What is gynecologic cancer?
Gynecologic cancer is any cancer that begins in the tissue and organs of the female reproductive system. There are five main types of gynecologic cancers, which are named after the organ it originated in. These cancers include:
- Ovarian cancer: cancer that begins in the ovaries, the female reproductive glands located on each side of the uterus
- Cervical cancer: cancer that begins in the cervix, which is the lower, narrow end of the uterus (the organ where a fetus grows) that leads to the vagina (birth canal)
- Endometrial (Uterine) cancer: cancer that begins in the uterus, the hollow, pear-shaped pelvic organ in women where fetal development occurs
- Vaginal cancer: cancer that begins in the vagina, the channel between the bottom of the uterus and the outside of the body
- Vulvar cancer: cancer that occurs on the vulva, the external part of the female genitals, which includes the clitoris, the vaginal lips, the opening to the vagina, and the surrounding skin and tissue
Because gynecologic cancer is a set of individual types of cancer, there are various risk factors and symptoms amongst them.
What are the risk factors for developing a gynecologic cancer?
Gynecologic cancer can affect any woman, and the chance of acquiring it increases with age. However, this does not mean that all women will develop one of these cancers. While risk factors vary among each type of gynecologic cancer, there are some in which they all share.
The following things are known risk factors known to increase a woman’s chance of developing a gynecologic cancer. Most of these can be avoided, or at least attempts to avoid them can be made:
- Human papillomavirus (HPV) infection
- Tobacco use
- Being overweight or obese
- Long-term use of oral contraceptives (birth control pills)
- Poor nutrition
- Exposure to diethylstilbestrol (DES), a synthetic estrogen given during pregnancy, prior to the year 1970, to prevent miscarriage
- Human immunodeficiency virus (HIV/AIDS) infection
Risk factors that are out of a woman’s control can include:
- Age: the risk increases with age
- Race: White and Hispanic women are more likely to be diagnosed
- Family history: not all gynecologic cancers have hereditary genes, however, if you have a family history of breast or ovarian cancer, talk with your doctor so s/he can determine if genetics may be a risk factor
Some proactive steps you may consider taking to reduce your risk or prevent gynecologic cancer may include:
- Getting the HPV vaccine
- Quitting smoking
- Eating healthier and exercising regularly
- Limiting the number of sexual partners you have
- Using latex condoms during sex
Keep in mind that many women with one or more risk factors never develop gynecologic cancer. Furthermore, while there is no proven way to completely prevent these diseases, there may be steps you can take to lower your cancer risk. If you have concerns about your personal risk of developing any type of gynecologic cancer, schedule an appointment to talk with your doctor.
What are gynecologic cancer symptoms?
The more you know regarding the symptoms of gynecologic cancers, the better equipped you’ll be to recognize early warning signs. Below is a broad list that covers some symptoms you should be aware of:
- Abnormal vaginal bleeding or discharge
- Pain during sex
- Bloating and/or feeling of fullness outside of usual bloating just before or during menstruation
- Frequent or urgent bowel changes
- Pelvic pain
Again, this is just a broad list of common symptoms. For additional information regarding the signs and symptoms of each cancer types, use the resources linked below:
If you experience one or more of these symptoms for more than a month, make an appointment with your gynecologist. Even if symptoms aren’t present, it’s wise to see your gynecologist for regular exams.
What should I ask my doctor about cervical cancer testing?
Open dialogue not only helps you establish a relationship with your doctor, it provides you with the opportunity to learn specific information regarding gynecological cancer. Here are six questions that you may consider asking your doctor or gynecologist include:
Common questions about cervical cancer screening tests
- What is a Pap test and what is its purpose? A Pap (Papanicolaou) test, also called a Pap smear, is a procedure to test for cervical cancer. It involves collecting cells from your cervix so that they can be looked at under the microscope to find cancer and pre-cancer. The Pap test can detect cancer cells as well as abnormal cells that could develop into cancer if left untreated. It can also find non-cancerous conditions, such as infections and inflammation.
- When should I have my next Pap test? The frequency of your pap tests typically depends on your age and health history. According to the American Cancer Society, women aged 21 to 29, should have a Pap test every 3 years. Women aged 30-65 should have a Pap test in combination with an HPV test every 5 years. Women over age 65 can typically stop cervical screenings. Talk to your doctor about what is best for you.
- What do my Pap test results mean? Pap tests are not perfect and can come back with results such as normal, abnormal, and inconclusive. They can even be a false positive and false negative. Results other than normal do not necessarily mean that you have cancer, however, your doctor may suggest more tests to verify.
- Is the HPV test right for me? Unlike the Pap test which checks for cervical cell changes, the HPV test checks for the presence of the HPV virus. Generally, an HPV test is performed in combination with a Pap test (called co-testing) in women over the age of 30 every 5 years. Talk to your doctor about co-testing if you are age 30-65.
- When can I stop getting a Pap test? Most women between the ages of 21 to 65 should be screened regularly. Even postmenopausal women who are still younger than 65 still need regular Pap tests. Women who have had a hysterectomy, and/or women who have no history of cervical cancer or abnormal Pap results, and/or women who are older than 65 and have had 3 normal Pap tests in a row do not need Pap tests. Talk with your doctor to find out when it’s okay for you to stop getting screened.
- Are there any other gynecologic cancer tests that I need, based on my personal health and family cancer history? If so, what are they? Why do I need them? How do they work? In addition to Pap smears, women who are 18 years of age or sexually active should consider a pelvic exam. Women beginning menopause that are also considered high risk may want to consider an endometrial tissue sample. Patients with a known family history of breast or gynecological cancers may consider genetic testing to see if they carry a specific gene mutation that could increase their risk of cancer. Your doctor will be able to discuss additional options with you.
Can I request the CA-125 blood test for ovarian cancer screening?
The CA-125 blood test measures the amount of protein CA 125 in your blood. Most often this is used for ovarian cancer patients during and after treatment. During treatment the oncologist may look for lowering CA 125 levels. And after treatment, rising CA 125 levels may indicate that cancer has recurred.
Because CA 125 levels in your blood can be increased due to non cancerous conditions, it’s not a sure sign that cancer is present. Because of this it’s not used as a regular ovarian cancer screening test for all women. However, if you are at high risk for developing ovarian cancer it could be used as a screening test by your gynecologist.
Those at high risk for ovarian cancer have a confirmed BRCA1 or BRCA2 gene mutation or have women in their immediate family with a breast cancer or ovarian cancer diagnosis. Keep in mind that because CA 125 can be increased by non cancerous conditions there is a chance you could go through additional testing only to find out there is no cancer present. Discuss this test with your doctor and with the insurance representative at your doctor’s office to see if it will be covered by insurance before making your decision to have the test performed.