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GYN Cancer: Are you at risk for a gynecologic cancer

January 22, 2019
January is Cervical Cancer Awareness Month, an initiative that seeks to educate women about the issues and conditions that lead to more than 13,000 new diagnoses of invasive cervical cancer each year in the U.S. However, cervical cancer is just one of the gynecological cancers women may face during their lifetimes. How do you know if you’re at risk, and more importantly, what can you do to stay healthy “down there”?

Gynecological cancers can affect any part of the female reproductive system, including the ovaries, the uterus, the cervix, the vulva, and the vagina. While uterine/endometrial cancer is the most common gynecological cancer affecting 61,880 women annually, ovarian cancer is proportionally the most deadly, affecting 22,530 women and causing 13,980 deaths per year.

Are you at risk?

Kimberly Levinson, MD — Associate Director, Gynecologic Oncology
Dr. Kimberly Levinson, associate director of gynecologic oncology at the Greater Baltimore Medical Center and an assistant professor at the Johns Hopkins School of Medicine for the Kelly Gynecologic Oncology Service, says that risk factors vary for each kind of gynecological cancer.

“Ovarian cancers can be associated with specific genetic abnormalities, such as the BRCA genes, however, most ovarian cancers are sporadic,” she explains. “With endometrial cancers, obesity is a factor due to excess estrogen that can lead to abnormal cell growth.”

Almost all cases of cervical cancer are attributable to the HPV virus, and this virus is the cause of some vulvar cancers as well. Acquiring the HPV virus puts women at risk for dysplasias, pre-cancerous cells in the cervix that can eventually evolve into cancer.

Smoking is also associated with HPV-related cervical and vulvar pre-cancers and cancers.

While having a history of sexually transmitted infections is associated with an increased risk of cervical cancer, this is likely due to the increased risk of acquiring the HPV virus and potentially a decreased immune response to HPV. Sexually transmitted infections are not associated with an increased risk of non-HPV related gynecological cancers.

“The risks of some gynecologic cancers do increase with age,” Dr. Levinson adds. “For instance, ovarian and uterine cancers are more common in post-menopausal women.”

What to watch for

Just as risk factors vary between different forms of gynecologic cancer, so do symptoms. The most common indication of endometrial cancer is unexplained bleeding; other cancers may not present with any symptoms at all.

“Cervical changes are usually discovered during routine screenings,” Dr. Levinson says. “There may not be any overt symptoms until the cancer reaches later stages, but screenings can detect pre-cancerous cells early on, allowing us to prevent this cancer altogether.”

How often to schedule screenings depends on your individual health status and previous history. Talk with your doctor to determine the guideline that’s right for you.

Ovarian cancer is the most difficult gynecological cancer to detect because there’s no screening process and symptoms often don’t appear until the cancer is already in advanced stages, making it more difficult to successfully treat.

“With any form of cancer, specific disease factors and staging determine the most appropriate treatment options,” Dr. Levinson notes. “If the cancer is caught early, surgery often plays a role, then your doctor can determine whether additional treatment, often with chemotherapy or radiation is needed.”

Innovations in cancer treatment include new immunotherapies and targeted approaches that are delivered through the abdomen directly to ovarian tumor sites. Studies and trials indicate improved outcomes among certain patient groups.

Safeguard your health

When administered prior to the onset of sexual activity, the HPV vaccine prevents infection and thus prevents these cancers. This vaccine therefore offers front-line protection against the development of HPV-related cancers. Other than vaccination, the most important thing women can do at any age to maintain good gynecological health is to keep up with regular screenings.

“See your gynecologist right away if you’re having any issues,” Dr. Levinson urges. “This is the person who’s best qualified to triage your problem. If symptoms persist, be persistent and find out why.”

Amy Lynch for GBMC
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