Be Alert for Signs of Gynecological Cancer

For all of types of cancer, an early diagnosis means earlier treatment and a higher survival rate. However, of the three most common types of gynecological cancers—cervical, ovarian, and endometrial—only cervical cancer has a routine screening test. This means it’s important to know the symptoms associated with these cancers, and to quickly report them to your doctor if they occur.

Cervical Cancer

Cervical cancer screening gives you the best chance of catching this condition early. For women ages 30 to 65, screening may be a Pap test every three years, or a Pap test plus a human papillomavirus (HPV) test every five years.

“A woman who is age 65 or older can stop screening as long as she has had prior regular screenings that have all been negative. If a Pap test is abnormal or an HPV infection is present, further evaluation may include cervical biopsies and/or a colposcopy. A woman with an abnormal Pap test or a positive HPV test will likely need screening more frequently and may need to continue screening after age 65,” explains Melissa Frey, MD, a gynecologic oncologist at Weill Cornell Medicine.

Early cervical cancer is often asymptomatic; however, as the disease progresses, symptoms can include heavy vaginal bleeding, irregular vaginal bleeding, or bleeding after intercourse. More advanced cervical cancer may produce pain in the pelvis or back, changes in bowel or urinary habits, or blood in the urine or stool. If you experience any of these symptoms, especially if they are persistent, see your gynecologist or another health-care provider as soon as possible.

Endometrial Cancer

Endometrial cancer, which is cancer of the innermost layer of cells that lines the uterus, is the most common of the gynecological cancers in the U.S.

The most common symptom of endometrial cancer is abnormal uterine bleeding. This includes bleeding after menopause or heavy or irregular bleeding in women who are still menstruating.

“Other symptoms of endometrial cancer can include a palpable uterine mass [a lump that can be felt during an exam] and abdominal pain or bloating,” notes Dr. Frey.

“There is no recommendation for routine screening for endometrial cancer unless a woman has a strong family history of endometrial cancer or a known genetic mutation, such as Lynch syndrome. Women at increased risk can consider sonograms of the uterus and endometrial biopsies. For all other women, screening is only recommended if there is a suspicion for endometrial cancer,” explains Dr. Frey.

Ovarian Cancer

In the early stages, ovarian cancer is often asymptomatic. Symptoms of advanced ovarian cancer include pain in the pelvis, abdomen, or back, bloating, changes in bowel or urinary habits (especially urinary urgency and frequency), and feeling full quickly when eating.

“If a gynecologist suspects a pelvic mass on exam or if a woman has any symptoms of ovarian cancer, further evaluation is needed,” says Dr. Frey.

There is currently no recommendation for ovarian cancer screening in women who are having no symptoms. However, women who have family members with breast, ovarian, fallopian tube, or peritoneal cancer can be evaluated to see if they have increased risk of a mutation in the BRCA1 or BRCA2 gene in their family history. If they do, then genetic testing may be advised.

“For women with an elevated lifetime risk of ovarian cancer, either due to a family history of ovarian cancer or a mutation in the BRCA1 or BRCA2 gene, a gynecologist can consider screening with pelvic ultrasound and a blood test for a tumor marker called CA125. However, the woman and her gynecologist must discuss the limitations of such ‘screening,’ as we currently have no evidence that these tests can reliably detect ovarian cancer in its early stages,” explains Dr. Frey. “Women with a BRCA1 or BRCA2 mutation should discuss the option of removal of the fallopian tubes and ovaries as a possible way to avoid ovarian cancer.”

If you experience any of the symptoms mentioned for two or more weeks, see your gynecologist or other healthcare provider and have it checked out. If you do have cancer, the sooner you find out, the sooner you can begin treatment that may save your life.

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