Cancer

What are Gynecologic Cancers?

Gynecologic cancers strike the organs of the female reproductive system, including the ovaries, cervix, uterus, placenta, fallopian tubes, vagina and vulva. While there may be signs or symptoms, often there are not.
In the States, 82,000 women are diagnosed with gynecologic cancer each year. It’s the fourth most common type of cancer in women and affects approximately 1 in 20 women.

• Cervical Cancer
• Endometrial and Uterine Cancer
• Fallopian Tube Cancer
• Gestational Trophoblastic Disease and Choriocarcinoma
• Ovarian Cancer
• Vaginal Cancer
• Vulvar Cancer

When facing a diagnosis of cancer, or the possibility, you want the best team of experts. The skilled staff at the University of Pennsylvania Health System provides the latest technology, research, information and support you need to aid you from diagnosis through treatment

Stages of Cancer

What is cancer “staging”?
When cancer is first diagnosed, your physician will carry out tests to investigate the extent of the cancer and to see whether it has spread to another part of the body from where it started. Staging is a way of recording the size and growth of a tumor.
Why staging is important?
Staging is used to determine the type of treatment you will need such as radiation, chemotherapy and/or surgery. There are staging systems designated for most forms of cancer.  Classifying a cancer’s stage enables doctors to have a common language to describe tumors. In addition, treatment results can be compared between tumors and guidelines for treatment can be standardized between different treatment centers.
What are the stages of cancer?
In general, there are four stages of cancer. However, the “staging diagnosis” depends on the type of cancer and the staging system the doctor is using. There are different ways of grouping cancers. Some staging systems have more groups and some less.

Stages are most often clarified by roman numerals and may be broken down further by alphabet characters. The following is a basic breakdown of how a cancer is staged:

• Stage 1 – The cancer is relatively small and contained within the organ it started in.
• Stage 2 – The cancer is localized, but the tumor is larger than in Stage 1. Stage 2 indicates that there are lymph nodes close to the original site that have cancer cells.
• Stage 3 – The cancer is larger and there are cancer cells in the lymph nodes in the area.
• Stage 4 – The cancer has spread (metastasized ) from where it started to another body organ, such as the liver, bones or lungs.

It is important to remember that while certain generalities can be taken from these stages, each individual and each cancer are in many respects, unique. Your physician will provide you with an accurate cancer diagnosis and stage.

Four Things You Can Do for Your Gynecologic Health

Gynecologic cancer affects the organs of the female reproductive system, primarily the cervix, ovaries, uterus and lining of the uterus, fallopian tubes, vagina and vulva. Each year, approximately 82,000 women in the United States are diagnosed with gynecologic cancer.
Part of maintaining your gynecologic health is knowing what you can do yourself to minimize your risk for gynecologic cancers. Experts agree there are four steps you can take to maintain your gynecologic health:

• Get to know your family history. If someone in your family, in particular a mother, sister or aunt, has suffered from gynecologic cancer — especially ovarian cancer — you are at greater risk of developing the disease yourself. Knowing your family history will help you and your doctor determine whether you should undergo certain screening tests.
• Educate yourself about gynecologic cancers. Don’t be afraid to talk with your doctor about gynecologic cancer. Before your next visit, write down your questions and concerns. In addition, use the many resources available on gynecologic cancer: the Internet, your local library or bookstore. Arming yourself with knowledge leads to empowerment and greater peace of mind.
• Make an appointment for your annual gynecologic exam and PAP test. An annual exam is one of the best tools at your disposal for detecting cancers early. A gynecologic exam usually includes a PAP test to screen for cervical cancer and a manual check of the gynecologic organs for any abnormalities. Dependent upon your age and other health factors, you may receive an HPV test in addition to a pap test.
• Determine your risk. Go over your risk factors for gynecologic cancers. Be sure to talk about risk factors with your doctor so you can determine what screenings or preventive measures you need to take.

By following these four recommendations, you’re taking the right steps toward gynecologic health.

Preventing Gynecologic Cancer

While there’s no guaranteed way to prevent gynecologic cancer, one of the best ways to prevent all forms of cancer is a healthy lifestyle, including a balanced diet and regular exercise. Talk with your doctor about specific preventive measures you can take.
As with most cancers, it’s important to know your family history of gynecologic cancer. This will help you take action toward prevention. Plus, you and your doctor can use this knowledge to determine the need and frequency of self-examinations and screening tests.
Recent scientific research has yielded further clues about preventing certain gynecologic cancers:

• Use of oral contraceptives: Several studies have shown oral contraceptives are related to a decreased risk of ovarian cancer and uterine cancer.
• Smoking: Quitting smoking decreases your risk of uterine and cervical cancer.
• Sexually transmitted diseases: Use condoms to prevent the spread of STDs, which can increase your risk of cervical cancer.
• Tubal ligation: Studies have found that women who’ve had a tubal ligation — surgery to tie off the fallopian tubes to prevent pregnancy — have a decreased risk of ovarian cancer.

Finally, when thinking about prevention, be aware of ways to detect these cancers as early as possible. Most cancers are more successfully treated in the early stages of the disease. Therefore, it’s important to stick to a schedule of annual gynecologic exams, including the PAP test, to detect any evidence of gynecologic cancer at its earliest stages.

Who is at Risk?

While all women are at risk for gynecologic cancer, some factors can increase a woman’s risk. Knowing your own risk for gynecologic cancer is one of the best ways to maintain your gynecologic health. How patients understand and translate health risks impacts their decision-making when it comes to treatment options. Genetic testing and counseling for ovarian cancer and breast cancer risk offers many benefits to patients, including implementing preventative treatment options and/or lifestyle changes that can reduce a person’s risk of having cancer.
To aid patients in assessing their cancer risk, Penn offers a Cancer Risk Evaluation Program for breast and ovarian cancer at the Abramson Cancer Center of the University of Pennsylvania, Joan Karnell Cancer Center at Pennsylvania Hospital and Penn Medicine at Radnor.
The risk factors for each type of gynecologic cancer are different. One of the most important risk factors for ovarian cancer is family history. Talk with your doctor if you have a sister, aunt or mother who has been diagnosed with ovarian cancer. As you age, your risk of ovarian cancer increases, particularly at menopause. Women who haven’t borne children or have infertility problems are at higher risk, while pregnancy decreases the risk.
Risk factors for cervical cancer include smoking, early age of first intercourse, a high number of sexual partners, and infection with HIV. However, woman without any of these risk factors have developed cervical cancer. An annual gynecological exam, including a Pap test, reduces your risk as it allows early detection of cervical cancer when it’s most treatable.
For uterine cancer, risk factors include obesity, high blood pressure, diabetes, use of certain hormones or drugs and late menopause. You also have a slightly higher risk if you haven’t been pregnant.
The risk factors for vulvar cancer — a very curable type of cancer — include diabetes, advanced age and chronic irritation of the vulva.
Extremely rare, vaginal cancer is usually found in elderly women and is treated with radiation therapy. Also very rare, cancer of the fallopian tubes has risk factors similar to those for ovarian cancer.