Guest commentary: Gynecological cancers, knowing your risk
Each year, approximately 110,000 new cases of gynecologic cancers are diagnosed in the United States.
In recognition of the recent Gynecological Cancer Awareness Month in September and as part of our ongoing effort to help reduce these numbers, we want to use this opportunity to educate and inform the community about prevention and early detection.
Regular checkups, cancer screenings and maintaining a healthy lifestyle are important steps to reducing risk. Being informed about gynecological cancers, knowing your body and noticing any changes early can also make a big difference.
GYNECOLOGICAL CANCERS
Gynecological cancers are types of cancers that affect a woman’s reproductive system. There are five types:
– Cervical
– Ovarian
– Uterine
– Vaginal
– Vulvar
Treatment for these cancers depends on the type and how far the disease has progressed. Early detection is the key to successful treatment and survival.
Gynecological cancers can develop in various parts of the female reproductive system. Cervical cancer starts in the cervix, the narrow lower part of the uterus.
Ovarian cancer originates in the ovaries, located on either side of the uterus, and can also begin in the fallopian tubes or peritoneum.
Uterine cancer begins in the uterus, the pear-shaped organ where a baby grows during pregnancy.
Vaginal cancer develops in the vagina, the tube-like passage connecting the uterus to the outside of the body.
Vulvar cancer is a rare cancer that forms in the external female genital organs called the vulva.
CERVICAL CANCER
Cervical cancer usually develops slowly over time. Early detection through a Pap smear screening test can reveal abnormal cells in the cervical tissue. Your gynecologist will determine if the abnormal cells need to be treated. In rare situations untreated cells may eventually become cancer cells.
Most of these cervical cancers are caused by various high-risk strains of the human papillomavirus (HPV), which is spread through sexual contact. When the body is exposed to HPV, the immune system recognizes the virus as a foreign invader and produces an immune response to destroy the virus. However, in some individuals, the virus can persist and eventually lead to the development of cervical cancer cells.
The risk of cervical cancer can be reduced through regular screening tests and by getting the HPV vaccine, which helps protect against HPV infection.
OVARIAN CANCER
The ovaries are almond-shaped organs in the female reproductive system that produce eggs and certain hormones.
Ovarian cancer can be caused in three ways:
– Ovarian epithelial cancer forms in the tissue covering the ovary; in the thin, smooth tissue membrane that lines the abdominal cavity and covers most of the organs in the abdomen, called the peritoneum, or in the lining of the fallopian tube, which delivers eggs from the ovaries to the uterus.
– Ovarian germ cell tumors begin in the eggs, which are also known as germ cells or reproductive cells that develop into eggs in females and sperm in males.
– Ovarian low-malignant potential tumors can start in the tissues covering and within the ovary.
Ovarian cancer can cause nonspecific symptoms, such as abdominal swelling or pain, but for some patients, no symptoms at all are experienced. Since it can be difficult to diagnose and symptoms can seem vague or like common issues, it’s vital to see a physician for regular checkups or if anything in the body feels abnormal. It is better to get checked than to brush off persistent symptoms.
Five percent to 10% of cancers are related to disease-causing gene mutations passed down through family members. It’s also important to know your family history and whether you carry any of these mutations. The BRCA 1 or 2 mutation can significantly increase the risk of developing breast, ovarian and other cancers.
If you’re concerned about the risk of developing hereditary cancer, experts with the Cancer Genetic Risk Assessment Program at the Lee Health Cancer Institute can help you understand your options. Pre-test counseling is available free of charge.
For more information on genetic counseling at Lee Health, call 239-343-9512.
UTERINE CANCER
Uterine cancer can refer to endometrial cancer or uterine sarcoma. Endometrial cancer develops in the endometrium, the inner lining of the uterus. It is one of the most common gynecologic cancers and normally develops in women after menopause.
Uterine sarcoma forms in the myometrium, the muscle wall of the uterus, and is very rare.
Risk factors for uterine cancer include:
– Having obesity
– Having diabetes
– Having untreated polycystic ovarian syndrome (PCOS)
– Taking estrogen without progesterone. If the uterus is still present, birth control pills have both estrogen and progesterone.
– Having Lynch syndrome (a genetic predisposition to certain groups of cancers)
– Being over 50 years old
If there is unusual pain or irregular vaginal bleeding, it’s important to discuss these symptoms with your provider. Abnormal uterine bleeding and any postmenopausal bleeding is a reason to see your gynecologist.
VAGINAL CANCER
This is a rare cancer that forms in the vaginal lining. Those who are older than 60 years old, smokers, or individuals who have HPV are at a higher risk of developing vaginal cancer.
Like ovarian cancer, vaginal cancer does not always show symptoms, making regular Pap smears and pelvic exams crucial for early detection.
It is rare for cancer to begin in the vagina. Most often, cancer will form in other areas of the reproductive system, like the cervix or uterus, and then spread to the vagina if it is not caught early enough.
VULVAR CANCER
Vulvar cancer starts as a growth of cells on the vulva, the area of skin that surrounds the urethra and vagina.
This type of cancer is often presented as an itchy lump or sore and is usually diagnosed in older adults.
Some types of vulvar cancer include:
– Vulvar squamous cell carcinoma of the skin, which is associated with an HPV infection
– Vulvar melanoma that starts in the pigment-producing cells called melanocytes
– Extramammary Paget’s disease of the vulva, which begins near sweat glands in the skin. Sometimes, it happens at the same time as another kind of cancer, like cancer in the breast, colon, urinary system, or other parts of the reproductive system.
GYNECOLOGICAL CANCER SYMPTOMS
This list includes symptoms for all types of gynecological cancers:
– Vaginal bleeding after sex
– Vaginal bleeding or spotting after menopause
– Vaginal bleeding between periods or periods that are heavier or longer than normal, especially if older than 40 years old
– Watery vaginal discharge that has a strong odor or contains blood
– Pelvic pain or pain during sex
– Lower abdominal pain or cramping in the pelvis
– A noticeable mass in the vagina
– A lump or sore on the vulva, especially if it is an open sore or wart-like
– Itching of the skin of the vulva that does not go away
– Changes in the skin or thickening of the skin of the vulva
– Pain and tenderness of the skin of the vulva
– Painful urination or feeling like you frequently need to urinate
– Black-colored stools or constipation
– Feeling the urge to poop even though your bowels are empty
– Feeling a pelvic mass when pressure is put on the pelvic area
If you experience any of these symptoms, please promptly discuss them with your physician and follow their recommended next steps.
Trusting your instincts and following up when something feels off is essential — because we are our first line of defense. When it comes to our health, peace of mind is powerful, and early action can make all the difference.
CARE AVAILABLE CLOSE TO HOME
If you or a loved one receives a cancer diagnosis, state-of-the-art care is available close to home at the Lee Health Cancer Institute in Fort Myers and Bonita Springs.
A compassionate team of medical professionals will guide you through the process, explain the next steps, and ensure you receive the treatment and support you need.
Nurse Navigation starts as soon as a diagnosis is made. Nurse navigators meet with patients to educate them about their disease and treatment options, while also connecting them to vital emotional, medical, spiritual and financial resources.
“My job is to make sure patients have everything they need to navigate their cancer journey,” nurse navigator Frances Hutchinson said. “A diagnosis can be overwhelming, so we work to simplify the process and make sure no one feels alone. We’re part of their team, fighting alongside them. It truly makes a difference when patients feel supported and can access care close to home.”
If you or someone you know is facing a cancer diagnosis, help is available nearby. For more information on gynecological cancers or to schedule an appointment with a physician, visit www.leehealth.org.
Dr. Cherrie Morris is chief physician executive for the Lee Health Women’s Health Institute. For more information, visit https://www.leehealth.org/.