Gynecologic cancers – know the symptoms and how to prevent them

Gynecologic Cancer Awareness Month is a reminder for women to make their health a priority. 

Gynecologic cancers include all cancers of the female reproductive system, including cancers of the cervix, ovaries, uterus, vulva and vagina. According to the American Cancer Society, there were an estimated 116,760 new cases diagnosed and approximately 34,080 deaths from gynecologic cancers in the U.S. in 2020.  

We spoke with Ritu Salani, MD, MBA, professor of UCLA Obstetrics and Gynecology and director of the UCLA division of gynecologic oncology, to learn more about these diseases. Here’s what she wants every woman to know about symptoms, prevention, early diagnosis and treatment so you can take care of yourself and your loved ones.

Cervical cancer

Symptoms of cervical cancer commonly include abnormal vaginal bleeding (in between cycles or after intercourse), foul-smelling vaginal discharge, or abnormal findings on a Pap test. If suspected, your provider will perform cervical biopsies and possibly a colposcopy.

Things you can do to reduce your risk of developing cervical cancer: 

1. HPV vaccination: Ideally between ages 9-26 but can be given up to age 45. This may prevent multiple types of cancers (cervix, vulvar, anal, head and neck). 
2. Pap test + HPV testing: Recommendations vary from 3-5 years for normal testing. 
3. Practice safe sexual habits
4. Avoid tobacco use

Uterine cancer (also called endometrial cancer)

Symptoms of endometrial cancer commonly include abnormal bleeding (in between cycles) or bleeding after menopause (which is never normal). If suspected, your provider will obtain a pelvic ultrasound and an endometrial biopsy. 

Things you can do to reduce your risk of developing endometrial cancer:

1. Maintain a healthy body weight
2. Know your family history of cancers (endometrial, colon, ovary) which may be associated with Lynch syndrome. 

Ovarian cancer

Ovarian cancer presents with vague symptoms which includes abdominal bloating, pelvic pressure, loss of appetite or feeling full early, or changes in bowel or bladder habits. If suspected, your provider will order imaging tests (ultrasound or CT scan) and, if an ovarian mass is noted, consider checking blood tests such as a CA-125 level. 

Things you can do to reduce your risk of developing ovarian cancer:

1. Know your family history (e.g. cancers of the ovary, breast, colon, prostate, pancreatic) which can be associated with mutations in the BRCA gene and Lynch syndrome. The family history of both your mother and father can impact you. 
2. Oral contraceptive pill use before menopause.

Vulvar cancer

Symptoms of vulvar cancer commonly include itching, irritation, discoloration, or a mass/lesion the vulva. If suspected, your provider will perform a vulvar biopsy.

Things you can do to reduce your risk of developing vulvar cancer: 

1. HPV vaccination: Ideally between ages 9-26 but can be given up to age 45. This may prevent multiple types of cancers (cervix, vulvar, anal, head and neck). 
2. Avoid tobacco use.
3. Inspect your vulva for skin changes. 

What are the facts every woman needs to know about gynecologic cancer?

• Routine physical exams may detect abnormal cells (on Pap test or seen on exam) of the cervix or vulva and allow for treatment before becoming cancerous.
• Pap smears/tests do not detect endometrial or ovarian cancer.
• Postmenopausal bleeding is never normal. Know your family history (both male and female relatives) and ask if genetic testing is right for you.
• Reduce your risk of cancer and other health problems by:
• Maintaining a healthy weight
• Eating a well balanced diet
• Exercising regularly
• Avoiding tobacco use

At UCLA our multidisciplinary team of experts work together to evaluate each patient’s situation and to customize a treatment plan that is in the best interest of each individual patient. We have experts in minimally invasive procedures, radical surgery, radiation therapy and chemotherapy and clinical trials. Remember, early diagnosis is key to successful treatment. 

Keep your health on track and schedule a yearly pelvic exam with a UCLA Obstetrics and Gynecology provider, request an appointment online or call 310-794-7274.