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Women's Cancer - April '07
Gynecologic Cancers: Maintain your gynecologic health with education and early detection
Angela Kueck, MD
When it comes to women’s gynecologic cancers (cervical, endometrial and ovarian cancers), early detection is important for successful treatment. At The University of Toledo Medical Center, physicians conduct comprehensive yearly gynecologic examinations and provide screening that may detect some gynecologic cancers early.
“Women need to see a gynecologist and get a yearly exam,” says Angela Kueck, MD, assistant professor of obstetrics and gynecology at The University of Toledo. “Women should begin seeing a gynecologist within three years of becoming sexually active, or by the age of 21 and every year after that.” A typical exam includes a pelvic exam, Pap smear and comprehensive health and family history. In addition, women should notify their physician if they have vaginal bleeding after menopause, new onset of heavy menstrual periods or bleeding between periods.
Cervical cancer is the most preventable gynecologic cancer
Cervical cancer is cancer in the cervix that is mainly caused by human papillomavirus (HPV), a sexually transmitted infection. HPV infection is common in sexually active women, but causes cancer only in a few. Smoking, a high number of sexual partners and early age of first intercourse are other risk factors. Cervical cancer does not present any symptoms in the early stages which is why Pap tests are so important. In more advanced stages, cervical cancer may cause vaginal bleeding after intercourse or between periods, abnormal discharge and pelvic pain. A vaccine to prevent cervical cancer became available in 2006 and is being offered to girls ages 9 to 26 at UTMC.
Endometrial cancer is the most common gynecologic cancer
Endometrial cancer is cancer in the uterus and is the fourth most common cancer found in women. Risk factors for the cancer include obesity, hypertension, diabetes and late menopause. Vaginal bleeding after menopause and irregular or excessive vaginal bleeding before menopause may be a warning sign of uterine cancer. A diagnosis is typically made by an endometrial biopsy and is treated usually by hysterectomy and surgical staging. This may also be done with a minimally invasive approach in select patients.
Ovarian cancer is the most deadly of the gynecologic cancers
Ovarian cancer is cancer in the ovaries and is the fifth leading cause of cancer death among women in the United States. Although the cause of ovarian cancer is unknown, it may be linked with the tissue repair process that follows monthly menstruation. There are no established tests to screen for ovarian cancer.
Risk factors for the cancer include inherited gene mutations, family history, older age and infertility. Symptoms for ovarian cancer may include abdominal pressure, urinary urgency and pelvic discomfort or pain. Additional symptoms can include unexplained changes in bowel habits, loss of appetite, or unexplained weight gain. A pelvic ultrasound and a blood test called a CA 125 may be checked to evaluate for ovarian cancer.
Standard treatments include surgery, chemotherapy
Typical treatment of all three types of cancer may include surgery, chemotherapy and radiation therapy. Additional treatments include laser surgery and hormone therapy.
Advancements in treatment lead to better prognosis
Dr. Kueck says the new HPV vaccine is a major advancement in the prevention of cervical cancer. “Right now it is approved for girls ages 9 through 26,” she says. “We do not know yet if it will help older women who have already been exposed to HPV, but it is a preventive vaccine for younger girls.”
Another significant advancement is the use of laparoscopic surgery for endometrial cancer. During a hysterectomy, a typical surgery for the cancer, the uterus and ovaries are removed. “Now we can do the treatment laparoscopically, which is minimally invasive,” says Dr. Kueck. “Patients are able to go home the next day and recovery is much faster than it used to be. There is less pain, and studies have shown it is as effective as traditional open surgery.”
A leading-edge treatment for ovarian cancer includes the use of chemotherapy. “We are able to put a port into the abdomen and the chemotherapy is given directly to that area, better targeting the cancer and improving survival in patients,” says Dr. Kueck.
Yearly exam most effective way to prevent women’s cancers
Despite the development of better treatments for the different types of women’s cancer, Dr. Kueck emphasizes the importance of seeing a gynecologist for a yearly checkup. “The most important thing women can do is take care of themselves,” she says. She encourages women of all ages to continue to see their gynecologist to help prevent cancer and other health issues.
To schedule an appointment with Dr. Kueck or a gynecologic exam at UT Medical Center, please call 877-451-2299.
