Gynecologic (Female Reproductive) Cancers

Introduction

Cancer can develop in any part of the female reproductive system. The most common sites for cancer to occur are the cervix, the lining of the uterus (endometrium), or the ovaries. Less common cancers can also occur in the vagina or the labia.

Causes

Cervical cancer is often driven by human papilloma virus (HPV). Endometrial cancer is associated with estrogen exposure which is affected by natural estrogen production and levels, number of pregnancies, and body mass index (BMI).

Clinical Manifestations and Diagnosis

Cervical cancer is often found on routine gynecologic exam with Pap smear. And more advanced cases, patients may have pain during sexual intercourse or bleeding outside of their typical menstrual cycle.

Endometrial cancer is often diagnosed as postmenopausal bleeding. If you have this clinical sign, see your primary care physician or gynecologist as soon as possible for evaluation.

As with most other cancers, a biopsy is often required for diagnosis of gynecologic cancers. Additional staging imaging may include PET scan or CT or MRI of the pelvis.

Treatment Strategies

Cervical cancer may be surgically removed if caught in an early stage. More advanced cervical cancers often require chemotherapy and radiation together to increase the chance of cure.

Endometrial cancers are almost always surgically resected with a procedure called a hysterectomy. Additional treatments with radiation therapy and/or chemotherapy may be required depending upon the characteristics of the tumor under the microscope or at the genomic level.

Prognosis and prognostic factors

Each patient has a unique cancer type and stage with different underlying risk factors. During a oncology consultation visit, ask your doctor about the expected outcomes.

As with most cancers, the size of the primary tumor, lymph node spread, and distant metastatic spread are all important factors for patient prognosis.

Treatment Side Effects

Radiation treatment side effects tend to affect the tissues that are close to the tumor where the radiation is directed. Some side effects can be more pronounced during and shortly after radiation treatment (acute side effects). While other side effects may occur many months or years after treatment (chronic or late side effects).

For patients receiving radiation therapy to the pelvis for cervical cancer or endometrial cancer, side effects typically include increased stool frequency and urgency, loose or watery stools, skin irritation and redness and peeling around the treatment site. The side effects tend to be short-term during and shortly after radiation therapy. However, they may persist longer-term in some patients. Patients may also experience increased urinary frequency and urgency. Fatigue is also common.