Gynecologic Cancers

Gynecologic cancers attack women’s reproductive organs.

The three most common types of gynecologic cancer — uterine, cervical and ovarian — attack the uterus, ovaries and cervix. In addition, less common forms of the disease also attack the fallopian tubes, vagina and vulva. All women are at risk for developing gynecologic cancer, and each type of the disease has its own unique signs, symptoms and risk factors. Each type of cancer also has its own set of treatment and prevention strategies.

Uterine Cancer

The most common type of gynecological cancer, uterine cancer is diagnosed in 24 out of every 100,000 women. The disease takes two forms — endometrial cancer and uterine sarcoma — with the endometrial type being the most common. According to the American Society of Clinical Oncology (ASCO), 95 percent of uterine cancers are diagnosed as endometrial cancer. The National Cancer Institute (NCI) logged 43,470 new cases in 2010.

This disease forms in the tissue lining of the uterus and effects mostly menopausal women, but does develop in women under 40 as well.

The good news is that endometrial cancer has a very high cure rate. When the disease is diagnosed, surgery is the most common treatment option. Oncologists generally start with a total hysterectomy, removing the uterus and cervix and usually some lymph glands to evaluate for cancer spread. Depending on the stage of the cancer, the surgeon may opt for a radical hysterectomy — removing the uterus and cervix as well as part of the vagina. The ovaries, fallopian tubes and nearby lymph nodes are usually removed.

The degree of endometrial cancer is measured in stages, with stage I indicating the cancer is contained in the uterus, while a stage IV diagnosis indicates the cancer has spread beyond the uterus to the rectum, bladder and other organs. The earlier cancer is detected, the higher the rate of cure.

In the event that cancer cells may be left over even after surgery, other treatment options — radiation therapy, hormone therapy and chemotherapy — are also available and can be used alone or as combination therapies. They can also be used in lieu of surgery if that is not the best option. Lastly, patients may also want to consider taking part in a clinical trial, and become part of the research process. Clinical trials are performed to find new cancer treatments, and patients who take part in clinical trials may be among the first to receive a new treatment.

Cervical Cancer

Cervical cancer begins at the opening of the lower part of the uterus. A slow-growing cancer, it may or may not have symptoms, but can be found with regular Pap tests. Cervical cancer is predominately caused by a human papillomavirus (HPV) infection, for which a vaccine is now available.

This cancer most often affects women younger than 50, but rarely occurs in women younger than 20. According to the NCI, there were 12,200 new cases in 2010.

The two main kinds of cervical cancer are:

  • Squamous Cell Carcinoma. About 80 to 90 percent of cervical cancers are squamous cell carcinomas, which arise from the cells that line the surface of the cervix.
  • Adenocarcinoma. This less common type of cervical cancer develops in the glandular cells lining the cervical canal. Between 10 and 20 percent of cervical cancers are adenocarcinomas.

As with all types of cancer, the treatment options for cancer of the cervix depend on the stage in which the disease is discovered. Surgery, radiation and chemotherapy — alone or in combination — are the traditional therapies used to treat cervical cancer.

Early-stage (Stage I) disease that is confined to the cervix is most often treated by radical hysterectomy and removal of the lymph nodes. According to ASCO, women who want to preserve their ability to bear children can opt for a radical trachelectomy, which removes the cervix, the top part of the vagina and the pelvic lymph nodes, but leaves the rest of the uterus.

Cervical cancers that have progressed to stages II through IV are most often treated with a combination of radiation therapy and chemotherapy. In addition, there are also clinical trials being conducted to develop alternative treatments. Patients who participate in clinical trials generally are the first to gain access to new treatments.

Ovarian Cancer

Ovarian cancer affects roughly 12 out of every 100,000 females in the U.S. each year. According to the NCI, there were 21,880 new cases in 2010. Of the women diagnosed with ovarian cancer, over half are age 60 or older, and the disease is more common in white women than in their African-American counterparts. The disease is also more common in women who have a family history of ovarian cancer, and research indicates that some ovarian cancers are caused by inherited gene mutations.

This cancer forms in the tissues of the female reproductive glands in which eggs are formed. Most of these cancers are ovarian epithelial carcinomas — cancer that begins in the cells on the ovary’s surface, but some — malignant germ cell tumors — begin in egg cells. As part of the treatment regimen, women with an increased risk of ovarian cancer sometimes have surgery — prophylactic oophorectomy — to prevent it.

Tests examining the ovaries, pelvic area, blood, and ovarian tissue are used to detect this cancer, with roughly 20 percent of ovarian cancers being found in the early stages. Surgery, chemotherapy and radiation therapy are the main treatments for ovarian cancer, and can be used alone or in combination. New types of treatments, such as biologic and targeted therapies, are currently being tested in clinical trials. According to the NCI, biologic treatments, sometimes called biotherapy or immunotherapy, use a patient’s own immune system to fight the cancer. On the other hand, targeted therapies use drugs or other substances to identify and attack specific cancer cells without harming normal cells.

Because these treatment options are currently being developed, patients may want to consider getting involved in clinical trails, which afford patients access to the newest, leading-edge therapies.

More information on Ovarian Cancer can be found here.

 

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