Gynecologic cancers include all cancers of the female reproductive system, including cancers of the cervix, ovaries, uterus, vulva and vagina. Gynecologic cancers account for approximately 12.4% of all cancers in women in the U.S. each year. According to the American Cancer Society, there were an estimated 109,000 new cases diagnosed and approximately 33,100 deaths, from gynecologic cancers in the U.S. in 2019.
Ritu Salani, MD, MBA, professor of obstetrics and gynecology and director of the UCLA Division of Gynecologic Oncology, discusses what every woman should know about symptoms, prevention, early diagnosis and treatment.
Cervical cancer
It is estimated that doctors will diagnose 13,800 new cases of cervical cancer in the U.S. in 2020. Common symptoms of cervical cancer include abnormal vaginal bleeding (in between cycles or after intercourse), foul-smelling vaginal discharge or abnormal findings on a Pap test. If cervical cancer is suspected, your provider will perform cervical biopsies and possibly a colposcopy.
Things you can do to reduce your risk of developing cervical cancer:
- HPV vaccination: Ideally between ages 9 and 26, but can be given up to age 45. This may prevent multiple types of cancers (cervix, vulvar, anal, head and neck).
- Pap test + HPV testing: Recommendations vary from every 3 years to every 5 years for normal testing.
- Practice safe sexual habits.
- Avoid tobacco use.
Uterine cancer (also called endometrial cancer)
It is estimated that doctors will diagnose 65,620 new cases of uterine cancer in the U.S. in 2020. Common symptoms include abnormal bleeding (in between cycles) or bleeding after menopause (which is never normal). If uterine cancer is suspected, your provider will obtain a pelvic ultrasound and an endometrial biopsy.
Things you can do to reduce your risk of developing uterine cancer:
- Maintain a healthy body weight.
- Know your family history of cancers (endometrial, colon, ovary), which may be associated with Lynch syndrome, a common cause of hereditary colorectal cancer.
Ovarian cancer
It is estimated that doctors will diagnose 21,750 new cases of ovarian cancer in the U.S. in 2020. Ovarian cancer presents with vague symptoms that include abdominal bloating, pelvic pressure, loss of appetite or feeling full early, or changes in bowel or bladder habits. If ovarian cancer is suspected, your provider will order imaging tests (ultrasound or CT scan) and, if an ovarian mass is noted, consider blood tests such as a CA-125 level.
Things you can do to reduce your risk of developing ovarian cancer:
- 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 affect you.
- Oral contraceptive pill use before menopause.
Vulvar cancer
It is estimated that doctors will diagnose 6,120 new cases of vulvar cancer in the U.S. in 2020. Common symptoms of vulvar cancer include itching, irritation, discoloration or a mass/lesion on the vulva. If vulvar cancer is suspected, your provider will perform a vulvar biopsy.
Things you can do to reduce your risk of developing vulvar cancer:
- HPV vaccination: Ideally between ages 9 and 26, but can be given up to age 45. This may prevent multiple types of cancers (cervix, vulvar, anal, head and neck).
- Avoid tobacco use.
- Inspect your vulva for skin changes.
Facts every woman needs to know
- Routine physical exams may detect abnormal cells (on Pap test or seen on exam) of the cervix or vulva and allow for treatment before they become cancerous.
- Pap 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 and avoiding tobacco use
At UCLA, our multidisciplinary team of experts work together to evaluate each patient’s situation and 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. Early diagnosis is key to successful treatment.
All UCLA clinics have rigorous infection-prevention protocols in place and are ready to care for you. For more information about what you should know about gynecologic cancer care and COVID-19, go to UCLA Health Connect.
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.
For information on UCLA's Jonsson Comprehensive Cancer Center, visit https://cancer.ucla.edu. JCCC is one of only 51 cancer centers in the U.S. designated as comprehensive by the National Cancer Institute for its state-of-the-art research focused on developing new and better approaches to preventing, diagnosing and treating cancer.
