September is Gynecologic Cancer Awareness Month, so if you haven’t seen your gynecologist in a while, now is a good time to make an appointment! There are five gyn cancers: uterine; ovarian; cervical; vulvar; and vaginal.
Uterine cancer is the most common of the gyn cancers and is the fourth most common cancer in women; approximately 35,000 women are diagnosed with uterine cancer annually here in the U.S. Risk factors include older age; obesity; diabetes; use of estrogen by itself; use of Tamoxifen following breast cancer; lifelong history of irregular or infrequent periods; and family history. Given that it is most common in older, postmenopausal women and abnormal bleeding is its major symptom, it is usually diagnosed at an easily treatable stage. Younger women can get uterine cancer, so it is important to report abnormal bleeding or pelvic pain promptly.
Ovarian is the second most common gyn cancer, with 20,000 women diagnosed each year. Risk factors for this cancer are family history of breast, uterine or colorectal cancers; no prior pregnancies; and treatment for infertility. Use of birth control pills, especially for greater than 5 years, lowers the risk of ovarian, as well as uterine cancers. Symptoms of ovarian cancer are vague, and this cancer is frequently not diagnosed until it has spread beyond the ovaries. Symptoms such as pelvic pain and pressure, lower back pain, frequent urination, feeling full without eating much, or changes in bowel movements that last more than two weeks should be reported to your doctor. An ultrasound can be used to help diagnose ovarian cancer.
The third most frequent gyn cancer is cervical. We only see about 12,000 cervical cancers annually here in the US, thanks to the Pap test. In the 20 years I’ve been in Tahoe, the only cases of cervical cancer I have seen have been in women who have neglected to get a pap smear for more than 10 years. The overwhelming majority of cervical cancer is related to the sexually transmitted human papilloma virus (HPV). Vaccination prior to onset of sexual activity could prevent 75% of HPV related cervical cancer!
Vulvar cancer is on the rise, mainly due to HPV, and we are seeing it in younger women. Typically, vulvar cancer affected women over 60. It is diagnosed in 3500 women each year. Symptoms include abnormal itching, sores or ulcers, or unusual red or white patches. Most cases are found early, and treatment, when detected early, is pretty straightforward.
Vaginal cancer is the least common gyn cancer, with only 1,000 new cases annually. Symptoms may include abnormal bleeding or discharge, as well as pain or pressure. Like all the lower genital tract cancers (cervical, vulvar and vaginal), HPV is the cause of most cases. Another commonality: cigarette smoking.
There are many ways you can be proactive and lower your risk of developing any of these gyn cancers: eat healthy and maintain an ideal weight for your height; don’t smoke; get an HPV vaccine if you are under 26 – and have your kids (daughters AND sons) vaccinated before they start having sex; consider using birth control pills if you need contraception anyway, as they lower the risk of ovarian cancer, the most deadly of the gyn cancers; and get regular check ups by your gynecologist!
Dr. Kelly Shanahan is a board certified gynecologist and the owner of Emerald Bay Center for Women’s Health. She and nurse practitioner, Patience Wenck, are in the office at 1154 Emerald Bay Road Tuesday – Thursday, and some Fridays. Call 530-542-4961 to schedule an appointment.