Protect your “neighborhood” from gynecologic cancer

Summer

Many of us have heard of the television program America's Most Wanted, which showcases the nation's most dangerous criminals. If there were a similar show for health problems, cancer would be featured every week. Those of us who have been affected by cancer know it's a nasty villain that causes tons of damage and heartache every year.

As a gynecologist, my aim is to catch gynecologic cancers while they are young. Catching them early makes them easier to treat and greatly increases the chances of survival. In this way, my cancer specialist colleagues and I are like law enforcement officers.

But the most important role in policing your body is yours. Think of your body as a neighborhood and yourself as the "neighborhood watch." It is up to you to know when something seems suspicious and to tip off the professionals. In this column, we'll cover how you can keep "your neighborhood" safe and how you can recognize the most dangerous gynecologic cancer villains.

The first most important thing to know is where cancer likes to hang out. Just like criminals are more concentrated in run-down neighborhoods, cancer is more likely to pop up in bodies that are run down too. Age, smoking, and poor diet and exercise habits all relate to a greater likelihood of cancer.

You may also be more likely to get gynecologic cancers if a family member has ever had a gynecologic cancer or if you've had a previous infection, like HPV, HIV, or other immune-suppressed conditions. In "cancer speak," these are known as your risks. Doing your best to limit those risks you can control will decrease your likelihood of getting cancer, and being aware of the risks you can't control, like age and genetics, can greatly increase your likelihood of catching it early.

So how will you know if there is a gynecologic cancer lurking in your neighborhood? Just as a car thief might appear one way and a bank robber in another, the signs of gynecologic cancers differ based on the different types of cancer. The most important thing is to be aware and keep your eyes open. Here is a list of the five gynecologic cancers and how to spot them.

Ovarian cancer, the least common but most deadly of all gynecologic cancers, occurs in the ovaries. All of the early signs relate to a growing mass in your lower abdomen. Be aware of pelvic or abdominal pain, difficulty eating or feeling full quickly, and bloating. If you have urinary symptoms, either increased urgency or frequency, get it checked out promptly. While the problem could relate to something as simple as too much caffeine, it is also an early sign of ovarian cancer. Call your primary care provider or gynecologist and get an appointment.

Uterine cancer, sometimes referred to as endometrial cancer, occurs in the uterus. It is the most common type of gynecologic cancer. Although there is no screening for this type of cancer, by paying attention to risk factors and listening for warning signs, we can detect it in its most treatable stage. Be aware of abnormal bleeding or discharge, menopausal bleeding, or pressure in your pelvis, and call your doctor if you notice these symptoms.

Cervical cancer is third in our list of rogues. Thanks to a few recent advancements -including screening pap smears and, more recently, HPV identification and treatment of precancerous conditions—we are making good progress against cervical cancer.

You may notice that your doctor is recommending that you have a pap smear less frequently. You might take this as an indication that you can skip your yearly pelvic exam. This is not so. Though it may seem like the most notable part of your annual visit, the pap smear is not the only thing your doctor is doing. He or she is also looking for changes in your skin and general vulvar and vaginal health. Make your annual "well woman" visit, regardless of whether you are due for a pap smear.

Vaginal cancer has fewer early symptoms than the other gynecologic cancers. In our criminal metaphor, you might think of it as being sneaky or a con-artist. Luckily, it is also quite rare. Like cervical cancer, the best defense is your annual checkup. Your provider will note signs of this cancer during your routine exam.

Vulvar cancer is also quite rare. But it shares some symptoms with common gynecologic problems, like yeast infections. The benefit of vulvar cancer, is that the symptoms can be seen. Don't be afraid to examine yourself, using a hand-held mirror, if necessary. If you have chronic itching; skin discoloration; a lump or bump, pelvic pain; abnormal bleeding or discharge; or an open sore, ulcer or cauliflower-like growths, don't ignore them. Call your provider, who can help address the symptoms and ensure that you do not have vulvar cancer.

Congratulations. You are now a fully trained "neighborhood watchwoman" for gynecologic cancers. You know that healthy choices help keep your "neighborhood" clean and safe, how important your annual exam really is, how to spot gynecologic cancer "villains," and what to do if you experience them: call your provider for an appointment. Together, we can keep ourselves as safe as possible from gynecological cancers.

Kimberley Sampson, MD, is a gynecologist with SVMC OB/GYN, which is a part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care. "Health Matters" is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care.