SAN ANTONIO – September marks Gynecologic Cancer Awareness Month. These are cancers that form in the female reproductive tract.
There are five main types of cancer that affect this part of a woman’s body:
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Cervical
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Ovarian
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Endometrial (Uterine)
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Vaginal
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Vulvar
“These are frequently lethal cancers if they’re found later on,” said Dr. J. Brian Szender, chief of Surgery at Methodist Stone Oak, he also the Gynecologic Oncology Program Director at the START Center.
Cervical Cancer
Cervical cancer is a type of cancer that affects the cervix.
Dr. Szender said cervical cancer is common in the United States, but it’s not the most common of the five gynecologic cancers. He noted that there are about 15,000 cases each year.
Signs and symptoms of cervical cancer include:
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Abnormal vaginal bleeding, such as bleeding after vaginal sex, after menopause, between periods, or menstrual bleeding that is longer or heavier than usual
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An unusual vaginal discharge, which may contain blood and may occur between periods or after menopause
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Pain during sex
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Pain in the pelvic region
More advanced symptoms may include:
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Swelling of the legs
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Problems urinating or having bowel movements
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Blood in the urine
Dr. Szender said the best prevention against cervical cancer is the Gardasil vaccine. This vaccine helps protect against human papillomavirus (HPV), a family of viruses with several types that can cause dangerous cancers.
“HPV causes 99.7% of all cervical cancers,” Szender said.
The Gardasil vaccine is available for everyone, both men and women, between the ages of nine and 45.
The best way for women to be checked for cervical cancer is by attending their yearly check-ups with their OBGYN. During these visits, a Pap smear is performed to screen the cervix for cervical cancer.
Szender advises women not to wait until their next yearly appointment if they experience abnormal symptoms, even if a previous Pap smear was normal.
“One of the common misconceptions about Pap smears is, ‘Well, I had a Pap smear, and it was fine, so if I have some bleeding, my doctor would have known, and something would have shown up on the Pap smear.’ But that’s not always the case,” Szender said.
Ovarian Cancer
Ovarian cancer is a type of cancer that can affect the ovaries in a woman’s body. Additionally, cancer can also be found in the fallopian tubes, and there is also primary peritoneal cancer, which is found in a thin layer of tissue lining the abdomen.
“Seventy percent of these cancers start in the fallopian tubes,” said Szender.
Ovarian cancer is common in the United States. Szender said about 30,000 cases are diagnosed each year.
Symptoms of ovarian cancer can be hard to notice. They include:
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Bloating
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Pelvic or abdominal pain
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Feeling full quickly
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Urination frequency
Since women may sometimes experience these symptoms for other reasons, they don’t always recognize that it could be cancer. Dr. Szender said if you start experiencing these symptoms and they last for more than two weeks, call your doctor.
One way a woman can prevent this disease is through tubal sterilization. This procedure involves doctors removing the fallopian tubes to reduce the risk of developing cancer in the future. While it is effective at preventing the disease, it makes the chance of getting pregnant rare.
Another way to prevent ovarian cancer is by taking birth control pills. Dr. Szender said they help reduce the risk of ovarian cancer by 50%.
“They’re better at preventing pregnancy, but they’re really good at preventing cancer as well,” Szender said.
This is because birth control can stop the signal to the brain to have the ovaries ovulate. When a woman ovulates, some damage occurs on the outside of the ovaries. As the body repairs this damage, there is a risk that a mistake in the genes can lead to cancer. By stopping ovulation, the chances of damage to the ovaries are significantly reduced, helping prevent cancer from forming.
Endometrial (Uterine) Cancer
Endometrial cancer is a type of cancer that affects the uterus and the endometrium. It is also known as uterine cancer.
Dr. Szender said this is the most common type of gynecologic cancer, with about 60,000 cases diagnosed each year in the United States.
This type of cancer is typically diagnosed in women after menopause.
Some of the most common signs of endometrial cancer include:
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Vaginal bleeding after menopause
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Pain in the pelvis
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Losing weight without trying
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Being able to feel a mass (tumor)
If you start experiencing any of these symptoms, Dr. Szender says called your OBGYN immediately.
Vaginal Cancer
Vaginal cancer is a type of cancer that starts in a woman’s vagina. The most common type of vaginal cancer is called squamous cell carcinoma, which usually begins in the lining of the vagina.
This type of cancer isn’t as common as others. The American Cancer Society says it accounts for 1% to 2% of cancers in the female reproductive tract. It typically affects older women, usually those over 69 years old.
Some of the signs and symptoms of vaginal cancer include:
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Abnormal vaginal bleeding (often after sex)
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Abnormal vaginal discharge
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A mass or lump that can be felt in the vagina
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Pain during sex
Having these symptoms doesn’t necessarily mean you have cancer; it could be something else, like an infection. The best thing to do is call your OBGYN if you are experiencing any abnormal symptoms.
Vulvar Cancer
Vulvar cancer is a type of cancer that forms on the outer surface of the vulva.
The American Cancer Society says this form of gynecologic cancer is also rare, accounting for about 6% of all cancers in the female reproductive tract. It estimates that about 6,900 cases will be diagnosed in the United States in 2024.
Signs and symptoms of vulvar cancer include:
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Lesions along the vulva
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Skin discoloration
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A bump or lump that could have a wart-like feel
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Thickening of the skin of the vulva
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Itching
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Pain or burning
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An open sore that lasts for a month or more
Since many of these cancers have similar symptoms, Dr. Szender says knowing your family history and going to the doctor as needed will help prevent cancers before they arise or before they reach a late stage.
Another helpful tool is genetic testing.
Genetic testing looks for certain mutations in a person’s genes and is typically done through a blood draw. Once the blood is drawn, doctors can check for any inherited genes that could lead to cancer later in life.
If you have a family history of cancer or think you could have cancerous symptoms, talk to your doctor.
“We’re dedicated to women’s care and women’s health. That’s why we chose this field, and it’s really easy to just to just ask us questions,” Szender said.
When it comes to treatment, most of these types of cancers are treated through a combination of surgery and systemic therapy.
The removal of some reproductive parts may help stop the spread of cancer.
Men play an important role in spreading awareness. Dr. Szender said males with cancers like prostate, colon, and pancreatic cancer can pass down cancer genes that cause gynecologic cancers in their daughters.
“All men are sons, one way or another. And a lot of men are husbands, and many men are fathers, and these can affect our loved ones,” said Szender.