, taking tamoxifen for breast cancer treatment or prevention, and having a close family member who had ovarian, colorectal or uterine cancer.
There are currently no proven ways to reduce your risk and no screening test. But the following factors may lower your risk: using birth control pills, a progesterone containing IUD, being physically active, maintaining a healthy weight and taking progesterone if you’re on estrogen.
Signs and symptoms include vaginal discharge, bleeding between periods or vaginal bleeding after you have undergone menopause. Additional symptoms may include pain or pressure in your pelvis.
Vaginal and vulvar cancers
Vaginal cancer occurs in the vagina, a tubelike organ that connects the bottom of the uterus to the outside of the body. Vulvar cancer affects the vulva, which is the exterior portion of the female genitals.
Symptoms of vaginal cancer include unusual vaginal bleeding or discharge, constipation, blood in your urine or stool, going to the bathroom more frequently than usual, and pain below your stomach between your hip bones, particularly during sex or urination.
Symptoms of vulvar cancer include bleeding, itching or burning on the vulva; a rash, warts, sores or lumps on the vulva; pain during urination or sex; and changes in the color of the vulva.
Like other gynecologic cancers, there aren’t proven ways to prevent vulvar or vaginal cancer. You may be more likely to develop vulvar or vaginal cancer if you have cervical precancer or cancer; have vaginal or vulvar precancer; have HPV for a long period of time; have HIV; smoke; or have ongoing vulvar burning and itching.
Getting the HPV vaccine early can reduce a women’s risk of the type of HPV that causes cervical, vulvar and vaginal cancers.
When to see a health care provider
If you have unusual vaginal bleeding, see your health care provider right away. If you have other symptoms for two weeks or more, see your provider. To find a primary care provider or gynecologist near you, visit www.pardeehospital.org.
Dr. Della Valle is an obstetrician and gynecologist at Pardee OB/GYN Associates.