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A predicted 106,000 women will be diagnosed with gynecological cancer in 2023.
Early detection of gynecological cancers is key to improved outcomes, so it’s important to know the warning signs.
The experienced specialists at the Swedish Cancer Institute can help you and your family access the screenings and tests that help detect cancer and understand your risks.
The National Cancer Institute estimates that more than 106,000 women in the United States will be diagnosed with gynecological cancer in 2023. While the thought of gynecologic cancer provokes anxiety for many, there are preventive measures women can take to protect themselves and detect cancer in its earliest stages.
To learn more about the five most common types of gynecologic cancers and get the latest information on prevention, detection and treatment, we spoke with Chirag Shah, M.D. MPH, medical director for the Gynecological Oncology & Pelvic Surgery program at the Swedish Cancer Institute.
The most common gynecological cancers
Gynecologic cancer includes any cancer that begins within the female reproductive organs, located in the pelvic area below the stomach and between the hip bones.
“While the majority of gynecological cancer diagnoses happen after menopause, these cancers can affect women at every age,” says Dr. Shah. “And because early detection is linked to improved survival rates, it is important that women check with their providers to ensure they are getting the recommended screenings for their age and risk factors.”
The most prevalent type of gynecological cancer, endometrial cancer originates in the lining of the uterus — called the endometrium — which builds up and then naturally sheds every month during menstruation. Endometrial cancer tends to be more common after menopause.
Ovarian cancer starts in the cells on or in an ovary. Because the early symptoms of ovarian cancer are usually mild, it can spread to the fallopian tube or other pelvic organs before it is detected. It’s most common in postmenopausal women but can develop at any age.
Cervical cancer usually occurs in people over the age of 30. It is typically a slow-growing cancer, so regular screening is essential. Human papillomavirus (HPV), transmitted through sexual activity, is the leading cause of cervical cancer.
Vaginal cancer is a rare cancer affecting only about 5,000 people in the United States annually. In the early stages, the symptoms of vaginal cancer usually are not noticeable. When symptoms (e.g., abnormal vaginal discharge) begin to appear, they are not exclusive to vaginal cancer and can be symptoms of other, less serious conditions.
A rare type of cancer, vulvar cancer occurs on the outer part of the female genitals and includes squamous cell vulvar carcinoma, melanoma of the vulva, vulvar adenocarcinoma and basal cell carcinoma.
How to reduce the risk of gynecological cancer
“Some gynecologic cancers such as ovarian cancer have long had a reputation for being ‘silent’ — which implies that they are not preventable or detectable until it’s too late and that only limited treatment options are available,” says Dr. Shah. “But with advancements like modern testing, screening and genetic discovery, early detection is possible.”
Get the HPV vaccine
Cervical, vaginal and vulvar cancers are caused by HPV, and the HPV vaccine protects against the types of HPV that most often cause these cancers. It works best when received before any exposure to HPV.
The HPV vaccination is recommended for:
- Preteens age 11 to 12 (it can be given starting at age nine).
- Everyone through age 26 years (if not already vaccinated).
Some adults between the ages of 27 and 45 years who are not already vaccinated may decide to get the HPV vaccine to protect them from new HPV infections, but more people in this age group have already been exposed to HPV.
Schedule regular gynecological screenings
Of all the gynecologic cancers, only cervical cancer has regular screening tests that can find cancer early, when treatment works best. Depending on age and risk factors, women between the ages of 30 to 65 should work with their provider to choose one of these three testing options:
- A Pap test and an HPV test (co-testing) every 5 years.
- A Pap test every 3 years.
- An HPV test every 5 years.
“Following a regular screening schedule is important, regardless of whether you have received the HPV vaccine or are sexually active,” says Dr. Shah.
Learn to spot the warning signs of gynecological cancer
Gynecological cancers have some shared symptoms, but each is unique. And not everyone with gynecological cancer experiences the same symptoms. That's why it is important to pay attention to any warning signs you may experience.
“If you have vaginal bleeding that is unusual for you, talk to a provider right away,” says Dr. Shah. “This includes any vaginal bleeding after menopause, or if you have not yet gone through menopause but notice that your periods are heavier, last longer than normal for you, or if you’re having unusual bleeding between periods. When a patient experiences abnormal bleeding we usually recommend a biopsy to help establish whether it is malignant.”
You should also see a doctor if you have any other warning signs that last for two weeks or longer and are not normal for you, such as:
- Feeling full too quickly or having difficulty eating, bloating, and abdominal or back pain, which are common with ovarian cancer.
- Pelvic pain or pressure, which are common with ovarian and uterine cancers.
- More frequent urination, an urgent need to urinate or constipation, which are common for ovarian and vaginal cancers.
- Itching, burning, pain or tenderness of the vulva, as well as changes in vulva color or skin, such as a rash, sores, or warts, which can be signs of vulvar cancer.
Maintain a healthy weight
“We know that obesity is linked to an increased risk of endometrial cancer,” says Dr. Shah. “This is because obesity increases estrogen levels and endometrial cancer is a hormonally driven cancer. Maintaining a healthy body weight significantly decreases the risk.”
Medical weight loss programs, like the medical weight management program at Swedish, offer individualized care and customized plans for building healthy eating habits that help reduce the risk of disease, including cancer.
Ask about genetic testing
Depending on your family’s health history of breast or ovarian cancer your provider may recommend genetic counseling and testing. Talk with your doctor if you are at increased risk for gynecologic cancer. Ask what you might do to lower your risk and whether you are a candidate for testing.
“At Swedish, our genetic counselors work directly with patients to ensure they receive the correct genetic tests and optimize their insurance plans to receive the maximum coverage,” says Dr. Shah.
How are gynecological cancers diagnosed?
Diagnosis of gynecological cancer depends on what type of cancer is suspected. Your provider may order one or more tests or exams, which may include:
- A pelvic exam.
- Tests and procedures such as a biopsy, colposcopy or endoscopy.
- Diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT and transabdominal (outside the body) or transvaginal (inside the vagina) ultrasound.
If you receive a diagnosis of cancer, experts at Swedish will work with you to develop a personalized treatment plan.
How are gynecological cancers treated?
Gynecologic cancer often requires more than one kind of treatment and may include:
- Chemotherapy, which uses medicine (in intravenous or pill form) to shrink or kill the cancer.
- Radiation, which uses high-energy rays (similar to X-rays) to kill the cancer.
- Immunotherapy, which uses medicine to upregulate one’s own immune system to fight cancer
- Surgery to remove cancerous tissue.
Getting a cancer diagnosis brings a difficult mix of emotions, and it can be hard to feel confident about choosing your treatment plan. Swedish Gynecologic Oncology experts are here for you. They will talk with you about the best treatment options available for your type and stage of cancer, so you understand the risks and benefits of each treatment and their side effects to help ensure your treatment plan aligns with your lifestyle and health goals.
Clinical trials and genetic testing offer hope for the future
Swedish is a national and international center for clinical trials, which are helping develop treatments to address cancer at the molecular level. Every gynecological cancer patient at Swedish has the opportunity to undergo genetic testing and genetic sequencing of their cancer, helping their care team obtain detailed information to tailor treatment to each patient.
This information goes beyond identifying BRCA 1 and 2 genes. It includes total cancer risk panels that provide information about how relatives should be screened and which family members would benefit from risk-reducing surgery. Further, the molecular signature can match patients to targeted therapies and clinical trials, ensuring personalized care.
Learn more and find a provider
If you have concerns about gynecological cancer, Swedish is here for you.To learn more about genetic testing and clinical trials, as well as gynecological cancer screening and treatment, contact the Swedish Cancer Institute. We can accommodate both in-person and virtual appointments.
Join our Patient and Family Advisory Council.
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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