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Rachel Cady, MD, Obstetrics & Gynecology Specialist at Welia Health
Over 100,000 gynecologic cancers are diagnosed each year in the United States. These include cancers originating from the uterus, endometrium (lining of the uterus), ovary, cervix, vagina, and vulva. Being proactive in taking care of yourself, noting persistent or unusual symptoms, and annual exams all increase the likelihood of early cancer detection and successful treatment.
Endometrial cancer
While endometrial cancer is the fourth most common cancer in women, it accounts for just 4% of cancer-related deaths. The average age of diagnosis is 63. Risk factors include family history, Lynch syndrome (an inherited condition), obesity, tamoxifen use, diabetes, high blood pressure, and history of irregular periods.
Prevention of endometrial cancer includes such things as regulating weight, regulating abnormal periods, and referral to a geneticist in some cases for testing. In fact, we know that 3 in 5 uterine cancers could have been prevented by being at a healthy weight and being active. The most common presenting symptom is abnormal bleeding, so women with abnormal bleeding should be evaluated. This is commonly done using ultrasound and office biopsy of the endometrium.
The treatment for uterine cancer is hysterectomy with removal of tubes and ovaries, as well as lymph nodes in some cases.
Cervical cancer
The human papilloma virus (HPV) is the cause of the vast majority of cervical cancers. Vaccination in boys and girls ages 9-26 is recommended. Additionally, new guidelines also suggest vaccination up to age 45, in patients with a known history of HPV.
Screening with Pap smears should start at age 21, and continue until age 65. The frequency of Pap-smear testing depends on a woman’s history or risk factors. Screening should continue longer in women who have a history of severe precancerous lesions, a history of cervical cancer, or a compromised immune system. Similarly, women who have had a hysterectomy need Pap smears of the top of the vagina, if there is a history of cervical cancer or precancerous lesions, or poor immune system. Women still should have periodic pelvic exams regardless of age or history of HPV past age 65.
Ovarian cancer
This is the fifth most common cause of cancer death, but the 10th most common cancer diagnosis in women. Risk factors include BRCA gene mutation, Lynch syndrome, older age, early first menses, late menopause, no deliveries, family history of ovarian cancer, and endometriosis. Oral contraceptives and removal of fallopian tubes lower an individual’s risk of ovarian cancer.
Symptoms can be very subtle and include such things as bloating, poor appetite, urinary frequency, and abdominal or pelvic pain. Screening for ovarian cancer remains a challenge. Using ultrasound and the Ca-125 tumor marker can be helpful in select cases. Some preventive treatments include oral contraceptives, referral to a genetic counselor in high-risk patients for testing, no smoking, healthy weight management, and removing fallopian tubes.
Vulvar cancer
This type of cancer accounts for less than 1% of cancers in women, and it occurs most often in patients in their mid 60s and older. Risk factors include smoking, history of HPV, history of lichen sclerosus, and poor hygiene. Patients will often present with vulvar itching or a non-healing vulvar lesion. Diagnosis is made by biopsy and treatment is surgical removal of the lesion. Five-year survival is over 90% when the cancer is stage 1.
To learn more, if you have any questions or concerns, or are due for a screening, please call 320.679.1313 to schedule your appointment with Rachel Cady, MD or Michael Cady, MD board-certified Obstetrics & Gynecology Specialists at Welia Health.
