What is Gynecologic Cancer?
FACOG, FACS
Gynecologic cancers are a group of cancers that develop in the woman’s reproductive organs, including cervical cancer, ovarian cancer, vaginal cancer, vulvar cancer, and uterine/endometrial cancer. Each of these cancers is different, with distinct causes, risk factors, and treatment options. However, across all gynecologic cancers, treatment is most effective when the cancer is found early. Understanding more about women’s cancers, risk factors, and symptoms can lower your chance of developing advanced-stage gynecologic cancer.
What to Expect if You Were Diagnosed With a Gynecologic Cancer
If you have been diagnosed with gynecologic cancer, the first step is to schedule a consultation with a gynecologic oncologist. This type of doctor specializes in treating cancers that develop in the female reproductive system. If you’re in the Hampton Roads area, we offer gynecologic oncology appointments in Doylestown, Sellersville, and Feasterville. Ultimately, the goal of this first appointment with a gynecologic oncologist is to provide you with an individualized treatment plan.
Before your appointment, our team will review the medical records shared with them to understand your needs better. When meeting with Mark Shahin, M.D., FACOG, FACS, you will learn more about your type of cancer, if surgery is needed, and the types of treatment to expect.
Don’t Ignore These Signs and Symptoms of Gynecologic Cancer
Cancers that begin in the female reproductive system are called gynecologic cancers. This includes cervical, ovarian, uterine, vaginal, and vulvar cancers. Each of these cancers has different risk factors, signs, symptoms, and treatments.
Knowing your body and what is normal for you can help you recognize any warning signs of gynecologic cancer. Pay attention to changes that may seem out of the ordinary. Early detection can improve your chances of successful treatment.
“Bodies can change, and some change is normal,” said Mark Shahin, M.D., FACOG, FACS. “But paying attention to the changes in your body can help alert you when something is wrong.”
The following information refers to symptoms experienced by people assigned female at birth. If you have had a surgical reassignment, please discuss any concerns with your physician.
What are the Common Symptoms of Gynecologic Cancers?
Many of these potential signs and symptoms may have other causes and do not necessarily indicate cancer. However, it is important to see a physician if you experience unusual symptoms. Examples of these symptoms include:
Abnormal vaginal bleeding or discharge
Abnormal vaginal bleeding or discharge is a common sign for cervical, ovarian, vaginal, and uterine cancers. Over 90% of women diagnosed with endometrial cancer, a type of uterine cancer, experience abnormal bleeding. If you experience bleeding outside of your menstrual period, heavy bleeding, or bleeding during sex, speak to your doctor. If you are post-menopausal, tell your doctor if you experience any bleeding or spotting.
Loss of appetite or sudden weight loss
Feelings of fullness, lack of hunger, and sudden weight loss can be signs of a medical condition. If you experience any of these without changes to your diet or exercise, consult your doctor. Frequent indigestion or nausea may also be a cause for concern. Changes in appetite can be a symptom of ovarian cancer or other non-reproductive cancers.
Abdominal or pelvic discomfort
People with ovarian or endometrial cancer often experience ongoing pain or discomfort in the pelvis or abdominal area. This may include frequent gas, indigestion, pressure, bloating, or gas. These symptoms often also have other, non-cancerous causes. If you have concerns or are experiencing them along with other symptoms, speak to your doctor.
The need to frequently urinate
Ovarian or vaginal cancers may cause a more frequent or urgent need to urinate. If you’re not pregnant and haven’t increased your liquid intake, frequent trips to the bathroom may be a cause for concern.
Pain or discomfort in the vulva
If you’re experiencing pain, burning, itching, or tenderness in the vulva, this may be a sign of vulvar cancer. Pay attention to any changes in vulva color or any rashes, sores, or warts on the skin.
Ovarian Cancer Stages
Once you have been diagnosed with ovarian cancer, your physician will determine the stage of your cancer to help guide your treatment plan. To do this, your physician will look at the extent of the primary tumor, any spread to nearby lymph nodes, and whether the cancer has spread to other parts of the body.
Ovarian cancer is staged using the FIGO (International Federation of Gynecology and Obstetrics) staging system. The stage of the cancer is determined by examining tissue removed by surgery. If surgery cannot be done right away, staging will be based on the results of a physical exam, biopsy, and imaging tests done before surgery.
Ovarian cancers in Stage I are located in one or both ovaries.
- Stage IA cancers are confined to one ovary and have no tumors on the external surface of the ovary.
- Stage IB cancers are in both ovaries but have no tumors on the external surface of the ovaries.
- Stage IC cancers can be in one or both ovaries but do have tumors located on the external surface of the ovaries.
Stage II
Cancer in this stage has spread beyond the ovaries to the uterus, fallopian tubes, or other nearby organs. It has not spread to the lymph nodes or distant parts of the body.
- Stage IIA cancers have spread to the uterus, the fallopian tubes, or both.
- Stage IIB cancers have spread to other nearby organs in the pelvic area.
Stage III
Stage III ovarian cancer has spread to the lymph nodes or the abdominal lining but has not spread to distant parts of the body.
- Stage IIIA1 cancers are in the lymph nodes found at the back of the abdomen. The areas of spread can be any size.
- Stage IIIA2 cancers have grown from the pelvis to the abdomen. The cancer in the abdomen is small and can only be seen under a microscope. It may or may not have spread to the lymph nodes in the back of the abdomen.
- Stage IIIB cancers have spread to the abdomen and are visible but are smaller than two centimeters. The cancer may or may not have spread to the lymph nodes in the back of the abdomen.
- Stage IIIC cancers have spread to the abdomen and are larger than two centimeters. The cancer may or may not have spread to the lymph nodes in the back of the abdomen.
Stage IV
Stage IV describes cancers that have spread outside of the abdomen to distant parts of the body.
- Stage IVA cancers have spread to the fluid around the lungs but have not spread to other distant areas.
- Stage IVB cancers have spread to the spleen, liver, lymph nodes outside of the abdomen, and/or other organs or tissues, including the lungs and bones.
Cervical Cancer Stages
After you receive your cervical cancer diagnosis, your physician will determine the stage of your cancer to help guide your treatment plan. To do this, your physician will look at the extent of the primary tumor, any spread to nearby lymph nodes, and whether the cancer has spread to other parts of the body.
Cervical cancer is staged using the FIGO (International Federation of Gynecology and Obstetrics) staging system. This identifies the clinical stage of the cancer, which is based on a physical exam, biopsies, imaging tests, and sometimes additional testing such as cystoscopy and proctoscopy.
Stage I
Cervical cancers in stage I have grown from the surface of the cervix into the deeper tissues of the cervix but have not spread to nearby lymph nodes or other parts of the body.
- Stage IA cancers are very small and can only be seen under a microscope.
- Stage IB cancers range in size and have spread more than 5mm into the tissue of the cervix but have not spread outside of the cervix.
Stage II
Stage II cervical cancers have spread through the cervix and the uterus but have not spread into the walls of the pelvis or the lower part of the vagina.
- • Stage IIA cancers have not spread into the tissues next to the cervix (parametria).
- • Stage IIB cancers have spread into the parametria.
Stage III
Cervical cancers in this stage have spread to the walls of the pelvis or the lower part of the vagina. The cancer may have spread to nearby lymph nodes but has not spread to other parts of the body.
- Stage IIIA cancers have spread to the lower part of the vagina but have not spread to the walls of the pelvis or nearby lymph nodes.
- Stage IIIB cancers have spread into the walls of the pelvis and/or are blocking the tubes that carry urine from the kidneys to the bladder.
- Stage IIIC cancers have spread to nearby lymph nodes. Tumors in this stage can be any size.
Stage IV
Cervical cancer has spread into the bladder, rectum, or distant parts of the body.
- Stage IVA cancer has spread to the bladder or rectum. It may also be growing out of the pelvis.
- Stage IVB cancer has spread to organs outside of the pelvic area.
Radiation Therapy for Cervical Cancer
Radiation therapy treats cancer by using high energy rays to target and eliminate cancer cells. Your physician may recommend radiation therapy as part of the main treatment for your cervical cancer. Depending on the stage of your cancer, radiation therapy may be used alone, after surgery, or concurrently with chemotherapy. Radiation therapy may also be used if your cervical cancer returns after treatment or spreads to other parts of the body.
External Beam Radiation Therapy
External beam radiation therapy uses a machine to deliver radiation to the area of the body affected by cancer. This procedure is painless and only lasts a few minutes, though set up for the treatment takes longer.
To treat cervical cancer, this form of radiation therapy is often combined with chemotherapy (chemoradiation), but it can also be used as the main treatment for cervical cancer for patients who cannot tolerate chemoradiation or cannot or do not want to have surgery.
Internal Radiation Therapy
Internal radiation therapy, also called brachytherapy, places sealed radioactive substances directly into or near the cancer. A type of internal radiation therapy called intracavitary brachytherapy is usually used for cervical cancer treatment. The radiation materials are placed into a device which is then placed directly into the vagina or cervix. This is usually used in addition to external radiation beam therapy.