Gynecologic Cancer Awareness

Cancer Type

Cancer of the cervix
Most cervical cancers begin in the cells lining the cervix. There are 2 main types of cervical cancers: squamous cell carcinoma and adenocarcinoma. About 80% to 90% of cervical cancers are squamous cell carcinomas.

Source: American Cancer Society Cervical Cancer.

Cancer of the endometrium (uterus)
Endometrial cancer is a cancer that starts in the endometrium, the inner lining of the uterus (womb). It is a highly curable tumor. This type of cancer is different from cancer of the muscle of the uterus (see below) which is known as sarcoma of the uterus.

Source: American Cancer Society Endometrial (Uterine) Cancer.

Sarcoma of the uterus
Uterine sarcoma is a cancer of the muscle and supporting tissues of the uterus (womb). Types of uterine sarcoma: endometrial stromal sarcoma, undifferentiated sarcomas and uterine leiomyosarcomas.

Source: American Cancer Society Uterine Sarcoma.

Cancer of the vagina
The vagina is sometimes called the birth canal. The vagina goes from the cervix (the lower part of the uterus) to open up at the vulva (the external genitals). Types of cancer of the vagina: squamous cell cancer, adenocarcinoma, melanoma, sarcoma.

Source: American Cancer Society Vaginal Cancer.

Cancer of the vulva
The vulva is the outer part of the female genitals. A rare kind of gynecological cancer.

Source: American Cancer Society Vulvar Cancer.

Cancer of the fallopian tubes
In this cancer, tumor develops from cells inside the fallopian tubes. Cancer of the fallopian tubes is very rare. Fallopian tube cancer and ovarian cancer have similar symptoms.

Source: American Cancer Society Ovarian Cancer.

Cancer of the ovaries
Ovarian cancer is cancer that begins in the ovaries. Ovaries are reproductive glands found only in women. There are three types of ovarian cancer: eptithelial (most common), germ cell and stromal cell.

Source: American Cancer Society Ovarian Cancer.

Gestational trophoblastic diseases
Gestational trophoblastic disease (GTD) is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus. GTD does not develop from cells of the uterus like cervical cancer or endometrial (uterine lining) cancer do. Instead, these tumors start in the cells that would normally develop into the placenta during pregnancy. Most GTDs are benign (non-cancerous) and they don't invade deeply into body tissues or spread to other parts of the body. But some are cancerous.

Source: American Cancer Society Gestational Trophoblastic Disease.

News

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Risk Factors/Prevention

Risk Factors

Anything that increases a person's chance of developing a disease is called a risk factor. Although certain factors increase a woman's risk for developing gynecologic cancer, they do not always cause the disease.

• Age
  Most gynecologic cancers develop in post-menopausal women (after age 60), though some cancers can strike women at much younger ages.
• Pharmaceuticals
  Certain fertility drugs that failed to result in pregnancy may increase risk. DES, an estrogen drug (diethylstilbestrol) taken during pregnancy puts daughters at risk for a rare form of cervical and vaginal cancer. Tamoxifen increases risk.
• Genetics
  If a family history of gynecologic or breast cancer exists, women may want to consider being tested since those found to carry certain genes known to cause gynecologic cancers are at greater risk.
• Reproductive history
  Early onset of menstruation (before age 12), having no children or having a first child after age 30, and/or experiencing menopause after age 50 are risk indicators.
• Nutrition
  A high-fat diet and obesity increase risk for endometrial cancer, especially for people with Type I diabetes.
• Lifestyle
  Sex before age 18, sleeping with numerous partners, or having a partner with a sexually transmitted disease (STD), such as HIV, or being a smoker all can increase one's gynecologic cancer risk.
• Hormone Replacement Therapy (HRT)
  Endometrial and ovarian cancer risk is increased with the prolonged use of HRT or estrogen replacement therapy (ERT).

Prevention

Of all the gynecologic cancers, only cervical cancer has proven prevention and screening tools:

• A Pap test can find abnormal cells that may turn into cervical cancer. Removal of the abnormal cells prevents cervical cancer. Pap tests can also find cervical cancer early, when the chance of being cured is very high
  
  
• The human papillomavirus (HPV) vaccine is available for girls and women to prevent cervical cancer. It is recommended for girls ages 11-12, but can be given beginning at age 9. It also can be given to girls and women age 13-26 who did not get any or all of the shots when they were younger. Ideally, girls should get three doses of this vaccine before their first sexual contact. The HPV vaccine protects against the types of HPV that most often cause cervical cancer.
  
  
• In addition to the Pap test, the HPV test may be used for screening women 30 or older. It also is used to provide more information when Pap test results are unclear for women 21 and older.

Source: Centers for Disease Control Gynecologic Cancers: Prevention and Screening

Screening

• All women should begin cervical cancer screening at age 21.
  
  
• Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
  
  
• Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
  
  
• Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.
  
  
• Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
  
  
• Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
  
  
• Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.

Source: American Cancer Society Cervical Cancer Screening Guidelines.

Symptoms

Each gynecologic cancer is unique, with different signs and symptoms.

Cervical Cancer
Early on cervical cancer may not cause signs and symptoms. Advanced cervical cancer may cause bleeding or discharge from the vagina that is not normal for you, such as bleeding after sex. If you have any of these signs, see your doctor.

Ovarian Cancer:

• Vaginal bleeding (particularly if you are past menopause) or discharge
• Pelvic pain or pressure
• Abdominal or back pain.
• Bloating(abdominal)
• A change in your bathroom habits, such as having to pass urine very badly or very often, constipation, or diarrhea.

Uterine Cancer

• Vaginal discharge that is not normal for you.
• Abnormal vaginal bleeding.
• Pain or pressure in your pelvis.

Vaginal and Vulvar Cancers:

• Vaginal discharge or bleeding that is not normal for you.
• A change in bathroom habits, such as having blood in the urine or stool; going to the bathroom more often than usual; or feeling constipated.
• Itching or burning of the vulva
• Changes in vulva color or skin, such as a rash, sores, or worts

Source: Centers for Disease Control Gynelogical Cancers: Symptoms

Take Action

U-M Clinical Studies

Clinicaltrials.gov

Women's Cancer Network-Gynecology Oncology Group Clinical Trials

Resources

University of Michgan

National Resources

American Cancer Society: Cancer Facts for Lesbians and Bisexual Women

National Cancer Institute: Gynecologic Cancers

Foundation for Women's Cancer

Women's Cancer Network

National Cervical Cancer Coalition

National Comprehensive Cancer Network

Centers for Disease Control and Prevention

• Gynecological Cancers
• HPV Vaccine Information for Young Women