Gynecologic Cancers
Gynecologic Cancers
Dr. Nicholas Taylor (left) and
Dr. Israel Zighelboim
This is a group of cancers that affect the female reproductive system. There are several types of gynecologic cancers including cervical cancer, ovarian cancer, uterine cancer, vaginal cancer and vulvar cancer. However, ovarian cancer accounts for more gynecologic cancer deaths than all other gynecologic cancers combined.
Gynecologic oncologists Dr. Nicholas Taylor and Dr. Israel Zighelboim practice the surgical and medical management of gynecologic cancers through the Gynecologic Oncology program at St. Luke's Cancer Center; they are board certified in Obstetrics and Gynecology and Gynecologic Oncology. Patients have access to innovative cancer treatments including radiation therapy, chemotherapies, hormonal therapies and a variety of investigational protocols. Services are coordinated before, during and after treatment and to ensure continuum of care for all patients.
Ovarian
Ovarian cancer is the fifth leading cancer killer of women, according to the American Cancer Society. This is because ovarian cancer is usually not detected until it has spread to areas beyond its origin in the ovary. Early detection is difficult because there are no early signs, no specific symptoms and no reliable screening test.
At St. Luke's Cancer Center, women with ovarian cancer are offered options that may maximize their survival while maintaining desired quality of life. Advanced ovarian cancer is best treated with a combination of aggressive cytoreductive surgery to remove, or debulk, the visible tumor followed by chemotherapy.
Causes
Many times, women with ovarian cancer have no symptoms or just mild symptoms until the disease has reached an advanced stage. The lack of a reliable screening test puts women at a disadvantage for finding ovarian cancer early, before the disease has progressed.
When ovarian cancer symptoms do present, they may resemble those of intestinal flu. When combined with other symptoms, like abdominal bloating, fatigue and a heavy feeling in the pelvic area, a thorough evaluation is in order.
Symptoms
Ovarian cancer symptoms can be mild and may not present immediately. Signs may include:
- Sense of pelvic heaviness
- Vague lower abdominal discomfort
- Vaginal bleeding
- Weight gain or loss
- Abnormal menstrual cycles
- Unexplained back pain that worsens over time
- Increased abdominal girth
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- Increased gas
- Indigestion
- Lack of appetite
- Nausea and vomiting
- Difficulty eating usual volumes of food
- Bloating
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Risk Factors
- Age - two-thirds of women who develop ovarian cancer are over 55
- Menstruation before age 12
- No children or first child after age 30
- Menopause after age 50
- Prolonged use of the fertility drug clomiphene citrate, especially without achieving pregnancy, may increase the risk
- Family history of ovarian cancer, breast cancer, or colorectal cancer
- Personal history of breast cancer
Tests, Procedures and Treatments
A doctor will perform a physical examination, review symptoms with the patient and perform testing for ovarian cancer that can include:
- Pelvic exam
- Blood tests
- Ultrasound
- Biopsy
Treatments for ovarian cancer can include:
- Cytoreductive Surgery to remove, or debulk, the visible tumor followed by chemotherapy.
- Intravenous (IV) and intraperitoneal chemotherapy (IPC) administered directly to the cancer site with a catheter placed into the abdominal cavity. Performed on an inpatient or outpatient basis, IPC literally bathes cancerous tissue with a powerful solution of cancer-fighting drugs.
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Cervical
Cervical cancer is one of the most common cancers that affect a woman's reproductive organs. It is also one of the most preventable types of cancer.
The human papillomavirus (HPV) is the most common cause of cervical cancer. There are more than 100 different strains of the virus, but only a few strains are considered to be high risk.
Two Main Types of Cervical Cancer
- Squamous cell carcinomas begin in the thin, flat cells that line the bottom of the cervix. This type accounts for 80 to 90 percent of cervical cancers.
- Adenocarcinomas occur in the glandular cells that line the upper portion of the cervix. These cancers make up 10 to 20 percent of cervical cancers.
Sometimes both types of cells are involved in cervical cancer. Very rare cancers can occur in other cells in the cervix.
Causes
Cervical cancer symptoms can go unnoticed. Women may pass symptoms off as PMS or ovulation pains. Many times, cervical cancer has no symptoms at all. When symptoms do present, they usually do not appear until the cancer is more advanced.
The first indication of cervical cancer may be from an abnormal Pap smear. A biopsy can confirm the diagnosis.
Symptoms
Cervical cancer symptoms may include:
- Abnormal vaginal bleeding
- Unusual heavy vaginal discharge
- Pelvic pain not related to the normal menstrual cycle
- Bladder pain during urination
- Bleeding between regular menstrual periods, after sexual intercourse, douching or pelvic exam
Tests, Procedures and Treatments
A doctor will perform a physical examination, review symptoms and perform testing for cervical cancer that can include:
Treatments for cervical cancer can include:
- Surgery
- Chemotherapy
- Radiation Therapy
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Uterine
Uterine (endometrial) cancer is the most common gynecologic cancer occurring in the United States. The disease usually affects women over age 50 and usually occurs after menopause.
Risk Factors
The following factors may increase the risk:
- Women over the age of 50 are at increased risk for uterine cancer.
- Usually, the disease occurs after menopause.
- Excess estrogen or hormone therapy
- Obesity
- Ethnicity - Caucasian women at higher risk for developing the disease.
Potential Symptoms
- Abnormal vaginal bleeding
- Excessive menstrual bleeding
- Irregular periods
- Pelvic pain
- Lower abdominal pain
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- Pain with intercourse
- Anemia
- Fatigue
- Weight loss
- Shortness of breath
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How is uterine cancer diagnosed?
- Pelvic Exam
- Ultrasound
- Biopsy
Tests, Procedures and Treatments
A doctor will perform a physical examination, review symptoms and perform testing for uterine cancer that can include:
- Blood tests
- Pelvic exam
- Ultrasound
- Biopsy
Treatments for uterine cancer can include:
- Surgery
- Chemotherapy
- Radiation Therapy
- Hormone Therapy
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Vaginal
Vaginal cancer is a rare cancer that occurs in the vagina. Early-stage vaginal cancer offers the best chance for a cure. However, vaginal cancer may not produce signs and symptoms until the disease has advanced.
Risk Factors
- Women age 60 and older have an increased risk
- History of abnormal cells in the cervix or having cervical cancer
- Having HPV (human papilloma virus)
- Women who were exposed to the drug DES (diethylstilbestrol) before birth; DES had been used to prevent miscarriage
Symptoms
- Unusual vaginal bleeding
- Watery vaginal discharge that may be bloody and foul smelling
- Lump or mass in your vagina
- Painful urination
- Constipation
- Pelvic pain
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Vulvar
Vulvar cancer is a rare cancer that affects the vulva in women. The vulva is the fold of skin that protects the vagina and urethral openings.
No one knows the exact cause of this cancer; however several risk factors have been identified.
Risk Factors
- Age; women 70 and over are at increased risk
- Having HPV (human papilloma virus)
- Being infected with HIV
- Family history of melanoma
- Smoking
- Lichen sclerosis, a chronic inflammatory skin condition affecting the vulva
Symptoms
- Lump or bump on the vulva
- Vulvar itching, burning, or sensitivity
- Pain during urination
- Change in the texture of the vulva
- Mole on the vulva or change on existing mole
- Bleeding not related to menstruation
Tests, Procedures and Treatments
A doctor will perform a physical examination, review symptoms and perform testing for vulvar cancer that can include:
Treatments for vulvar cancer can include:
- Surgery
- Chemotherapy
- Radiation Therapy
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