Gynecologic Cancer Treatment

Gynecologic cancer refers to cancer that forms in a woman’s reproductive tract. Widespread screening with the Pap tests have allowed doctors to find pre-cancerous changes in the cervix and vagina. This has helped prevent the development of some invasive cancers. Learn more about signs, symptoms and treatment options for gynecologic cancer below.

Gynecologic cancers include cancer of the following:

• Uterus
• Ovaries
• Cervix
• Vulva
• Fallopian tubes

There are often no outward signs of gynecologic cancers. If you are experiencing unusual vaginal bleeding, it’s important to contact your doctor right away. Signs and symptoms of gynecologic cancer vary by type of cancer and person. Some common symptoms include:

• Unusual bleeding, such as postmenopausal bleeding, bleeding after intercourse or bleeding between periods
• A sore in the genital area that doesn’t heal or chronic itching of the vulva
• Pain or pressure in the pelvis
• Persistent vaginal discharge
• Bloating
• Abdominal pain
• Changes in vulva skin

While all women are at risk for gynecologic cancer, some factors can increase a woman’s chances of developing the disease.

• Uterine cancer: Never pregnant, beginning menstruation early, late menopause, diabetes, use of estrogen alone (called unopposed estrogen) for hormone replacement therapy, family history of uterine cancer, high blood pressure and complex atypical hyperplasia. Tamoxifen, a drug frequently used to treat breast cancer, increases the risk of uterine cancer slightly. A genetic syndrome called hereditary nonpolyposis colon cancer (HNPCC) may also increase a woman’s risk.
• Cervical cancer: Strongly associated with sexually transmitted diseases, especially several strains of human papilloma virus (HPV), sexual activity at an early age, multiple sexual partners, smoking and obesity. The HPV vaccine can protect against types of HPV that most commonly cause cancer, according to the Centers for Disease Control and Prevention.
• Ovarian cancer: Obesity, never pregnant, unopposed estrogen, personal or family history of breast or ovarian cancer, genetic mutations in the BRCA1 or BRCA2 gene, HNPCC.
• Vaginal cancer: History of genital warts or an abnormal Pap test. There is an increased risk of clear cell carcinoma in women whose mothers took the drug diethylstilbestrol (DES) while pregnant. Women previously treated for carcinoma in-situ or invasive cervical cancer also have a higher risk of developing vaginal cancer.

Gynecologic cancers are often detected through a series of screening exams, including:

• Your doctor will first perform a pelvic exam to evaluate your vulva, vagina, cervix, uterus, Fallopian tubes, ovaries and rectum.
• During the pelvic exam, your doctor will gently scrape some cells from the cervix and vagina to examine under a microscope. This is called a Pap test.
• If the Pap test is abnormal, your doctor may perform a test called a colposcopy to closely examine the cervix. Scraping cells from the cervical canal (endocervical curettage) may also be necessary.
• A small sample of tissue may be taken from any suspicious area. This test is called a biopsy.
• Occasionally, doctors need to examine a larger sample of cervical tissue. It is obtained during a procedure called conization or cone biopsy.
• In some situations, your doctor may recommend an exam under anesthesia to better evaluate the extent of a cancer. Tests requiring anesthesia include examination of the bladder (cystoscopy) and rectum (sigmoidoscopy).
• Abnormal uterine bleeding, a common symptom of uterine cancer, is usually evaluated by performing a dilatation and curettage, also called a D and C.
• Your doctor may also ask for MRI, CT, PET or ultrasound scans of the abdomen and pelvis to better evaluate areas that cannot be directly viewed, such as the ovaries.

Treatment for gynecologic cancer depends on several factors, including the type of cancer, its extent (stage), its location and your overall health. It is important to talk with several cancer specialists before deciding on the best treatment for you, your cancer and your lifestyle.

• A gynecologic oncologist is a doctor who specializes in surgically removing gynecologic cancers.
• A radiation oncologist is a doctor specially trained to treat cancer with radiation therapy.
• A medical oncologist is a doctor who specializes in treating cancer with drugs (chemotherapy).
• Sometimes, your cancer may be cured by using only one type of treatment. In other cases, your cancer may be best cured using a combination of surgery, radiation therapy and chemotherapy. Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat cancer.
• Radiation oncologists use radiation therapy to try to cure cancer, to control cancer growth or to relieve symptoms, such as pain.
• Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
• Healthy tissues are also affected by radiation, but they are able to repair themselves in a way cancer cells cannot.

If you live in the Southeast region of the United States, give us a call to discuss your gynecologic cancer treatment options today. Our 30+ board-certified Charlotte oncologists practice at oncology centers in Charlotte, NC and surrounding locations.

The side effects you may experience will depend on the area being treated, the type of radiation used and whether or not you also received chemotherapy. Before treatment, your doctor will describe what you can expect.

• Some patients experience minor or no side effects and can continue their normal routines.
• Some patients may notice fatigue, skin irritation, vaginal irritation, frequent urination, burning with urination and/or diarrhea. These will all resolve after treatment ends.
• Some patients will have sexual changes, such as changes in the vagina.

If at any time you develop side effects, tell your doctor or nurse. He or she can give you medicine to help.