Gynecological Cancers

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1 Recognizing the Subtle Signs of Gynecological Cancers Created by the Wisconsin Women s Health Foundation for the GrapeVine Project Take Home Message #1 Cervical cancer is the only preventable gynecological cancer. The Pap test, HPV test, and HPV vaccine are all recommended preventative measures to not only detect, but also prevent, cervical cancer. Take Home Message #2 Know Your Body. The best way to detect ovarian, uterine, vaginal, or vulvar cancer is to know your body and speak to your healthcare provider when you feel abnormal signs or symptoms.

2 Why we need to talk about it: ALL women are at risk, and the risk increases with age. These cancers affect women s reproductive organs: Cervical Ovarian Uterine Vaginal Vulvar Each is unique with different signs, symptoms, risk factors & prevention strategies.

3 Signs to Watch For: Bleeding Normal Cyclical/occurs approximately every days, and lasts 5-7 days Begins light, moderate in the middle days, ends lighter No clots or clots smaller than a quarter Often varies from woman to woman Abnormal Visit your doctor right away! Bleeding between periods Longer bleeding cycles beyond typical 5-7 days Heavy bleeding (change pads or tampons hourly) Passage of clots larger than a quarter Any bleeding after menopause Discharge White or clear No odor/faint odor Thickness and amount depend on timing of cycle, but usually thin and slippery May become thick and stringy around ovulation days Discolored (brown, gray, yellow) In large amounts Accompanied with foul odor

4 Talk with your healthcare provider if you have... Abnormal vaginal bleeding (between periods, heavy bleeding, after vaginal sex, bleeding after menopause) Any of these symptoms for more than 2 weeks: Vaginal discharge Treatment for Gynecological Cancers Surgery: first line of treatment Chemotherapy: medicine to weaken and destroy cancerous cells Radiation Therapy: targeted treatment A combination of these methods Pelvic pain or pressure Bloating Lower back pain Constipation or diarrhea Vaginal or vulvar itching Vulvar skin changes (color changes, warts, or growths) Take Home Message #3 Prevent and Detect! Preventative care, early detection and early treatment are the most effective ways to ensure a positive outcome with gynecological cancers.

5 Cervical Cancer Begins in the cervix May not have symptoms right away Abnormal bleeding or discharge is main symptom S T A T I S T I C S : Cervical cancer was the leading cause of cancer deaths for women in the U.S. until recent decades, due to preventative care (Pap tests and HPV vaccine) In 2015, over 4,000 women will die of cervical cancer (about 82 women in Wisconsin) 12,000 women are affected annually with cervical cancer, most under 55 years of age Women who have regular Pap tests rarely develop cervical cancer. R I S K F A C T O R S : Risk increases with age (40-55 years at highest risk) Smoking Having HIV or a similar condition Exposure to the Human Papilloma Virus (HPV) is the cause of most cervical cancers Using birth control pills for a long time Having 3 or more children Having several sexual partners Reduce Your Risk Pap tests: women between years old Protect yourself from HPV: get the vaccine Smoking Cessation

6 HPV and Cervical Cancer Human Papilloma Virus (HPV) is a common virus passed between sexual partners. It is the main cause of cervical cancer, and increases the risk of vaginal & vulvar cancer. At least will have HPV at some point in their lives What is the HPV Vaccine? Series of 3 injections over 6 months no need to revaccinate Recommended for girls and young women aged 9-26 Efficacy decreases after exposure (and repeated exposure) to the HPV virus Sexually active women less likely to benefit Pregnant women should not receive the vaccine during pregnancy Covered by most insurance plans Girls will not become sexually active if they receive the vaccine. The vaccine does not prevent all sexually transmitted diseases, like HIV. The HPV vaccine is a live vaccine, but you cannot get HPV from it. HPV MYTHS DEBUNKED The vaccine cannot give you HPV nor cause cancer. The vaccine is safe and proven. Girls (and boys!) who are not yet sexually active need the vaccine to protect them later.

7 Ovarian Cancer Begins in one or both of the ovaries Mostly occurs in women over 40 Presents with bloating, pelvic pressure, abnormal bleeding Better outcomes with early diagnosis and treatment S T A T I S T I C S : 8 th most common cancer in the United States 5 th leading cause of cancer-related deaths Approximately 20,000 women are diagnosed with ovarian cancer every year R I S K F A C T O R S : Over the age of 40 Ashkenazi Jewish ancestry History of endometriosis 1 st degree relative with history of ovarian cancer Having tested positive for BRCA1 or BRCA2 gene Having never given birth or history of infertility History of breast, uterine, or colorectal cancer Reduce Your Risk FOCUS IS ON EARLY DETECTION. Ovarian cancer is not preventable. Use of oral contraceptives for 5 or more years Tubal ligation (tubes tied) Parity (having given birth)

8 Uterine Cancer Begins in the uterus Specifically, endometrial cancer originates in the endometrium (lining of the uterus) Symptoms: abnormal bleeding or discharge, pelvic pain or pressure The 4th most common cancer in women in the U.S. The most commonly diagnosed gynecological cancer Older than 50 years of age Obesity Difficulty getting pregnant (infertility) R I S K F A C T O R S : Estrogen replacement therapy (without progesterone) Fewer than five periods per year (prior to menopause) History of tamoxifen use (treatment for breast cancer) Family history of ovarian/uterine/colon cancer Reduce Your Risk Use birth control pills (taking progesterone, if you re only taking estrogen pills) Maintain a healthy lifestyle (eating a nutritious diet and being physically active) Know your body discuss any abnormal signs or symptoms with your healthcare provider

9 Vaginal Cancer Begins in the vagina, also known as the birth canal Symptoms include abnormal vaginal discharge or bleeding, change in bathroom habits, and/or pelvic pain and pressure Pain during sex or urination may also be an indicator S T A T I S T I C S : This cancer is very rare cancer, accounting for 6-7% of all gynecological cancers in the U.S. An estimated 1,000 women are diagnosed annually R I S K F A C T O R S : Smoking History of cervical cancer or cervical precancerous cells Human Papilloma Virus (HPV) Immunosuppressive conditions, like HIV/AIDS Reduce Your Risk Protect yourself from HPV get the vaccine! Quit Smoking Know your body and discuss any abnormal signs or symptoms with your doctor

10 Vulvar Cancer Begins in the vulva and the external two folds of skin, known as the labia Symptoms of vulvar cancer include: Intense itching and burning Persistent bleeding Skin color changes S T A T I S T I C S : Vulvar cancer is rare only approximately 3,500 women are diagnosed annually Outcomes are best when diagnosis is early R I S K F A C T O R S : HPV is the single most important risk factor Smoking Immunosuppressive conditions, like AIDS Being over 50 History of cervical cancer or precancerous cells Warts or wart-like growths Pain during sex Having chronic vulvar itching or burning Reduce Your Risk Protect yourself from HPV get the vaccine! Quit Smoking Know your body & discuss any abnormal signs or symptoms with your doctor

11 Questions to ask at your next appointment... What is my personal risk for getting gynecological cancer? When should I get my next Pap test? What do my Pap test results mean? When can I stop getting Pap tests? Resources Is the HPV test right for me? Should I get the HPV vaccine? I ve been noticing (symptom) what does that mean?