Gynecologic cancers of many types are the subject of several awareness campaigns during the month of September. The National Ovarian Cancer Coalition, for one, will focus on promoting earlier awareness of symptoms, genetic predisposition, and the lack of an early detection test for ovarian cancer, specifically; and other organizations, such as the Foundation for Women’s Cancer will be seeking to raise awareness of a broader array of gynecologic cancers, including ovarian, cervical, uterine/endometrial, vaginal, and vulvar cancer.
Ovarian cancer may be the most familiar of these. Statistically, 22,530 women will be diagnosed with ovarian cancer in 2019, and ovarian cancer is the cause of more deaths than any other type of gynecologic cancer. Early signs tend to be vague, generic, or absent (bloating, pelvic or abdominal pain, early satiety, and/or urinary symptoms), and helps to explain the statistic that approximately 75 percent of women are diagnosed in Stage III or Stage IV. Women are advised to consider whether these symptoms are persistent, more often, or more severe than what they would consider normal for them.
Other symptoms can include:
- Stomach upset
- Back pain
- Changes in menstrual cycle
- Abdominal swelling with weight loss
Complete pelvic exams, transvaginal US and CA-125 remain the most common screening tests, but they lack the reliability and specificity that would be necessary to be effective screening tools (i.e., not everyone with ovarian cancer will show an elevation in CA-125).
Can ovarian cancer be prevented? Some ovarian cancers are believed to actually begin in the fallopian tubes (traveling to the ovaries and growing more rapidly there), and women with BRCA1 and BRCA2 gene mutations may benefit from removal of the fallopian tubes (leaving the ovaries in place longer). Drug studies for risk reduction are also underway and genetic testing of tumors is leading to more targeted therapies for treatment, particularly for recurrences of ovarian cancer.
Early detection and prevention efforts for other gynecologic cancers have made notable advances in recent years:
- Regular PAP tests, HPV testing, and vaccination of girls and boys can prevent cervical cancer.
- Regular exercise, control of blood pressure and blood sugar, and weight management can reduce the rate of uterine cancer.
- Reducing the risk of HPV infection, through the use of condoms and/or vaccine can also reduce the risk of vulvar and vaginal cancer.
Interestingly, smoking is also listed as a risk factor for several of the gynecologic cancers. Some theorize, for example, that the suppressive effect of smoking on the immune system may lead to better conditions for the HPV infection to take hold.