By: Jay Allard, MD, Christine Fitzsimmons, DO and Amanda Stephens, DO, gynecologic oncologists at TMH Physician Partners – Gynecologic Oncology
To beat gynecologic cancer, we must talk about it. Talking about reproductive organs can feel like a taboo subject but understanding and recognizing these cancers is essential to intervening early, which is the best way to beat them. That’s one of the reasons we recognize Gynecologic Cancer Awareness Month each September – to start conversations, spread knowledge and, in turn, save lives.
As gynecologic oncologists, we’re specialized in treating gynecologic cancers, which are cancers that start in the female reproductive system. With the help of The Foundation for Women’s Cancer (FWC), we’re breaking each of these cancers down to help you stop them in their tracks.
Cervical cancer occurs in the cells of the cervix, which is the lower part of the uterus that connects to the vagina. Symptoms of cervical cancer can include:
- Abnormal vaginal discharge or bleeding
- Bleeding after vaginal sex
- Vaginal odor
- Pelvic or abdominal pain
These symptoms may be caused by cancer or other health problems, so it’s essential you see your gynecologist if you experience them. They’ll help you determine the root cause.
The great news is most cases of cervical cancer are now preventable. Persistent infection with various strains of the human papillomavirus – better known as HPV – can play a significant role in causing cervical cancer. Getting an HPV vaccine before becoming sexually active will drastically reduce your chances of contracting HPV, which could later lead to cancer. Kids should receive the vaccine at age 11 or 12.
It’s important to note HPV doesn’t just affect people with cervixes. While people without cervixes cannot develop cervical cancer, they can carry the virus and pass it along to their sexual partners who do have cervixes. That’s why it’s so important for all eligible children to receive the vaccine.
Smoking also contributes to persistent HPV infection by weakening the immune system which normally would help fight HPV infection.
The best way to find cervical cancer early is to have regular Pap tests, or Pap smears, and HPV tests between ages 21 and 65 at intervals recommended by your healthcare provider.
Ovarian cancer is a growth of cells that forms in the ovaries. The cells multiply quickly and can invade and destroy healthy body tissue.
Currently, there is no effective screening method for ovarian cancer. In fact, only 15 percent of ovarian cancer cases are detected at the earliest, most curable stage. That makes it essential that you listen to your body and take any symptoms seriously. If you experience any of the following for more than a few weeks, reach out to your gynecologist to get to the bottom of it:
- Urinary symptoms (urgency or frequency)
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
If these symptoms develop, specifically ask your doctor whether ovarian cancer could be the cause. Some additional early detection tips include:
- Schedule regular check-ups, including pelvic exams, even if you have already had a hysterectomy.
- Know your family history and ask your doctor about genetic testing.
- Ask your doctor about transvaginal ultrasounds and CA 125 blood tests if you have a high risk of ovarian cancer due to an inherited genetic syndrome such as Lynch syndrome, BRCA gene mutations or a strong family history of breast and ovarian cancer, fallopian tube cancer or primary peritoneal cancer.
Endometrial cancer, often referenced interchangeably with uterine cancer, is the most common gynecologic cancer. The leading cause of endometrial cancer is having too much of the hormone estrogen compared to the hormone progesterone. Because estrogen is found in fat cells, getting to and staying at a healthy weight is one way to lower your risk of endometrial cancer.
Other risk factors that can contribute to endometrial cancer include:
- Taking estrogen alone without progesterone
- Late menopause (after age 52)
- Never becoming pregnant
- A family history of endometrial or colon cancer
- Use of the drug tamoxifen
Early detection improves the chances that endometrial cancer will be treated successfully. See a gynecologist if you experience unusual vaginal bleeding, spotting or discharge. Women going through menopause should especially know the risks and symptoms of endometrial cancer. If you’ve gone without a period for 12 months, then suddenly have vaginal bleeding, spotting or discharge, talk to your doctor.
If endometrial cancer is suspected or diagnosed, you’ll want to consult a gynecologic oncologist. Women treated by gynecologic oncologists are more likely to get appropriate surgery and have a higher cure rate.
Vulvar cancer occurs on the outer surface area of the female genitals. The vulva is the area of skin surrounding the urethra and vagina, which includes the clitoris and labia. Signs of vulvar cancer or pre-cancer include:
- Chronic itching
- Abnormal bleeding or discharge
- Skin color changes (lighter or darker, red or pink)
- A bump or lump with wart-like or raw surfaces
While there is no standard screening for vulvar cancer, knowing what to look for can help with early detection. Check in with your body – any of the symptoms above, including an area on the vulva that looks different than normal, like a bump or lump (red, pink or white), thickening of the skin of the vulva or an open sore, should be checked out by your gynecologist.
Vaginal cancer is a rare form of gynecologic cancer that happens inside the vagina, which connects your uterus to your outer genitals. Most commonly, it occurs in the cells that line the surface of your vagina, which is sometimes called the birth canal.
Signs of vaginal cancer include:
- Unusual vaginal bleeding
- Bleeding after vaginal sex
- Problems with urination or bowel movements
- Watery discharge
- A lump or mass in the vagina
Vaginal cancer is most associated with HPV types 16 and 18, among other types. Again, the HPV vaccine is a powerful tool to help prevent HPV infection. Routine wellness visits and cervical cancer screenings can sometimes find early invasive vaginal cancer as well. If you experience any of the symptoms outlined above, see your gynecologist.
If you live in or around Leon County and your doctor suspects you have one of these gynecologic cancers, that’s where we come in.
At Tallahassee Memorial HealthCare (TMH), we have the most experienced and established gynecologic oncology program in the Big Bend region. There are only about 1,000 gynecologic oncologists in the country, and three of them are right here at our TMH Physician Partners – Gynecologic Oncology practice: Jay Allard, MD; Christine Fitzsimmons, DO; Amanda Stephens, DO. Together with our skilled team of advanced practice providers, nurses, support staff, navigators and others, we’ll work with you to develop a comprehensive plan of care tailored to your unique needs.
To learn more about gynecologic oncology services available at TMH, please visit TMH.ORG/Cancer or call us at 850-431-4888. For more information about gynecologic cancers, please visit www.foundationforwomenscancer.org.