Even though we only have a few days left, September is Gynecologic Cancer Awareness Month. As you recall, I am a gynecologic oncologist. After medical school, we train for four years in obstetrics and gynecology and then do an additional three to four years of fellowship training. It’s a long time to train but it’s an important job. I even had two kids along the way…but that’s another story.
Gynecologic cancer includes cervical, endometrial, ovarian, uterine, vaginal and the vulva. Endometrial cancer is the most common gynecologic cancer in the US. The endometrium is the lining of the inside of the uterus. Endometrial carcinoma is a cancer that forms from this inner lining. Uterine sarcomas are unusual and form from the muscle. Women with endometrial cancer usually present with postmenopausal or abnormal uterine bleeding before the menopause. Besides abnormal bleeding, other risk factors include obesity and/or nulliparity (never being pregnant).
Ovarian cancer is the most lethal gynecological malignancy. It usually presents after menopause. It forms on the surface of the ovary in the epithelial cells. In the past, ovarian cancer was called the “silent killer.” Now, it’s “silent no more.” That’s because symptoms were not thought to develop until the cancer was advanced. We’ve learned through research that women with ovarian cancer usually do not present with one symptom but several. These include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, and/or urinary symptoms (urgency or frequency)
Cervical cancer is the second leading cause of cancer death among women in the world. The tragedy is that it is nearly preventable with the new vaccine (yes, my children have been vaccinated) and with Pap smears. Cervical dysplasia (precancer) and cancer are caused by the Human Papillomavirus (HPV), the most common sexually transmitted disease. After infection, the cells in the cervix usually return to normal after the immune system destroys the virus. However, some HPV infections do not resolve and may remain persistent in the cervical cells for years. Chronic infection can lead to changes in the cells that can progress to dysplasia followed by cancer. In its early stages, cervical cancer usually has no signs or symptoms. That’s why it’s important to have a pelvic exam regularly. The most common symptoms with advanced stage are unusual vaginal discharge, abnormal bleeding, or bleeding or pain during sex.
For more information, another great site to check out is the Women’s Cancer Network. It’s affiliated with the Society of Gynecologic Oncologists and I have written for the site in the past. It’s worth the time.
Dr. Viv
