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Your Gynecologic Health |
Guide to Gynecological Cancers
Hoag's Gynecologic Oncology Specialty
If you are diagnosed with a gynecologic cancer you should see a gynecologic oncologist. Gynecologic oncologists are highly trained specialists who complete a four-year residency, followed by a four- to five- year fellowship in gynecologic cancer. Almost all gynecologic cancers require a treatment combination of surgery, chemotherapy and radiation from a gynecologic oncologist.
Hoag has been successful in battling gynecologic cancer because of a comprehensive approach to cancer care that starts with a high caliber medical, clinical and nursing staff dedicated to quality patient care; combined with state-of-the-art diagnostic and imaging tools that enable medical staff to increasingly detect cancers at their earliest stages; and leading-edge surgical procedures, radiation therapy, chemotherapy and other treatments that give patients access to the most advanced treatment options available today.
Hoag's five-year relative survival rates for uterine, ovarian and cervical cancers exceed national averages by approximately seven percentage points.
Hoag provides more than just clinical cancer treatment. Cancer treatment involves emotional and spiritual care as well. Through a gynecologic cancer support group, Hoag brings education, support and hope to women faced with the unique challenges of gynecologic cancer.
Although Hoag continues to make great progress in the fight against cancer, it remains focused on the importance of prevention and early detection.
For more information about Hoag's comprehensive gynecologic cancer program, please call Women's Health Services at 800/701-HOAG (4624).
Uterine Cancer
Uterine cancer is the most common type of gynecologic cancer. There are several types of uterine cancer, but usually it is detected on the endometrium, or lining of the uterus. Uterine cancer most often occurs after menopause, but sometimes it's detected around the time menopause begins. One of the most common tell-tale signs is irregular vaginal bleeding, which is why it's important for women to discuss any irregular vaginal bleeding with their physician. Uterine cancer is usually detected early when patients notify their gynecologists of irregular bleeding.
Symptoms
- Unusual vaginal bleeding or discharge
- Difficult or painful urination
- Pain during intercourse
- Pain in the pelvic area
Risk Factors
- Age, post-menopausal
- Endometrial hyperplasia, an increase in the number of cells in the lining of the uterus
- Hormone Replacement Therapy (HRT)
- Obesity
- Tamoxifen use
- Colorectal cancer
- Women who have never been pregnant
- Menstruation begins at an early age
- Entering menopause later in life
If you have these symptoms your doctor may perform a pelvic exam, Pap test, transvaginal ultrasound or a biopsy.
Treatment
Most women with uterine cancer will require a hysterectomy, including the removal of the ovaries and lymph nodes in the pelvis. Sometimes uterine cancer can be treated with radiation therapy or hormonal therapy.
Cervical Cancer
Cervical cancer is caused by abnormal cellular changes of the cervix. Most cervical cancers are squamous cell carcinomas. Squamous cells are thin, flat cells that form the surface of a woman's cervix. Cervical cancer is the only gynecologic cancer that can be completely prevented by regular medical screening, including the Pap test. Pap tests detect pre-cancerous changes of the cervix.
Symptoms
- Bleeding after intercourse
- Abnormal bleeding between periods
- Excessive vaginal discharge
Risk factors
- Failure to receive regular examinations and pap smears
- Smoking
- High number of sexual partners
- Early age of first intercourse
- HIV and/or HPV (wart virus) infection
Treatment
The current treatment for abnormal changes to the cervix is a biopsy procedure called loop electrosurgical excision procedure (LEEP). In this procedure a doctor uses an electric wire loop to cut off a thin, round piece of tissue from the cervix. If the disease has invaded deeper layers of the cervix other surgical procedures may be considered. Radiation therapy, chemotherapy and biological therapy are possible treatment options as well.
Ovarian Cancer
Ovarian cancer is the most serious of the gynecologic malignancies. The most common type of ovarian cancer, epithelial carcinoma, begins on the surface of the ovary. Ovarian cancer cells can break away from the ovary and spread to other tissues and organs as the disease progresses.
When ovarian cancer is diagnosed early, the five-year relative survival rate is greater than 90 percent. But ovarian cancer is hard to detect until it's in advanced stages. There is currently no standardized method for screening or early detection. The Pap test, excellent for detecting cervical cancer, is not an effective tool in detecting ovarian cancer. Women may have mild symptoms until the disease is in advanced stages.
Symptoms
- Bloated, full feeling in the abdominal area even after a light meal
- Vague abdominal and pelvic discomfort
- Fatigue and/or backaches
- Nausea, indigestion, constipation and/or diarrhea
- Loss of appetite
- Urinary frequency and/or urgency
- Menstrual disorders
- Pain during intercourse
- Unexplained weight gain (especially around the middle) or weight loss
- Shortness of breath
Your doctor may review your medical history, perform a physical exam and diagnostic tests to help find the cause of your symptoms. Some exams and tests include a pelvic exam, transvaginal ultrasound, CA-125 blood test, CT Scan, MRI and/or a biopsy.
Risk Factors
- Family history of ovarian cancer
- Personal or family history of breast or colon cancer
- Risk increases with age, especially around the time of menopause
- Women who have never had children
- Fertility drugs that cause a woman to ovulate
- Hormone Replacement Therapy (HRT) after menopause
Treatment
Surgery followed by chemotherapy is the primary treatment in the management of ovarian cancer. Sometimes radiation therapy many be administered.
Hoag's Hereditary Cancer Program
Genetic counseling and testing are available for hereditary cancer syndromes, which include ovarian and uterine cancers, through Hoag's Hereditary Cancer Program. For more information, call Hoag's Hereditary Cancer Program at 949/764-8094.
Importance Of Gynecologic Exams
An annual gynecologic exam assesses the general condition of a woman's health through breast and pelvic examinations, including a Pap test, which detects precancerous changes to the cervix. This is also a great opportunity for women to discuss concerns or key changes in their health, such as pain or bleeding with intercourse, abdominal bloating, or changes in bowel or urine habits.
Gynecologic cancer describes the entire spectrum of cancers affecting a woman's reproductive system, the most common of which are uterine, ovarian and cervical cancer. Because the onset of many symptoms associated with gynecologic cancer can be subtle, it's especially important to maintain a high level of awareness about them.
Gynecologic cancers represent a very small number of cancers. Early detection of these cancers is the key to survival. Most symptoms of gynecologic cancers are subtle, which is why annual physical exams, including a gynecologic exam, are so important.
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