There are five main gynecologic cancers: uterine, cervical, ovarian, vaginal and vulvar. Only one, cervical, has a routine screening test.
That leaves women relying on their own bodies for the rest. Many of the warning signs look like something else.
The stakes are high. The American Cancer Society projects 117,600 new cases of gynecologic cancer in the U.S. this year.
A team of specialists at Rutgers New Jersey Medical School and University Hospital in Newark (Drs. Nancy Zhou, Ana Tergas, Lisa Gabor, and Udele Tagoe, from left in photo above) treats women in the greater Newark area. They work with Rutgers Cancer Institute, the state’s only National Cancer Institute-designated Comprehensive Cancer Center.
Gabor said the cancers share more than people realize.
“Gynecologic cancers have overlapping symptoms and risk factors. Increasing age is a risk factor across the board, while smoking is particularly associated with cervical and vulvar cancers,” she said.
Ovarian cancer is the hardest to spot.
“Ovarian cancer has notoriously vague symptoms, including abdominal distention or bloating, changes in weight or appetite and abdominal or pelvic pain,” Gabor said.
The team shared more in a Q&A provided by Rutgers. Responses have been edited for length.
Q: Who is most at risk?
Gabor: Uterine and ovarian cancers can be linked to hereditary cancer syndromes, such as hereditary breast and ovarian cancer and Lynch syndrome, so personal and family histories of cancer may increase risk.
Human papillomavirus infection is particularly important in the development of cervical, vulvar and vaginal cancers. These cancers can all present with abnormal vaginal or postmenopausal bleeding.
Q: How are these cancers treated?
Gabor: Treatment may involve surgery, chemotherapy and radiation with the goal of maximizing success while minimizing side effects.
Q: What are some gynecologic cancer symptoms women might overlook?
Tergas: Since many symptoms of gynecologic cancers overlap with benign conditions, they may be overlooked.
Any bleeding after menopause warrants prompt investigation. Changes in menstrual patterns, especially heavy or uncontrolled bleeding, should also be evaluated. Persistent irritation, nonhealing wounds or ulcers of the vagina or vulva — especially when symptoms do not improve with treatment — require a thorough exam and possible biopsy.
Ovarian cancer symptoms may include bloating, decreased appetite, fatigue and weight loss, especially with a family history of cancer.
Q: Cervical cancer is the only gynecologic cancer with a routine screening test. What can women do to stay proactive?
Tagoe: High-risk human papillomavirus infection causes more than 90% of cervical cancers. While most young, healthy individuals clear the virus spontaneously, persistent infection can cause precancerous changes that may progress into cervical cancer.
Since HPV usually causes no symptoms, screening is an important tool in prevention. The Pap and high-risk human papillomavirus tests identify precancerous changes of the cervix. Women should discuss the appropriate screening strategy with their health care provider. The HPV vaccine protects against types responsible for most cervical cancers.
Most importantly, stay up to date with screening and follow up on abnormal results. Cervical cancer is highly preventable when HPV vaccination, screening and timely treatment of precancerous changes are combined.
Q: What kind of care can women get at Rutgers and University Hospital?
Tergas: At Rutgers and University Hospital, women facing gynecologic cancers have access to an academic medical center with experienced specialists that work collaboratively with the state’s only National Cancer Institute-designated Comprehensive Cancer Center — Rutgers Cancer Institute — right in their community. Our gynecologic oncologists provide full-spectrum care, including robotic and minimally invasive surgery, radical debulking surgery, chemotherapy and the latest targeted therapies.
We work within a multidisciplinary team to develop a coordinated plan tailored to each patient, who may also access clinical trials of promising new therapies.
Our goal is to care for the whole person by pairing expert medical treatment with supportive services such as nutrition and rehabilitation, fertility preservation counseling, palliative care and emotional and social support.
Q: What’s one message you want women to take away?
Zhou: Do not wait. Pay close attention to your body and act on what it tells you.
Many gynecologic cancers can be prevented or caught early, when they are most treatable, but only if women stay up to date on preventive care and seek care for symptoms that are new, persistent or unusual.
Early action can save lives.
For information about Rutgers New Jersey Medical School, go to njms.rutgers.edu.
For information about University Hospital, go to uhnj.org
