Blog by Kandace Tolic, NP
As a nurse practitioner in Gynecolgy Oncology (GynOnc), I work with patients who are referred with a gynecologic cancer which means a cancer in the reproductive organs. Gynecologic cancers include cervical, ovarian, uterine, vaginal and vulvar cancers. When women learn that I work in this area, I often get asked, “How will I know if I have one of these cancers?” Or, “Is there anything I can do prevent these cancers?”
The answers depend on the type of cancer. Each gynecologic cancer has its own signs and symptoms, and some are more obvious than others. Prevention also depends on the type of cancer and whether a screening test is available.
Let’s start with cervical cancer. This type of cancer has a very effective and well known screening test – the Pap screen which helps us catch cervical cancer (or pre-cancer) early, when treatment is most effective. Thankfully, additional progress has been made as we’ve learned about more about HPV, a common viral infection. HPV has certain strains that can cause changes to cells of the cervix which can lead to precancerous or cancerous cells. We now have the HPV co-test that detects whether HPV is present, as well as the HVP vaccine that helps with prevention.
Uterine or endometrial cancer is actually the most common gynecologic cancer. Endometrial cancer develops in the lining of the uterus. While we don’t have a screening tool, this one is often caught early. Several risk factors may increase one’s chance of endometrial cancer but an imbalance between estrogen and progesterone hormones seems to be a possible key factor. Abnormal bleeding is commonly seen so this cancer can be easier to detect. With early detection, treatment is usually effective and most women fare well.
The most challenging gynecologic cancer to catch early is ovarian cancer. Symptoms, which can include low abdominal pain, back pain, bloating and feeling full quickly, often mimic other less serious conditions. But sometimes there are more noticeable signs including vaginal bleeding or discharge. If you have a family history of ovarian cancer, there is a genetic test that can detect specific gene mutations. Most DNA mutations are not inherited but with a family history it’s helpful to talk to a doctor or genetic counselor to see if testing is recommended.
Vaginal and vulvar cancer is less common and very treatable if caught early. Vulvar cancer most often affects the outer vaginal lips. Symptoms could include a lump on the vulva, skin changes, itching, tenderness and sometimes bleeding. Vulvar cancer can form slowly over many years but risk factors include having HPV, a history of genital warts and/or abnormal Pap results.
So, what can one do to prevent and identify these cancers? Continue to get the Pap screen if your doctor still recommends it as well as all other recommended screenings. Talk to your doctor about any family history of cancer. Pay attention to your body so you can recognize anything that seems unusual. If you’re post-menopausal and have vaginal bleeding (or if not through menopause but experiencing unusual bleeding), talk to a doctor right away. Also see a doctor if you have any other warning signs that last for two weeks or longer and are not normal for you. Symptoms may be caused by something other than cancer, but the only way to know is to see a doctor.
Be encouraged that many advancements in treatment, screening and prevention have occurred with ALL types of cancers and will continue to improve as research moves forward.
Kandice Tolic is a nurse practitioner in Gynecology Oncology. She works at both the Park Nicollet Women’s Center and Regions Hospital – Cancer Care Center. Kandice dedicates herself to providing nurturing, sensitive care along with good educational support to her patients.