Five Questions about Gynecologic Cancer Prevention, Answered

Author

A headshot of Katelyn Dorney, MD of the Dana-Farber/Brigham and Women's Cancer Center in clinical affiliation with South Shore Hospital.

Katelyn McGovern Dorney, MD

A doctor discusses the results of a gynecologic exam with a patient

In an effort to increase awareness about the importance of cancer screening and prevention, this series asks experts in five cancer specialties – breast, colorectal, gynecologic, lung, and prostate – five questions focused on wellness, prevention, and the crucial screenings that help save lives.

As a gynecologic oncologist at the Dana-Farber Brigham Cancer Center  in clinical affiliation with South Shore Hospital, I often discuss the importance of regular cancer screenings and prevention with patients.

Here are five common gynecologic cancer questions I cover with patients.

When it comes to gynecologic cancer prevention, how important are routine or annual screenings?

Routine physical exams are very important, particularly a pelvic exam.

Routine screening can help detect abnormalities, precancers, or cancers as an earlier stage.

What kind of screening is available for gynecologic cancer and at what age should people start being screened?

Cervical cancer has a screening test – the Pap smear and HPV testing.

Patients should start testing at age 21. The interval of testing depends on last test result, patient’s age, and HPV status.

There are also many diagnostic tests that can be done in the office that are used to rule out a gynecologic cancer when a symptom arises.

For example, an endometrial biopsy can be used when a patient has abnormal vaginal bleeding or postmenopausal bleeding to rule out an endometrial cancer or precancer.

Biopsies of the vulva, vagina, and cervix can also be done in the office.

What are some of the risk factors for gynecologic cancer and are there lifestyle or diet changes that can lower someone’s risk?

Obesity is a big risk factor for endometrial cancer. Extra fatty tissue makes hormones that stimulate the endometrium. Maintaining a healthy weight can help reduce the risk of the most common type of endometrial cancer.

Cervical, vulvar, and vaginal cancers are often HPV related – HPV vaccination prior to sexual activity and exposure to HPV can help reduce the risk of these cancers. Smoking increases the risk of a persistent HPV infection.

There are some family cancer syndromes such as BRCA and Lynch Syndrome that put patients at risk of certain gynecologic cancers – knowing your family history (particularly family history of cancers) can be helpful. Prophylactic surgeries are sometimes recommended in these populations to decrease the risk of ovarian cancer or endometrial cancer.

What are some of the symptoms of gynecologic cancer that someone should be concerned about and discuss with their primary care provider or specialist?

The hallmark symptom of endometrial cancer is postmenopausal vaginal bleeding.

Post-menopausal vaginal bleeding is not normal and requires a workup. Abnormal bleeding patterns in a premenopausal woman should also be examined to ensure no cervical or endometrial abnormality.

Pain or new growths on the vulva or vagina should be evaluated to rule out a cancer. 

Ovarian cancer symptoms are sometimes vague and include bloating, change in bowel habits, early satiety, and abdominal pain.

What kind of treatment options are available for someone diagnosed with gynecologic cancer?

The treatment options for gynecologic cancer depends on which cancer is diagnosed: endometrial, uterine, cervical, vulvar, vaginal, or ovarian. 

Treatment ultimately depends on the stage and the grade of a cancer. Some cancers can be treated with surgery alone and some will require chemotherapy and/or radiation therapy instead of surgery or along with surgery.

 

Gynecologic cancer risk factors and screening graphic

 

 

 

Katelyn McGovern Dorney, MD is a gynecologic oncologist at the Dana-Farber Brigham Cancer Center in clinical affiliation with South Shore Hospital.

Learn more about  Gynecologic Oncology Care at the Cancer Center.