Gynecologic Cancer

What is a gynecologic oncologist?
A gynecologic oncologist, like those who work at the Program in Women's Oncology at Women & Infants Hospital, are obstetrician/gynecologists who have additional specialized training in the diagnosis and treatment of cancer of the female reproductive organs. You will be sent to a gynecologic oncologist if your primary care physician suspects you have gynecologic cancer.

Are there any studies going on that I can join?
Women & Infants' Program in Women's Oncology participates in many research studies and is a leading recruitment site for the prestigious Gynecologic Oncology Group. You can find a complete list and information about signing up on the website at womenandinfants.org/womenscancer.

What are the side effects of chemotherapy and how can I manage them?
Different people experience different side effects from chemotherapy. They can include: nausea, vomiting, hair loss, fatigue, anemia, mouth sores, taste and smell changes, infection, diarrhea, early onset menopause, infertility, fluid retention, rashes, and numbness and aching of the joints, hands and feet. There are medications to help you cope with some of the side effects. In addition, we offer an Integrative Care Program that can offer some relief through therapies like massage, reiki, acupuncture and yoga. We also offer support groups where people share their own remedies and suggestions.

If I need help finding support services during treatment, who do I turn to?
Women & Infants offers the services of a breast patient navigator who can help connect you with the services you need as you're going through treatment. This can include a support group, counseling, financial assistance, transportation to treatment, or other community services.

What if I become depressed?
Your physician can refer you for a consultation to a psychiatrist from Butler Hospital who is on hand weekly at the Program in Women's Oncology. He can evaluate your situation and help you connect with whatever long-term services you may need.

Cervical cancer

What are the risk factors for cervical cancer?
The main risk factor for developing cervical cancer is a positive test for the human papilloma virus (HPV). Other risk factors include having more than five sex partners in your lifetime and smoking.

What are the symptoms of cervical cancer?
Again, there are usually none. An abnormal Pap smear is usually the first sign that there is something wrong. Other signs could be bleeding after sex, irregular menstrual spotting or post-menopausal bleeding.

How is cervical cancer diagnosed?
If you have an abnormal Pap smear, your doctor will usually perform a test called a colposcopy, taking a small amount of cervical tissue for the pathologist to examine.

How is cervical cancer treated?
Several treatment techniques are available. The best depends on the woman's health, the stage of the disease and whether or not she wants to have children. The lesion can often be targeted with a surgical tool called a colposcope. A special laser can also be used to remove the abnormal tissue. These techniques are combined with chemotherapy and/or radiation to fight the cancer. Your doctor can tell you more specifics about your case.

What is cervical dysplasia?
This is a pre-cancerous condition of the cervix. It can also be called carcinoma in situ and squamous intraepithelial lesion.

How is cervical dysplasia diagnosed?
There are rarely symptoms to cervical cancer or precancerous lesions, so diagnosis is generally made through a Pap smear. You should have a Pap smear annually. If it comes back abnormal, your doctor will conduct more tests.

Do I need treatment if I have cervical dysplasia?
Not necessarily. Mild dysplasia can just disappear in some women. Other women choose to watch the situation through frequent doctor exams. Treatment options should be discussed, however.

What is a LEEP?
LEEP stands for loop electrosurgical excision procedure, which is one of the more common ways the doctor can treat cervical dysplasia.

Endometrial cancer

What are the risk factors for endometrial cancer?
Typical risk factors include: obesity; diabetes; never having children; taking estrogen replacement without progesterone; and polycystic ovarian syndrome. Women with these factors have been exposed to either high levels of estrogen or unopposed estrogen.

What are the symptoms of endometrial cancer?
Many women with endometrial cancer have bleeding after menopause, bleeding between their periods, or significant changes to their menstrual cycle, usually excessive bleeding.

How is endometrial cancer diagnosed?
Your doctor will slip a thin straw into your uterus to take a small amount of tissue in an endometrial biopsy. This is checked by a pathologist for cancer. If they need more tissue, you may need to have a dilation and curettage, which is performed under anesthesia.

How is endometrial cancer treated?
Usually, we recommend a hysterectomy to remove the uterus, ovaries and fallopian tubes. Then, you may need radiation, chemotherapy and possibly hormone treatment.

Ovarian cancer

What are the risk factors for ovarian cancer?
Risk factors include a family history of ovarian cancer or breast cancer. In addition, women with Lynch II syndrome are at a higher risk of developing ovarian cancer, especially after menopause.

What are the symptoms of ovarian cancer?
Women with ovarian cancer often do not note any symptoms at all, although bloating, increased abdominal size and urinary problems are potential signals.

How is ovarian cancer diagnosed?
There is no screening test for ovarian cancer. If you are experiencing symptoms, you should have a pelvic exam and possibly an imaging study. Diagnosis can only be made through surgery and removal of the suspicious mass. You should discuss surgery, and your desire to have children, with your gynecologic oncologist.

What is the treatment for ovarian cancer?
Surgery is always required, usually followed by chemotherapy.

Vulvar cancer

What are the risk factors for vulvar cancer?
The major risk factor we know of is a history of the human papilloma virus (HPV). In addition, there is some association with having multiple sex partners and smoking, especially in women under 65.

What are the symptoms of vulvar cancer?
You may develop a mass or sore on your genitals that will not heal. There might also be chronic itching, abnormal discharge, or pain.

How is vulvar cancer diagnosed?
The doctor will take a biopsy of tissue in the area and a pathologist will examine it for cancer.

What is the treatment for vulvar cancer?
A colposcopy will be done on the external and internal genitalia to identify which areas are involved. Smaller cancers will then be removed with the lymph nodes in the groin. Larger cancers will require radiation and chemotherapy.

Vaginal cancer

What are the risk factors for vaginal cancer?
The major risk factor we know of is a history of the human papilloma virus (HPV). In addition, there is some association with having multiple sex partners and smoking, especially in women under 65.

What is vaginal or vulvar dysplasia?
These are pre-cancerous conditions of the vulva or vagina.

How is vaginal or vulvar dysplasia diagnosed?
Most vaginal dysplasias are detected through your regular Pap smear, followed by a colposcopy and possible biopsy of tissue that is then examined by a pathologist for cancer. Vulvar dysplasia is diagnosed through biopsy of tissue from the sore or genital wart.