Uterine, ovarian and other gynecologic cancers don’t get the attention they deserve.
They should. The five most prevalent cancers that begin in women’s reproductive organs—uterine (mostly endometrial), ovarian, cervical, vulvar and vaginal cancers—are expected to be diagnosed in more than 116,000 American women and take the lives of more than 34,000 in 2021, according to the American Society of Clinical Oncology.
Yet many gynecologic cancers can be stopped: One type can be prevented with a vaccine, while others can be avoided by lowering risk factors. Here’s what women need to know about these diseases.
Subtle symptoms of gynecologic cancer
Gynecologic cancers come with warning signs, but many symptoms are often dismissed. This is especially true with ovarian cancer, the most fatal in the female reproductive organs.
“Bloating, abdominal pain, early satiety (feeling full after eating only a little food), changes in bowel habits (constipation or diarrhea), urinating frequently, fatigue, back pain, clothes fitting tighter, and nausea and vomiting are commonly chalked up to GI distress, IBS (irritable bowel syndrome), food poisoning, heartburn, sciatica and weight gain,” says Meaghan Tenney, M.D., a gynecologic oncologist at Northside’s University Gynecologic Oncology.
“I have many patients who tell me, ‘I thought I was just getting fat,’ when the abdominal distention causing their clothes not to fit well was actually their cancer and fluid buildup in the abdomen,” she adds.
Irregular vaginal bleeding—a sign of uterine (endometrial) and cervical cancers—can be mistaken for the bleeding women experience during the menopausal transition.
“Postmenopausal bleeding should never be considered normal, regardless of the duration or amount, and should prompt an immediate evaluation to rule out endometrial cancer,” Dr. Tenney says.
7 steps to lower your risk level
Such uncertainty makes lowering risks crucial. Cervical cancer is the only preventable gynecologic cancer, thanks to Pap tests and the vaccine for HPV.
“In the first 30 years after the United States adopted Pap test screening, the incidence (number of new cases) of cervical cancer decreased by about 70 percent,” Dr. Tenney says. “Not only does Pap screening decrease the number of new cases, it results in higher cure rates for cancer, likely because women are diagnosed at much earlier stages.”
Here are some other ways to lower your risk:
- Report your symptoms. Tell your doctor about abnormal vaginal bleeding or discharge, pelvic pain or pressure, abdominal or back pain, pain with intercourse, bloating, changes in bathroom habits, itching or burning of the vulva, and changes in vulva color or skin.
- Get vaccinated. The HPV vaccine can protect you from HPV, a sexually transmitted virus that sometimes causes cervical, vaginal and vulvar cancers. “In my opinion, the No. 1 advancement in the treatment of gynecologic cancers is the HPV vaccine,” Dr. Tenney says. “This is a two-shot series and is recommended for children (boys and girls) at 11 to 12 years of age, although it is approved for ages 9 to 45, so those who were not vaccinated as children can ‘catch up’ and get a three-shot series in young adulthood.”
- Get tested. Regular Pap tests can find precancerous cervix changes and early cervical cancer. But don’t assume that because you’ve had a pelvic exam, you’ve also gotten a Pap test, Dr. Tenney says. Talk to your doctor about it, and also ask if you need an HPV test.
- Stop smoking, especially if you have HPV. The combination increases the risk of vaginal cancer.
- Know your family history. “This is extremely important, especially as it pertains to family members with cancer,” Dr. Tenney explains. “As many as one-quarter of ovarian cancers and some endometrial cancers are caused by a genetic mutation.”
- Consider birth control pills. Ask your doctor whether they’re right for you to decrease your risk of uterine and ovarian cancers.
- Manage your weight. “Obese women are two to four times more likely to develop endometrial cancer compared to normal-weight women, so maintaining a healthy weight through diet and exercise can lower that risk,” Dr. Tenney says.
Improving survival rates indicate hope for the future
Women diagnosed today are much less likely to die of ovarian cancer than those diagnosed in 1975, but there is still work to be done to improve survival rates.
Although surgery remains the mainstay of ovarian cancer treatment, recent research has yielded promising new approaches. Among them: a class of oral medications known as PARP inhibitors that were approved by the Food and Drug Administration after clinical trials. PARP inhibitors have been shown to improve cancer survival rates, and Dr. Tenney calls them one of the biggest developments in ovarian cancer treatment in some time.
“Many women with ovarian cancer are living longer today, and I have patients who are 10-plus-year survivors, which used to be very rare,” Dr. Tenney says. “While most ovarian cancer patients will still eventually recur, there are a lot of exciting things happening in the ovarian cancer world.”