By Noah Goldman, MD
September is Gynecologic Cancer Awareness Month, an opportune time to shed light on cancers that uniquely affect women, including cervical, uterine, and ovarian cancers.
These cancers impact thousands of lives each year, but by understanding the risks, recognizing the symptoms, taking preventive measures, and listening to their bodies, women can protect their health and improve outcomes.
The Gynecologic Oncology Program at Penn Medicine Princeton Medical Center (PMC) offers comprehensive diagnosis and treatment of gynecological cancer and related conditions.
Cervical Cancer
Cervical cancer originates in the cells of the cervix, the lower part of the uterus that connects to the vagina. The vast majority of cervical cancers are caused by the human papillomavirus or HPV, a common sexually transmitted infection.
The American Cancer Society estimates that 13,820 new cases of invasive cervical cancer will be diagnosed in 2024, and about 4,360 women will die from the disease.
Early-stage cervical cancer often has no symptoms. However, as the disease progresses, symptoms may include:
- Abnormal vaginal bleeding (between periods, after intercourse or post-menopause).
- Unusual vaginal discharge.
- Pelvic pain or pain during intercourse.
Fortunately, cervical cancer can be detected early — when it’s most treatable — with regular screening tests, including a Pap test and HPV test. The American Cancer Society recommends that women should begin screening at age 25.
In addition, the HPV vaccine can protect against the HPV strains most commonly linked to cervical cancer and thereby prevent the cancer from ever developing.
The American Cancer Society recommends:
- HPV vaccination of children between the ages of 9 and 12.
- Children and young adults aged 13 through 26 who have not been vaccinated, or who haven’t gotten all their doses, should get the vaccine as soon as possible. Vaccination of young adults will not prevent as many cancers as vaccination of children and teens.
- Not getting the HPV vaccination if you are older than 26 years. (However, the HPV vaccine is approved for use up to 45 years old.)
The key to preventing HPV is to get vaccinated before becoming sexually active.
Uterine Cancer
Uterine cancer, also known as endometrial cancer, begins in the lining of the uterus, and is the most common gynecologic cancer in the United States.
About 67,880 new cases of uterine cancer will be diagnosed in 2024, according to the American Cancer Society, and the disease will claim an estimated 13,250 lives this year.
The incidence of uterine cancer has been rising in the United States, particularly among postmenopausal women. Though the exact cause is unknown, researchers have identified certain risk factors, particularly obesity and hormone imbalance, that are strongly linked to the disease.
Symptoms of uterine cancer include:
- Unusual vaginal bleeding, spotting or other discharge. The American Cancer Society notes that 90% of women with uterine cancer experience abnormal vaginal bleeding.
- Pelvic pain or pressure.
- Unexplained weight loss.
There is no surefire way to prevent uterine cancer, but there are steps you can take to reduce your risk:
- Maintain a healthy weight through diet and exercise.
- Manage conditions like diabetes and hypertension.
- Talk with your gynecologist about hormone therapy.
- Go for regular gynecologic check-ups.
Ovarian Cancer
Ovarian cancer begins in the ovaries, the reproductive glands that produce eggs. It can be especially challenging to detect early because of its vague symptoms and a lack of effective screening tools.
That’s why most ovarian cancers are diagnosed at an advanced stage, making it the deadliest of all gynecologic cancers. According to the American Cancer Society, approximately 19,680 new cases are expected this year, with an estimated 12,740 deaths.
However, fewer women are dying from the disease than in years past, in part because of advances in treatment.
The risk for ovarian cancer increases with age. Other risk factors include:
- Being overweight or obese.
- Having children later or never having a full-term pregnancy.
- Family history of ovarian cancer, breast cancer or colorectal cancer.
- Inherited mutations in the BRCA1 or BRCA2 genes.
Though there is no screening test for ovarian cancer, genetic testing for BRCA1 and BRCA2 mutations can help identify women at higher risk.
Symptoms of ovarian cancer are often subtle and can be mistaken for other conditions. The most common symptoms include:
- Bloating.
- Pelvic or abdominal pain.
- Difficulty eating or feeling full quickly.
- Urinary symptoms (urgency or frequency).
See Your Gynecologist
If you are concerned about your risk for gynecologic cancer or are experiencing symptoms, see your gynecologist. They may refer you to a gynecologic oncologist for an accurate diagnosis.
The Gynecologic Oncology Program at PMC offers a range of advanced diagnostic and treatment tools for gynecologic cancer, including:
- Genetic counseling.
- Complex pelvic surgery.
- Minimally invasive surgical options, including robotic surgery.
- Targeted radiation therapy.
- Fertility preservation.
Care is provided by a multidisciplinary team comprising board certified gynecologic oncologists, oncology certified nurses and nurse navigators, and other experts.
Moreover, as part of Penn Medicine, PMC provides access to highly advanced treatments through the Abramson Cancer Center, a world leader in cancer research and patient care. Specialized care is available, including proton therapy and clinical trials.
Gynecologic cancer can pose a significant health threat to women. One of the best things you can do to protect your health is listen to your body. Don’t ignore symptoms and be sure to see your gynecologist annually.
For more information or to find physician affiliated with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.
Noah Goldman, MD, is board certified in gynecologic oncology and is the Medical Director of Cancer Programs at Penn Medicine Princeton Health.
