If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers

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If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

This article first appeared in Reader's Digest. Read the original here.

The five-year relative survival rate for all types of ovarian cancer is 45 percent—but that number rises to 92 percent if the cancer is caught in stage IA or IB, before it spreads beyond the ovary, according to the American Cancer Society.

Sadly, because ovarian cancer symptoms can be hard to recognize, about 70 percent of cases aren’t caught until they've advanced to stage III or IV, when chances of survival are much lower, says Kevin Holcomb, M.D., director of gynecologic oncology at Weill Cornell Medicine. “Ovarian cancer isn’t really a silent disease,” Dr. Holcomb says.

“A significant number of women with ovarian cancer have symptoms in the months and weeks leading up to diagnosis. Unfortunately, many are vague and nonspecific. … Ovarian cancer whispers, so you have to listen closely.

” Un breast cancer, no tests have been developed to screen regularly for ovarian cancer accurately, which makes the cancer hard to detect unless you report symptoms early yourself. If you’ve been feeling more than one symptom for a week or more, ask your doctor about getting a pelvic examination, transvaginal sonogram, or a CA 125 blood test, which can help detect ovarian cancer.

“With ovarian cancer, not only can tumors grow quite large, but they can result in fluid growing around them, which can cause pretty dramatic abdominal extension,” says Amanda Fader, MD, associate professor and director of Kelly Gynocologic Oncology Service at Johns Hopkins Medicine. If your abdomen is growing while your face and arms are losing muscle and fat, it probably isn’t just weight gain.

Women diagnosed with ovarian cancer may suddenly develop severe constipation that alternates with diarrhea.

Your doctor might suggest tests for gastrointestinal problems irritable bowel syndrome, but ask if it could be a sign of cancer.

“Our hope is that if patients and physicians are aware of the symptoms, evaluations for ovarian cancer would come earlier as opposed to being the last think looked into,” Dr. Holcomb says.

If you find yourself getting full faster and unable to eat as much as you used to, you might be showing signs of ovarian cancer. Talk to your doctor if you've suddenly lost weight without planning to, Dr. Holcomb says.

Vomiting and nausea are symptoms common to many diseases, so your physician might not immediately suspect ovarian cancer. “Symptoms of ovarian cancer are not an isolated symptom, but a constellation of them,” Dr. Holcomb says. “In combination with nausea and bloating, there are also other changes.”

More frequent stops to the bathroom might indicate more than a small bladder, Fader says. If the change has been sudden and is in combination with other symptoms, talk to your physician or gynecologist right away. 

A number of causes might lead to a sudden change in your menstrual cycle or bleeding between periods, according to the Ovarian Cancer National Alliance. While an irregular period alone might not be cause for concern, a combination of other symptoms along with it could indicate a larger problem. These are other unusual menstrual cycle symptoms to watch for.

If sex suddenly becomes painful and continues to be for more than two weeks, it’s a good idea to talk to your doctor, advises the National Ovarian Cancer Coalition.

Source: https://meyercancer.weill.cornell.edu/news/2016-04-27/7-signs-ovarian-cancer-you-might-be-ignoring

Signs of Cervical Cancer Every Woman Should Know

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

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Early detection is critical, but signs and symptoms of cervical cancer can be tough to spot. Here's what you should know that could help save your life.

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About 13,000 American women will be diagnosed with cervical cancer this year, according to the Centers for Disease Control and Prevention (CDC).

While that may not seem a lot—especially when compared with the rate of breast cancer, which roughly one in eight women will develop in their lifetime—it’s still the third most common gynecologic cancer in the United States, says Caryn St.

Clair, M.D., gynecologic oncologist at New York-Presbyterian/Columbia University Irving Medical Center.

The good news: Thanks largely to the Pap smear, human papillomavirus (HPV) testing, and the HPV vaccine, there’s been a significant decrease in cervical cancer risk in developed countries over the last 50 years, says Dr. St. Clair. What’s more, experts anticipate the number of new cases of cervical cancer will continue to decline in women who have been vaccinated.

Now, for the not-so-great news: Signs of cervical cancer can be easily missed because its symptoms mimic those of many other conditions. And if it’s not caught early, survival rates drop rapidly. Here’s what you need to know.

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In short, cervical cancer is (in almost all cases) the result of sexually transmitted disease, says Amanda Nickles Fader, M.D., associate professor and director of the Kelly Gynecologic Oncology Service at Johns Hopkins School of Medicine in Baltimore.

Nearly all cervical cancers are caused by HPV (it’s extraordinarily rare otherwise) , one of the most commonly transmitted infections, affecting hundreds of millions of women around the world. (ICYMI, a shocking number of men have HPV.

) “The good news is that HPV and cervical cancer are preventable with the HPV vaccine, one of the safest, and most studied vaccines ever developed,” says Dr. Fader.

It’s important to know that not all strains of HPV cause cancer. There are about 200 subtypes of HPV that have been identified, and of those, about 40 or so are spread by sexual contact, says Dr. Fader. About 80-90 percent of cervical cancers are due to HPV 16 and 18, but some rarer types can also lead to cervical cancer, she notes.

There are three approved HPV vaccines, and all three effectively protect against HPV 16 and 18. “We can say that any HPV vaccine will protect against the vast majority of HPV-related cervical cancers, but none covers an absolute 100 percent,” says Dr. Fader. This is why  regular screenings are still recommended for vaccinated patients, she adds.

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Cervical cancer is most commonly diagnosed in women between the ages of 35 and 44, and rarely affects women under age 20, says Dr. Fader. About 15 percent of diagnoses are made in women older than 65, she adds (so share this with the women in your family too!).

If you’re experiencing any of these symptoms, bring them to your doctor’s attention. It may be nothing, or it may be something else ( another STD), but the key to survival is early diagnoses.

“Yes, [cervical cancer] is one that we’re beating, but not into submission,” says Nicole Williams, M.D., F.A.C.O.G., a board-certified gynecologic surgeon and founder of The Gynecology Institute of Chicago.

“If you haven’t had a Pap smear in the last three to five years and have these symptoms, you need to be seen.”

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This doesn’t feel cramps, but more of a vague heaviness— something just doesn’t feel right, says Dr. Williams. “You might feel some pressure or even pulling, and things feel a lot heavier than they did before,” she adds.

Signs of cervical cancer tend to creep up over time, and that’s what can make it tough to spot; you just don’t feel well but may be unsure why, says Dr. Williams.

(Related: Here’s What Could Be Causing Your Pelvic Pain)

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You’re not going to be able to feel it by pressing around on top of your stomach, but if you slide your finger into your cervix, it should feel smooth—“ a shiny, pink doughnut,” says Dr. Williams. If you feel something rough instead, see a doctor ASAP.

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Bleeding after sex is the most common symptom of cervical cancer. It doesn’t have to be a lot of blood, but even a little irregular spotting should be brought up with your doctor, says Dr. Williams. You may also experience a dull, achy pain, particularly after sex.

(That said, these symptoms can also be indicative of fibroids, STDs or vaginosis—that’s why cervical cancer is “a great pretender,” says Dr. Williams.) But if you’re experiencing any of this, “it’s generally not nothing,” she adds, so see a doctor.

(Read more about what it could mean to have pain during sex and pain after sex.)

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If you’re doing something that may alter the flow of or stop your period, such as taking a hormonal birth contol pill or if you use a hormone-containing IUD, it’s normal to experience some irregular bleeding or spotting.

Yet, if you’re not doing any such thing and you’re bleeding irregularly, that’s something you should bring up to your doctor, as that could be an early warning sign of cervical cancer or something else, says Dr. Williams.

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An early sign of cervical cancer can be a persistent—and persistent is key here—vaginal discharge that is watery, mucous- or pustulant, which can be quite smelly, says Dr. Williams. A very foul-smelling discharge (which occurs when a tumor starts to break down) is an indication of much more advanced disease.

It’s tough to tell the difference between discharge that’s a sign of cervical cancer and the many other reasons you might have abnormal discharge (because remember, discharge is a natural, normal thing). Plus, discharge often changes throughout your menstrual cycle.

This is yet another reason to get routine screening to rule out anything serious, says Dr. Williams.

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Not everyone with cervical cancer has this symptom, but low back pain has been associated with some cervical cancer cases, says Dr. Williams.

In advanced cases of cervical cancer, the cervix can become so large that it puts pressure on the lower back.

Again, symptoms such as this could be indicative of lots of things, many of them much less serious than cancer—which can make it difficult to spot the signs of cervical cancer on your own.

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One of the scariest things about cervical cancer, though, is that it is often asymptomatic—meaning you could have no symptoms at all, says Dr. St. Clair. “This speaks to the critical importance of good screening and prevention,” she adds. (Read how one woman’s cervical cancer scare changed her life.)

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Cervical cancer is typically diagnosed during a pelvic exam by a doctor or during a routine Pap test or HPV screening, says Dr. St. Clair.

Gynecologists follow screening guidelines set forth by organizations such as American Cancer Society and American College of Obstetrics and Gynecology to help them decide when to administer which tests; it has a lot to do with the patient’s age and medical history, says Carey August, M.D.

, chair of the pathology department at Advocate Illinois Masonic Medical Center. For example, although a Pap test is currently recommended for women ages 21-29, the HPV test is not, since many women in this age group will have an HPV infection but their immune systems are able to get rid of it, says Dr. August.

At the other end of the spectrum, if a woman is older than 65 and has never had cervical cancer or precancerous symptoms, she may not need to be screened at all, either by Pap test or HPV test. Every woman and her history and circumstances are different, so always consult your doctor ask for any tests you think you should be getting done.

“I can identify cells on the slide that look abnormal,” says Dr. August.

“While in rare cases, the abnormal cells mean that the patient already has cancer, the Pap test is also important because, using it, the pathologist can identify cells that are not already cancer cells but have the potential to become cancer. That’s why regular screenings are so important.” (Still have your doubts? Read this: I Only Had Sex with One Person and Got The Most Common STI.)

If your test comes back abnormal, you might need a cervical biopsy. That involves taking a tiny piece of cervical tissue, which is then examined by a pathologist under a microscope, says Dr. August.

If the pathologist finds that the biopsy shows a precancer (a dysplasia or squamous intraepithelial lesion), the gynecologist will treat this part of the cervix—this can mean removing a larger piece of tissue in a procedure called a “cone” or “LEEP.

” Again, the pathologist will examine slides made from this procedure to be sure the precancer has been completely removed.

If a patient already has cervical cancer, a gynecologist can usually see the tumor during a pelvic exam but will need to take a biopsy from it. Using microscope slides from the tumor biopsy, the pathologist will confirm whether it’s cancer and, from there, your doctor can begin planning treatment. (Related: How to Decipher Your Abnormal Pap Smear Results)

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When symptoms are caught early, cervical cancer is preventable, as doctors can treat them before they become a problem, says Jessica Shepherd, M.D., F.A.C.O.G., a board-certified ob-gyn in Dallas.

“If all of us proactively got regularly screened and treated appropriately, we could get rid of cervical cancer in the U.S.,” she adds. Yet despite this fact, one-third of U.S.

women diagnosed with cervical cancer die from the disease, according to the American Cancer Society.

One reason for this concerning statistic is that many women are hesitant to discuss specific sexual health issues their health care provider, says Dr. Shepherd. What’s more, it’s crucial to get the HPV vaccine (psst—here’s why your excuses not to are total B.S.), which drastically reduces your exposure to cervical cancer.

Pap tests should start at the age of 21 and be done every three years, as recommended by the CDC. (See the complete guidelines here). For women ages 30-65, a combination of the HPV test and a Pap test can detect nearly all cervical cancers. “We need to think about this vaccine as a preventative measure that support a woman’s overall health,” says Dr. Shepherd.

”Prevention is so important because it gives us the potential to eradicate the disease.”

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Source: https://www.shape.com/lifestyle/mind-and-body/signs-of-cervical-cancer

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

Linkedin Pinterest Gynecology Diagnosis and Screening for Gynecologic Conditions

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For many years, gynecologic cancers have held an erroneous reputation for being “silent” — the types of cancer that are not preventable or detectable until it’s too late and only limited treatment options are available. However, with the advent of modern testing, screening and genetic discovery, physicians and researchers have found that detection is possible and that many forms of gynecologic cancer can even be prevented.

Rebecca Stone, M.D., a Johns Hopkins gynecologic oncologist and surgeon, explains gynecologic cancer risks, the best forms of prevention for you and your loved ones, and possible signs and symptoms.

Know Your Risk

Gynecologic cancer represents any cancer that begins in a woman’s reproductive organs. Thus, any woman is at risk for developing gynecologic cancer. In the United States alone, approximately 100,000 women are diagnosed with gynecologic cancer each year. The following are important risk factors:

  • Family History: The strongest known risk factor for ovarian cancer is family history. We now estimate that one in five cases of ovarian cancer is due to mutations that occur in ovarian cancer susceptibility genes, such as BRCA1 and 2, which are passed down from generation to generation. Endometrial cancer also runs in some families, most often in association with Lynch syndrome. Lynch syndrome is a hereditary cancer syndrome known for increased risk of endometrial, ovarian and colon cancer.
  • Obesity: With obesity on the rise in the United States, physicians have seen a significant increase in endometrial cancer in particular. Stone says, “Obesity causes an increase in estrogen production and chronic inflammation, which can affect the lining of the uterus (the endometrium), leading to a greater risk of this cancer.”
  • Age: For the majority of gynecologic cancers, a woman’s risk is highest over the age of 60.
  • HPV: HPV is a sexually transmitted disease that has very strong ties to gynecologic cancer. Nearly all cases of cervical cancer are caused by HPV, and many strains of the disease can also cause vaginal and vulvar cancer.

Preventing Gynecologic Cancer

Knowing your risks for gynecologic cancer is very important, as is undergoing the recommended testing, screening and vaccines that are available for prevention.

  • Pap Tests: The Pap test is the most valuable cervical cancer screening tool available, particularly when combined with HPV testing. Pap tests and HPV testing can lead to the detection of precancerous changes in the cervix before they become a cancer. There is great interest in determining how we may be able to use the Pap test to detect ovarian and endometrial cancers. Scientists are actively investigating this.
    • For women 21 to 29, Pap tests are recommended every three years.
    • For women 30 and older, Pap tests combined with HPV testing (known as co-testing) are recommended every five years.
    • Screening may stop for women over 65 if they’re considered low risk.
  • Healthy Diet and Lifestyle: With obesity identified as a significant risk factor for endometrial cancer, maintaining a healthy diet and lifestyle is important. For women interested in achieving short-term and long-term weight loss goals, the Johns Hopkins Weight Management Center offers a Concierge Endoscopic Weight Loss Program to help you reach and sustain a healthy weight.
  • Genetic Testing: There are many indications for genetic counseling and testing, and women should review their family history with their doctors on a regular basis to understand their own personal need for this. In general, women with a family history of ovarian cancer or premenopausal breast cancer (breast cancer before the age of 45), as well as women with a history of endometrial or colon cancer before the age of 50, should see a genetic counselor. “That being said, many women at increased genetic risk for developing these cancers have no identifiable family history, and hopefully, genetic testing will be made available to all women as a preventive health service in the near future,” explains Stone.
  • HPV Vaccine: The HPV vaccine has been a valuable tool in preventing cervical cancer. In a landmark study recently published by the American Academy of Pediatricians, vaccination has reduced the rate of HPV in teenage girls by 63 percent and by 34 percent for women ages 20 to 24. Reducing the rate of HPV will in turn reduce the incidence of cervical cancer by over 3,000 cases per year in the United States.
    • The HPV vaccine is recommended for men and women between the ages of 11 and 26.

“There are many signs of gynecologic cancer that women can observe: abnormal bleeding, pelvic pain and bloating, to name a few,” says Stone. “Unfortunately, though, these can often be symptoms of other, more benign conditions, so it’s important not to be alarmed. Once you feel something, though, you should say something to your physician.”

  • Cervical Cancer: Abnormal bleeding (any vaginal bleeding that is not related to your menstrual period), heavier and/or longer menstrual bleeding than normal, bleeding after menopause, pain and bleeding during intercourse
  • Endometrial Cancer: Abnormal bleeding, postmenopausal bleeding, difficult or painful urination, pain during intercourse, pain and/or mass in the pelvic area
  • Ovarian Cancer: Feeling swollen or bloated in the lower abdomen; loss of appetite; gas, indigestion and nausea; frequent urination; abnormal vaginal bleeding
  • Vaginal Cancer: Abnormal bleeding, difficulty urinating, pain during intercourse, pelvic pain, constipation, a mass that you can feel
  • Vulvar Cancer: Constant itching; change in the color of your vulva; bleeding or discharge not related to menstruation; palpable nodule, mass or sore

Awareness of your risk factors, maintaining a healthy lifestyle, undergoing routine testing and screening, and looking for potential signs and symptoms can help you prevent and detect gynecologic cancers.

One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/if-you-feel-something-say-something-preventing-and-detecting-gynecologic-cancers

Vaginal Cancer

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

Vaginal cancer happens when cancerous cells grow in your vagina.

A woman’s vagina — her birth canal — is a channel that goes from the opening of her uterus to the outside of her body. Many kinds of cancer can spread to the vagina from somewhere else, but cancer that starts here is rare. There are about 6,000 new cases in the U.S. each year.

There are a few main types of vaginal cancer:

Squamous cell carcinoma . This is by far the more common. It happens when cancer forms in the flat, thin cells that line your vagina. This type spreads slowly and tends to stay close to where it starts, but it can move into other places your liver, lungs, or bones. Older women are most ly to get this form. Nearly half of all new cases are in women ages 60 and up.

Adenocarcinoma . This type starts in glandular cells in the lining of your vagina, which make mucus and other fluids. It’s more ly to spread to other areas, including your lungs and the lymph nodes (small organs that filter out harmful things in your body) in your groin.

Clear cell carcinoma . This is an even rarer form of adenocarcinoma. It often affects women whose mothers took a hormone called diethylstilbestrol (DES) in the early months of pregnancy. Between 1938 and 1971, doctors often prescribed this medication to prevent miscarriage and other problems.

Even more rarely, vaginal cancer can form in connective tissue or muscle cells (sarcoma) or in cells that make pigments (melanoma).

Some cases of vaginal cancer don’t have a clear cause. But most are linked to infection with the human papillomavirus, or HPV. This is the most common sexually transmitted disease (STD). An HPV infection most often goes away on its own, but if it lingers, it can lead to cervical and vaginal cancer.

You also might be more ly to get vaginal cancer if you:

  • Are 60 or older
  • Were exposed to DES
  • Drink alcohol
  • Have cervical cancer or precancerous lesions
  • Have HIV
  • Smoke
  • Have unusual cells in your vagina called vaginal intraepithelial neoplasia

Vaginal cancer often doesn’t cause symptoms. Your doctor might find it during a routine exam or Pap test.

If you have symptoms, they can include:

  • Unusual bleeding from your vagina
  • Watery or bad-smelling discharge from your vagina
  • Pain in your pelvis
  • Pain when having sex
  • Pain when peeing
  • Peeing more than usual
  • Constipation
  • A lump in your vagina

If you notice any of these things, it doesn’t mean you have vaginal cancer. You could just have an infection. But it’s important to get it checked out.

If a pelvic exam or a Pap test shows signs of a problem, your doctor may want to take a closer look by doing a colposcopy. They’ll use a lighted magnifying tool called a colposcope to check your vagina and cervix for anything unusual.

They might also take out a bit of tissue so a specialist can look at it under a microscope. This is called a biopsy.

After your doctor diagnoses vaginal cancer, they’ll do imaging tests and other exams to find out whether it’s spread to other parts of your body. This helps them decide the stage the cancer and how to treat it. The stages are:

  • Stage I: The cancer is only in your vaginal wall.
  • Stage II: It has spread to the tissue around your vagina.
  • Stage III: Cancer is in the wall of your pelvis.
  • Stage IVa: The cancer has reached the lining of your bladder, the lining of your rectum, or another area of your pelvis.
  • Stage IVb: It has spread to farther parts of your body your lungs or bones.

You and your doctor will decide on treatment many things, including how close the cancer is to other organs, its stage, whether you’ve had radiation treatment in your pelvic area, and whether you’ve had a hysterectomy to remove your uterus.

Your doctor will probably recommend one or more of these treatments:

Surgery. This is the most common treatment. Your doctor may use a laser to cut out tissue or growths. In some cases, they might remove all or part of your vagina. You may need a hysterectomy to remove your cervix or other organs.

Many women can have a normal sex life after surgery. But sex can raise your chances of infection, and it can cause bleeding or strain the surgical site. Your doctor will tell you what’s safe to do and when it's safe.

Radiation therapy. This treatment uses high-powered X-rays or other forms of radiation to kill cancer. Your doctor might use a machine that sends X-rays into your body, or they could insert a radioactive substance inside your body, on or near the cancer.

Radiation treatments in your pelvic area can damage your ovaries. That can cause them to stop making estrogen, leading to menopause symptoms hot flashes and vaginal dryness. If you’ve been through menopause, you probably won’t have these problems.

This type of therapy also can irritate healthy tissue. Your vagina might get swollen and tender. Sex may be painful.

Chemotherapy (“chemo”). This uses medication to kill or stop the growth of cancer cells. You might take the medication by mouth or get it injected into a vein (intravenous or IV). In some cases, your doctor might give you a chemo in lotion or cream form.

You may lose your sex drive or have side effects nausea, hair loss, and changes in body weight. These will improve or go away after treatment.

Your recovery depends on many things. The most crucial is the stage at which your doctor found your cancer. At the earliest stages, doctors can often cure vaginal cancer.

Five-year survival rates are around 67% for women at stages I and II. This means that 5 years after they were diagnosed or treated, 67% of women are still alive. It's about 47% for all stages combined.

Your age, your overall health, whether your cancer is new or has come back, and whether it caused symptoms also play a role in recovery.

The best way to protect yourself is to avoid getting HPV. The FDA has approved the Gardasil 9 vaccine to prevent HPV-related diseases, including the seven most common types of HPV that cause cancer. The vaccine is for people ages 9 to 45. Younger patients need fewer shots for full protection.

Certain lifestyle changes can also help reduce your risk of vaginal cancer:

  • Wait to have sex until your late teen years or beyond.
  • Don’t have sex with more than one partner.
  • Don’t have sex with someone who has more than one partner.
  • Use condoms during sex.
  • Get regular Pap exams.
  • If you smoke, stop. If you don’t smoke, don’t start.

SOURCES:

National Cancer Institute: “Vaginal Cancer Treatment.”

American Society of Clinical Oncology: “Vaginal Cancer: Risk Factors and Prevention.”

CDC: “Vaginal and Vulvar Cancers.”

American Cancer Society: “Vaginal Cancer.”

Mayo Clinic: “Cancer Treatment for Women: Possible Sexual Side Effects.”

FDA.gov: “FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old.”

Merck.com: “Gardasil 9.”

American Cancer Society: “Key Statistics for Vaginal Cancer,” “Survival Rates for Vaginal Cancer.”

Mayo Clinic: “Vaginal cancer.”

Johns Hopkins Medicine: “Vaginal Cancer.”

UpToDate: “Vaginal cancer.”

Obstetrics and Gynecology: “Factors Affecting Risk of Mortality in Women With Vaginal Cancer.”

Merck & Co.: “Gardasil 9 Prescribing Information.”

© 2020 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/cancer/what-is-vaginal-cancer

HPV: 5 Things All Women Should Know

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

Linkedin Pinterest Human Papillomavirus (HPV)

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In addition to treating patients, Trimble researches vaccines to treat human papillomavirus (HPV). The virus is the most common sexually transmitted infection, with more than 6 million Americans infected each year.

You’ve probably seen television ads for the HPV vaccine. If you have kids, your pediatrician has probably recommended the vaccine to guard against some cancers that are linked to HPV.

It can sound pretty scary: a common infection that causes cancer.

So should women worry about HPV? According to Trimble, the answer is no.

Rebecca Stone, M.D., a Johns Hopkins gynecologic oncologist and surgeon, explains gynecologic cancer risks, the best forms of prevention for you and your loved ones, and possible signs and symptoms.

Trimble discusses five things she wants women to know about HPV, cancer risk and the importance of vaccines.

  1. “Anyone who’s ever had sex may have been exposed to HPV,” says Trimble, adding that she wishes she knew how to get rid of the unnecessary stigma associated with the disease.

    “Raising awareness can give you choices, and knowing you have choices is empowering.”

  2. While more than 100 types of HPV exist, only about a dozen of them are associated with cervical disease. “Together, HPV 16 and HPV 18 account for 70 percent of all cervical disease,” says Trimble. Genital warts are a form of low-risk HPV, and they do not cause cancer.

    Doctors monitor HPV with Pap tests that look for abnormal cervical cells called lesions. Low-grade lesions — where the changes are only mildly abnormal — often clear up on their own. These are not considered precancerous.

    All cervical cancers arise from untreated, high-grade lesions, which do contain precancerous cells. If your immune system is healthy, it typically takes about 10 to 15 years for cervical cancer to develop from a high-grade lesion. But not all high-grade lesions become cancer — a person’s own immune system can eliminate them.

  3. While HPV does cause cervical cancer, the risk of developing cervical cancer from the virus is still quite low.

    For 90 percent of women with HPV, the condition will clear up on its own within two years. Only a small number of women who have one of the HPV strains that cause cervical cancer will ever actually develop the disease.

    Cervical dysplasia, where cell changes occur in the cervix at the opening to the uterus, is a more common outcome from HPV infection.

    “I have a huge group of patients with persistent HPV infection who have never had any reason to need treatment,” Trimble says. “So if you have HPV, you can put it on your nuisance list and take it off your worry list.”

  4. One of the biggest — but lesser-known — dangers of HPV involves the risk of head and neck cancer, with HPV spreading to the throat via oral sex.

    “The rate of cancers in the back of the throat is skyrocketing,” Trimble says. “Experts are using the word epidemic to describe it. It’s on track to outpace cervical cancer.”

    While women can get these cancers, most of the people who get it are heterosexual males. There is currently no way to screen for it, making it all the more important that parents get their children — including boys — vaccinated.

  5. Trimble thinks it’s sad that there’s so much controversy over the HPV vaccine, which has overwhelmingly been proven safe and can prevent devastating cancers linked with HPV. In fact, Trimble has dedicated her research to developing therapeutic vaccines capable of fighting HPV once someone has contracted the virus.

    (Preventive vaccines are given to healthy people to ward off infections; therapeutic vaccines are used to help people who already have a disease.

    ) In a recent study using a therapeutic vaccine, she and her team were able to successfully treat half of patients who had high-grade lesions, and they’re working on raising that number.

    “At least 20 percent of human cancers are caused by a specific infection,” says Trimble. “That implies it would be possible to prevent or treat disease by helping the immune system recognize infection. Once you’ve done that, you’ve won.”

    Ultimately, Trimble says HPV is a wimpy infection, and she’s encouraged by the huge immune responses these therapeutic vaccines can trigger.

    As she explained in a TED talk called “Kicking Cancer’s Butt,” Trimble says, “My goal is to cure cancer, and it’s beginning to look that’s possible.”

One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.

Source: https://www.hopkinsmedicine.org/health/conditions-and-diseases/human-papillomavirus-hpv/hpv-5-things-all-women-should-know

13 ovarian cancer warning signs you should never ignore

If You Feel Something, Say Something: Preventing and Detecting Gynecologic Cancers | Johns Hopkins Medicine

The American Cancer Society estimates that about 21,000 women will be diagnosed with ovarian cancer this year, and although it’s rare, it’s also the deadliest of all female reproductive cancers.

Un breast, uterine, and cervical cancers which have screenings and can be detected early, only about 20 percent of ovarian cancer cases are diagnosed before they’re advanced.

The good news is that if ovarian cancer is diagnosed and treated early, 94 percent of women will live five years or more. Another recent study in the Journal of Obstetrics and Gynecology also found that up to a third of women will survive at least 10 years.

The disease that whispers
“In years past we used to call ovarian cancer the silent killer but it’s really not completely silent, at least in some patients,” said Dr. Edward Tanner, an assistant professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine in Baltimore, Maryland.

Ovarian cancer is now dubbed the “disease that whispers” because although the symptoms are vague and can mimic symptoms of other conditions or diseases, most women will report that they noticed them.

In fact, research shows that women diagnosed with ovarian cancer have new symptoms crop up in recent months. They also tend to occur frequently, every day or every other day and at least 12 times a month, and are more severe.

The most common signs of ovarian cancer include: • Bloating or a swollen abdomen • Increased abdominal size • Urinary frequency, urgency or difficulty • Problems eating, such as feeling full quickly after a meal • Constipation, diarrhea • Nausea • Pelvic pain or pressure • Pain anywhere in the abdomen • Vaginal bleeding • Back pain • Painful sex • Weight loss

• Changes in menstruation

The other problem with ovarian cancer is that it can develop quickly, even in between visits to the OB-GYN. Nevertheless, all women should have a yearly well woman visit and pelvic exam.

“As an oncologist, I do see patients that have ovarian cancer diagnosed on an annual visit where it’s caught early, perhaps several months earlier than it would have been caught if the patient hadn’t had an annual exam,” Tanner said.

Causes of ovarian cancer
The only cause of ovarian cancer that researchers have identified is the BRCA1 and BRCA2 “breast cancer” genes. Studies show that 39 percent of women with the BRCA1 mutation, and 11 to 17 percent of those with the BRCA2 mutation will develop ovarian cancer by 70-years-old.

Other factors that are associated with the risk for ovarian cancer include endometriosis, obesity, early onset of periods or late menopause, and not having children.

“We know what elevates your risk but even having a genetic mutation doesn’t guarantee that you’re going to get ovarian cancer,” said Dr. Barbara A. Goff, a gynecologic oncologist at Seattle Cancer Care Alliance, and a professor of gynecologic oncology at the University of Washington School of Medicine in Seattle.

The future of early detection
For more than 20 years, researchers have been looking for an effective way to screen women for ovarian cancer without success.

Currently, the UK Collaborative Trial of Ovarian Cancer Screening,a large clinical trial, is looking at the combination of the CA-125 blood test and a pelvic and transvaginal ultrasound as an early screening tool. Early results published in May found that regular blood tests detected 86 percent of ovarian cancer. Final results are due out later this year.

“Until we have results, we can’t really say whether it’s going to be helpful or not,” Tanner said.

Other areas that researchers are investigating are the role of genetics as prevention and at the fallopian tubes.

Since it’s believed that many ovarian cancers start in the fallopian tubes rather than in the ovaries, it may be advantageous to remove the fallopian tubes and keep the ovaries intact in women who are having surgery, such as a tubal ligation, Goff said.

According to the American College of Obstetricians and Gynecologists (ACOG) position statement, although this protocol is promising, they can’t recommend it as the standard of care.

“What we don’t know yet is if there are some risks associated with that practice,” Goff said, citing complications or early menopause.

How to prevent ovarian cancer
Studies show that long-term use of the birth control pill and breastfeeding may reduce a woman’s risk because it reduces the rate of ovulation. Plus, studies show the more children a woman has, the lower her risk.

“It’s not the only factor that plays a role. It’s protective but it’s not the golden bullet,” said Dr. Oliver Zivanovic, a surgical oncologist at Memorial Sloan Kettering Cancer Center in Commack, New York.

Un other cancers that can be prevented with a healthy diet and exercise, unfortunately ovarian cancer hasn’t been shown to have the same link.

Nevertheless, leading a healthy lifestyle, which includes regular doctor visits is always a good idea.

If you have any of the signs of ovarian cancer, listen to your body and your intuition and make an appointment with your primary care physician or ob-gyn immediately.

“Don’t let your doctor say it’s just irritable bowel syndrome or a urinary tract infection, Zivanovic said. “When these things are not going away despite the fact that you’ve been treated, it’s a red flag.”

Source: https://www.foxnews.com/health/13-ovarian-cancer-warning-signs-you-should-never-ignore