Gynecologic Cancer: All You Need to Know

Posted by Divya Sathyanarayanan and Dr. Eijean Wu

September is recognized as Gynecologic Cancer Awareness Month. Gynecologic cancers poses a serious threat to women across the globe. In the United States, an estimated 110,070 new gynecologic cancer cases were diagnosed in 2018 and 32,120 deaths were reported during the same period¹.

We sat down with, Gynecologic Oncologist at CHA HPMC, to understand gynecologic cancer, treatment options, and prevention methods.

What is gynecologic cancer?

Gynecological cancers include cancer of the ovaries, fallopian tube, uterus, cervix, pregnancy related cancers, vulva, and vagina.

Which is the most common form of gynecologic cancer?

The most common form of gynecologic cancer is the endometrial cancer, which is cancer of the uterus. But fortunately, it is also one of the easily manageable form of cancer. More than 95% of the cases see treatment and recovery, as long as they are detected in stage I.

What are some of the common symptoms of gynecologic cancer?

Some of the common symptoms are:

• Abnormal bleeding: Get yourself evaluated by your primary care doctor or a gynecologist. This is for younger women who are still having periods. For women undergoing menopause, there shouldn’t be any bleeding
• Bloating: Many patients feel a sense of bloating and their belly feels big
• Unusual weight change: Some also witness weight loss or weight gain even without any change in their diet
• Constipation

If these symptoms are persistent for more than two to three weeks, you should get yourself evaluated. Bleeding and pain are the most common symptoms of cervical cancer. A PAP smear test is the most effective way to detect it.

Is gynecologic cancer hereditary?

We are finding that 15 to 20% of ovarian cancer cases have a genetic link. We are also learning more about the genomes to relate them better. The recommendation now across all the national societies is that all women diagnosed with ovarian cancer should get a genetic test to check for these most common genes. Firstly, it could be beneficial for the patient themselves because there are targeted therapies for women who have those specific genes and when they are on these treatments they may experience longer periods of not having the cancer relapse. There isn’t enough data to show that it increases their lifespan, but that’s mainly owing to the fact that many of these treatments were recently started. Secondly, even the patient’s family members can also benefit from the genetic testing as they can discover if the gene runs in their family. This helps other family members understand if they are at higher risk.

What are some of the medical advancements in this field?

One of the most exciting advancements in this field is the HPV (Human papilloma virus) vaccine. There are very few cancers that have a vaccination that is truly effective, with significant data that shows improvement in preventing cancer in men and women—HPV vaccine is one of them. Unfortunately, it does not have a high uptake in the United States. Internationally, several countries have started to make it mandatory for school age children to gain the benefit of taking the vaccine and preventing a whole series of cancer. These are helpful for not only gynecological cancers, but also head and neck cancers that are very significant and largely affect men.

What are the treatment options for gynecologic cancer cases?

Depending on the stage that it is detected, there are three main treatment options for gynecological cancer:

• Surgery
• Radiation therapy
• Chemotherapy or medical treatment involving infusion, pills, and injections

In 2018, CHA-HPMC introduced the cutting-edge, minimally invasive da Vinci Xi Surgical System for complex procedures, including gynecologic cases. Can you explain how this system benefits gynecological cancer patients?

One of the biggest benefits of the da Vinci Xi surgical platform, which has been seen in many studies, is that it reduces perioperative complications. This means it reduces chances of complication during surgery and reduces the time taken for the operation. The time factor is important because sometimes the patients have to be in unnatural positions, which can be decreased. Outside of the operating room, these patients tend to recover faster and their time in the hospital is much less. Usually, patients spend three to five days in the hospital post a normal surgery, but with minimally invasive procedure like da Vinci, they can even return home the same day or next day depending on their health.

What are some of the precautions to prevent development of gynecologic cancer?

There are some studies that have studied physical activity and cancer. Lot of endometrial cancers are related to obesity and metabolic syndrome which refers to the way the body processes glucose with the amount of insulin in the body. So, people who are obese face a higher risk of endometrial cancer. Physical exercises do help in decreasing the risk of cancer. Patients with endometrial cancer who are more active, can see less chances of recurrence post treatment. They live longer.

For ovarian cancer, there are pills to reduce the risk of cancer. There are some surgeries as well. Removing the ovaries significantly decreases the risk of developing ovarian cancer.
 
 
¹American Cancer Society. Cancer Facts and Statistics. Retrieved from https://www.cancer.org/research/cancer-facts-statistics.html. Accessed [September 04, 2019].
 
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