Gynecologic Cancer is cancer of the female reproductive system, which includes cervical cancer, endometrial/uterine cancer, ovarian cancer, vaginal cancer, vulvar cancer and peritoneal cancer. In the last two decades, considerable gains have been made in the detection and treatment of these cancers. When detected in early stages, most gynecologic cancers have a good cure rate.
For more information on gynecologic cancers and treatment options contact the Gynecological Cancer Recovery Program at the Women's Health Resource Center at (415) 600-0500, the Community Health Resource Center at (415) 923-3155 or IHH the Institute for Health and Healing at (415) 600-3660.
What you can do…
- See your health care provider for a pelvic exam and Pap smear annually.
- Use condoms to reduce the risk of all sexually transmitted diseases.
- See your health care provider if you experience any vaginal bleeding between periods or postmenopausal bleeding, vaginal discharge or bleeding after intercourse, unusual abdominal bloating or changes in bladder or bowel function.
- Quit smoking.
- Maintain a healthy body weight.
- Discuss your cancer risk factors and family history with your health care provider.
This cancer occurs most frequently in women aged 35 to 55 with approximately 16,000 cases of invasive cervical cancer and 500,000 cases of pre-invasive cases, known as squamous cell lesions, diagnosed in the United States each year. In almost all cases of cervical cancer there are no symptoms. Fortunately, a highly effective diagnostic test, the Pap smear, can detect cervical cancer at its earliest stage and has reduced the probability of developing cervical cancer to nearly 1%. The American College of Obstetricians and Gynecologists recommends that a Pap smear be done for all women by age 18 or women who are sexually active, regardless of age.
The biggest risk factor for developing cervical cancer is a history of genital or venereal warts, which is caused by the human papilloma virus (HPV). The virus is a sexually transmitted disease. There are more than 70 types of HPV that infect humans and 90% - 95% of squamous cell carcinomas of the cervix cont HPV DNA. Because venereal warts are caused by a virus that stays in your body, you remain infected throughout your life. Treatment for HPV may not eradicate the warts forever, although it may help lessen your risk for cervical cancer.
Other risk factors for developing cervical cancer include:
- Suppression of immune system
- History of herpes simplex virus infection
- Early age at first intercourse
- Multiple sexual partners
- Multiple pregnancies
- Cigarette smoking
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Endometrial cancer, carcinoma of the lining of the uterus, is the most common gynecologic malignancy, making up approximately 95% of all uterine cancers diagnosed. The survival rates for endometrial cancer are quite high and have steadily increased over the last 40 years since this cancer is usually diagnosed at an early stage. There is no known cause or routine screening test for this type of cancer, therefore recognition of early symptoms such as abnormal vaginal bleeding or discharges are critical. Special procedures, including an endometrial biopsy and a dilation and curettage (D&C), are used to diagnose and confirm endometrial cancer.
Risk factors to developing endometrial cancer include:
- A family history of endometrial cancer
- Lack of children
- Postmenopausal women
- Obesity of greater than 50 pounds over the ideal body weight
- Late menopause
- Estrogen replacement therapy
- History of pelvic radiation therapy
- Women who do not ovulate
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Ovarian cancer is often called the disease that "whispers" because it has few early symptoms and is most often detected in its advanced stages when it has become less treatable and widespread. Partly because of this, the mortality rate from ovarian cancer exceeds that for all other gynecologic cancers combined and is the fourth most frequent cause of death in women in the United States. Approximately 70% of the women diagnosed with ovarian cancer have advanced stages of the disease and about one in 70 women in the United States will develop ovarian cancer. It can occur at any age, even in childhood, but is most common after menopause. The disease accounts for about 20,000 new cases and 12,500 deaths in the United States annually.
The most common form of ovarian cancer is epithelial carcinoma, which begins in the lining of the ovary. There is no simple early detection method for ovarian cancer, and the symptoms are extremely vague. Women may experience non-specific abdominal symptoms such as pain, pelvic pressure, low back discomfort, mild nausea, feeling full early when eating, or constipation and gas. Transvaginal ultrasound, using a minimally uncomfortable vaginal probe, in combination with a serum tumor marker known as CA-125 is fairly accurate in screening for ovarian cancer for women with many risk factors. However, this test is not reliable for screening the general population.
Awareness of your risk factors for ovarian cancer is key to early detection.
Risk factors for developing ovarian cancer include:
- Previous diagnosis of breast cancer
- Family history of ovarian cancer
- Early menses
- Late menopause
- No children
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Carcinoma of the vagina is relatively uncommon affecting only 1% - 2% of the women in the United States each year. There are two types of vaginal cancer, squamous cell carcinoma usually found in women between the ages of 60 and 80 and adenocarcinoma usually found in women between the ages of 12 and 30.
Squamous cell carcinoma originates in the skin lining of the vagina and is usually caused by the human papilloma virus (HPV), a sexually transmitted virus. Adenocarcinoma of the vagina has been associated with exposure to diethylstilbestrol (DES). This drug was given to women, from 1945 until the early 1970s, who were at risk of miscarriage.
The most common symptom associated with cancer of the vagina is abnormal vaginal bleeding and discharge, painful urination and pain during intercourse. The most common risk factor is for developing vaginal cancer is a history of genital or venereal warts, which is caused by the human papilloma virus (HPV). The virus is a sexually transmitted disease. There are more than 70 types of HPV that infect humans. Another risk factor is a history of vaginal radiation therapy.
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A rare kind of cancer in women, cancer of the vulva involves the outer part of a woman's vagina, the inner or outer labia. Most women with this type of cancer are over age 50. Overall prognosis for cancer of the vulva is good and early detection can make it even better. It is recommended that all women should perform a vulvar self-exam on a monthly basis. If lumps, bumps, or lesions are found one should seek medical attention. There may be severe burning, itching or pain in vulva or the skin may look white and feel rough. The key to successful treatment of vulvar cancer is in early diagnosis.
The most common risk factor is for developing vulvar cancer is a history of genital or venereal warts, which is caused by the human papilloma virus (HPV). The virus is a sexually transmitted disease. There are more than 70 types of HPV that infect humans.
Other risk factors include:
- Commonly a history of chronic vulvar itching.
- Steroid creams should not be used to treat itching without a biopsy.
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