Most women who come in for their yearly exam have questions about gynecologic cancers. Every year about ​​110,000 new cases of cancer develop in the female reproductive organs. But with the proper prevention, timely diagnosis, and comprehensive treatment, the outlook for this group of cancers—which includes ovarian, cervical, endometrial, vaginal, uterine, and vulvar—continues to improve.

Physicians at Summit Health specialize in understanding and treating the full range of gynecologic cancers. Together, a team of OB/GYNs, primary care physicians, gynecologic oncologists, radiation oncologists, and oncologists provides seamless, coordinated care that is conveniently located under the same roof.  

“Routine check-ups and problem-focused visits with your women’s health provider are paramount to not only early diagnosis of gynecologic cancers, but also possible prevention,” says Roshni Patel, DO, an OB/GYN at Summit Health. “Women often think that they do not need to visit an OB/GYN once they are finished with childbearing. However, this misconception can delay diagnosis and, ultimately, treatment.”

A Pap smear is an easy, safe, and effective screening tool that has been used for decades to detect precancerous changes that can help prevent the development of cervical cancer. Along with the HPV vaccine, Pap smears have dramatically reduced cervical cancers among women.  In addition, Pap smears can detect some early vaginal cancers. Pap smears are also the only screening test that is available for preventing gynecologic cancers; however, getting regular check-ups can help with early diagnosis of other cancers, which  leads to better outcomes, adds Lalitha Anand, MD, FACP, gynecologic oncologist at Summit Health.

Symptoms of Gynecologic Cancers

Listening to your body can save your life. Women often dismiss symptoms until they become quite problematic, but evaluation is the key to intervention. While most gynecologic cancers appear after menopause, they can also strike young, healthy women in their prime.

“It is very important for women to discuss any new symptoms freely with their primary care physician or gynecologist and follow regular screening guidelines for Pap smears,” explains Dr. Anand.

Make an appointment with your physician if you experience any of the following:

• Abnormal vaginal bleeding or discharge, including irregular bleeding between periods or post-menopausal bleeding
• Pelvic pain or pressure
• Abdominal or back pain
• Changes in bowel habits, such as frequent urination, constipation, or diarrhea
• Weight loss or lack of appetite
• Itching, burning, or a change of appearance to the vulva, such as changes in skin color or rashes like sores and warts
• Extreme fatigue

The Road to Diagnosis

Dr. Patel encourages women with any of these persistent symptoms to come in for an evaluation. Her first step is to obtain a thorough history and perform a physical examination of the affected area. She will then order any necessary diagnostic testing, including blood work or imaging scans such as ultrasound or MRI. Based on the results of those tests, a biopsy may be performed to gather more information.

“Part of what makes Summit Health unique is the seamless coordination of care between all medical specialties,” explains Dr. Patel. “Depending on the results of the test, the physician will then coordinate care directly with the gynecologic oncologist regarding next steps. They will also keep the patient’s primary care physician or any other specialists in the conversation.”

HPV Linked to Gynecologic Cancer 

One of the most important ways to reduce your risk of developing gynecologic cancer is to protect yourself against the human papilloma virus (HPV). Dr. Anand explains that HPV is associated with the development of nearly all cervical cancers and some cancers of the vagina and vulva. As a result, she says, the HPV vaccine is recommended for girls, ages 11 to 12.

“It is important to recognize that this three-dose series of vaccinations was previously recommended up to the age of 26, but it is now recommended for individuals up to the age of 40.  Therefore, women under the age of 40 who did not previously receive the vaccination series are being encouraged to receive this very important preventative measure,” advises Dr. Anand. As noted earlier, the HPV vaccination has been proven to reduce the risk for cervical cancer as well as certain cancers of the head and neck that are associated with the virus.

She also adds that maintaining a healthy diet with a daily exercise routine, smoking cessation, and safe sex practices may further reduce the risk of developing gynecologic cancer.

Types of Gynecologic Cancers

While gynecologic cancers are often grouped together, each kind is different. Here are some important things to know about the symptoms of each cancer and what ages they generally affect.

• Cervical cancer — A highly preventable type of cancer that typically appears in midlife. Nearly 93 percent of all cervical cancer cases are caused by HPV. Receiving the HPV vaccine, Gardasil®, can significantly reduce the risk of cervical cancer. Regular Pap smears can also detect precancerous changes.
• Ovarian cancer — Generally seen in post-menopausal women, ovarian cancer is one of the most common gynecologic cancers. Unfortunately, it is also the most serious. Some women do not have symptoms until the disease progresses, while others experience abdominal pain or a change in bowel habits.
• Uterine cancer — Abnormal vaginal bleeding is usually the first sign of this prevalent form of gynecologic cancer. Discuss any irregular bleeding, particular after menopause, with your physician.
• Vaginal cancer — This rare form of gynecologic cancer is generally found in women over 60 and can be detected by a Pap smear. A history of HPV increases your risk.
• Vulvar cancer — Another relatively uncommon cancer that can occur at any age. Telltale signs include an itchy lump or sore on the outer part of the vagina.

Gynecologic Cancer Services Offered at Summit Health

Every patient is different and has a unique cancer journey. With access to a wide breadth of  medical and oncological services, our dedicated team develops a personalized plan to meet the needs of everyone.

“It is understandable that a diagnosis of one of these cancers is frightening, but at Summit Health we are able to help our patients at all stages, from screening and prevention to diagnosis and treatment,” explains Dr. Anand. “Depending on the type and stage, gynecologic cancers are treated in a multimodality fashion, which may include surgery, systemic chemotherapy, and radiation therapy.”   

Summit Health offers the following comprehensive medical, oncological, and wellness services for patients with gynecologic cancers:          

• Accurate and timely diagnosis that includes insight from physicians, radiologists, and pathologists.
• Comprehensive care from a collaborative team of gynecologists, surgical oncologists, and radiation oncologists.
• State-of-the-art surgical services for complex cases using minimally invasive techniques such as laparoscopic and robotic surgeries that reduce recovery time and minimize postoperative complications.
• Highly specialized systemic chemotherapy and radiation therapy in our state-of-the-art facilities with certified registered nurses and physicians on site for treatment.    
• Oversight from a multidisciplinary tumor board to ensure individualized treatment.
• Partnerships with multiple specialties, including nutritional services, cognitive behavioral health (individual therapy and support groups), integrative medicine (acupuncture and massage therapy), palliative care, and pain management, as well as reproductive endocrinology for fertility preservation.
• Access to select clinical trials and research studies that offer new therapies to treat aggressive forms of disease and improve quality of life.

“Having all of these services in one place makes the delivery of care more streamlined for patients. In addition, the coordination between multiple specialties makes the burden of cancer management easier for the patient and their loved ones,” explains Dr. Patel.