Symptoms of gynecologic cancer can be vague, which makes them easy to brush off. But since early detection is key, it’s important to seek help when you feel that something’s not right.
The good news? Gynecologic cancers — those related to the female reproductive tract, including ovarian, uterine, and cervical cancers — may be highly treatable.
The bad news? They can be difficult to detect.
“I always tell my patients that if something is happening every single day for a few weeks that is out of the ordinary, please let me know,” said Alaina J. Brown, M.D., M.P.H., assistant professor of obstetrics and gynecology at Vanderbilt University Medical Center, and a physician with Vanderbilt-Ingram Cancer Center. “I think a lot of times women will justify reasons why ‘it’s not a big deal.’ Women are oftentimes the primary caregivers in their household and they’re too busy taking care of other people instead of themselves. It’s really important for them to stop and pay attention to what their body is telling them.”
“I think a lot of times women will justify reasons why ‘it’s not a big deal.’ It’s really important for them to stop and pay attention to what their body is telling them.”
We asked Brown to share with us the main symptoms of gynecologic cancers, as well as how these cancers are diagnosed and treated. “Earlier detection is key,” said Brown, “so we should always try to be as vigilant as possible.”
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Ovarian, fallopian and primary peritoneal cancer
Causes: “These kinds of cancers are oftentimes sporadic, but may also be genetically related,” Brown said. “A BRCA mutation, for instance, puts you at increased risk for breast cancer, but also for ovarian, fallopian and primary peritoneal cancers. There are some preventative strategies for women with genetic predisposition to this type of cancer, such as a risk-reducing salpingo-oophorectomy — which is removing both the tubes and ovaries — to minimize the risk of developing cancer.”
Symptoms/Diagnois: “They’re very vague, so ovarian cancer is often diagnosed at an advanced stage. Women will complain of abdominal bloating, early satiety (feeling full sooner than normal or after eating less than usual) or fatigue, and a lot of times these symptoms are ignored by patients as well as their providers, just because it could be caused by a number of things such as benign GI disease or stress.”
Treatment: “A combination of surgery and chemotherapy.”
Causes: “Mainly sporadic,” said Brown. “There can be a genetic predisposition to developing this cancer, particularly if a patient has Lynch syndrome, which is basically a syndrome that puts you at increased risk for several different cancers including colorectal or uterine cancer, so it’s important for patients to know their family history. Similar to ovarian cancer, if a patient has a genetic predisposition to this type of cancer, there are preventative strategies such as a hysterectomy to decrease their risk of developing uterine cancer.”
Symptoms/Diagnosis: “Uterine cancer is often diagnosed early because women will have post-menopausal bleeding — which is always abnormal — or they’ll have really heavy bleeding if they’re pre-menopausal. This bleeding typically triggers them to see their physician, have an endometrial biopsy, and get a diagnosis earlier. So it’s normally found as a stage one cancer.”
Treatment: “Surgery is generally curative for most uterine cancers, though there are some cases where you may need to have adjuvant therapy after surgery, which could be radiation and/or chemotherapy.”
Causes: “This cancer is not generally thought to be genetically related and is often related to an HPV (human papillomavirus) infection,” Brown said.
Symptoms: “The classic symptom for cervical cancer is spotting after intercourse, which we call post-coital spotting. Cervical cancer is the only gynecological cancer that we have good screening for — the Pap smear — and so cervical cancer oftentimes is diagnosed at an early stage.”
Treatment: “In general, cervical cancer is managed surgically, although if it’s more advanced, we generally treat it with chemo-radiation, which is chemotherapy and radiation together.”
Causes: “This cancer is similar to cervical cancer in that it is not generally thought to be genetically related and is often related to an HPV infection,” Brown said. “Older patients who have lichen sclerosis, which is an issue with the vulva, can also be predisposed to developing vulvar cancer.”
Symptoms/diagnosis: “Vulvar cancer is typically diagnosed at an earlier stage because a patient will have an itching, non-healing lesion on the vulva, which their provider will biopsy.”
Treatment: “This is usually managed with surgery, although if it’s more advanced patients may get radiation and/or chemotherapy.”