Vaagn Andikyan, MD, and Mitchell Clark, MD, Gynecologic Oncology

September is Gynecologic Cancer Awareness Month and while many have heard of these cancers, some may not be aware of the symptoms or risk factors. Gynecologic cancer is cancer of the female reproductive organs — the ovaries, uterus, cervix, vagina, and vulva. The most common gynecologic cancers are: endometrial, ovarian, and cervical. Each of these cancers present in different ways, so it’s vital to your health to commit to annual checkups with your OB-GYN who can advise on unusual symptoms and necessary screenings.

Dr. Vaagn Andikyan and Dr. Mitchell Clark of Stamford Health’s Women’s Specialty Center discuss the most important things to know about gynecologic cancers.

What is endometrial cancer?

Endometrial cancer is cancer of the endometrium, which is the lining of the uterus. Obesity is the most common risk factor for endometrial cancer. The rising rates of obesity in the United States are contributing to rising rates of endometrial cancer. Getting to and maintaining a healthy weight is a valuable way to lower the risk of endometrial cancer.

Signs and symptoms of endometrial cancer:

The most common symptom of endometrial cancer is abnormal vaginal bleeding. For younger women, there are many noncancerous reasons for irregular vaginal bleeding. But for post-menopausal women, it is important to see your doctor right away if you have irregular vaginal bleeding, spotting, or discharge.

What is cervical cancer?

Cervical cancer is cancer of the cells lining the cervix. Infection with human papillomavirus (HPV) is the most common contributor to cervical cancer. Smoking also increases the risk of cervical cancer.

Vaccination against HPV is recommended for people between ages 9 and 12. HPV testing and pap smears are recommended for all individuals with a cervix to assess if they have HPV infection or precancerous changes on their cervix. Precancerous changes can be treated before they progress to cancer. All individuals are advised to quit smoking.

Signs and symptoms of cervical cancer:

Cervical cancer does not usually present with symptoms in the early stages. Because there are often no symptoms, it is important to have an HPV test and a pap smear when you see your OB-GYN. If your HPV test is positive or you have an abnormal pap smear, your doctor will discuss next steps to determine if cancer is present. It’s important to note there are different reasons for an abnormal pap smear, and you should not panic. Rather, it’s important to follow up as recommended by your doctor.

What is ovarian cancer?

Ovarian cancer is cancer of the ovary, which can start in the ovary or fallopian tube. The risk of ovarian cancer increases with age. Using oral contraception earlier in life is protective against ovarian cancer. The longer an individual takes the birth control pill, the lower the risk of developing ovarian cancer. A small number of individuals in high-risk families may have inherited a genetic change that increases their risk of ovarian cancer.

Signs and symptoms of ovarian cancer:

Ovarian cancer does not have obvious symptoms in the early stages and is not easily detected by routine exams.

The symptoms of ovarian cancer are usually vague and can be confused with a variety of other conditions, which is why this cancer is so difficult to diagnose based on symptoms alone. The most common signs include bloating, abdominal or pelvic pain, difficulty eating or feeling full quickly, and weight loss. If symptoms persist for weeks, please call your doctor.

What is vulvar cancer?

Vulvar cancer is a relatively uncommon gynecologic malignancy. The vulva describes the skin and structures that make up the external female genitalia. It's worth noting that patients can develop vulvar cancer even after a hysterectomy.

Signs and symptoms of vulvar cancer:

While it is often asymptomatic, vulvar cancer can manifest as a lesion or bump accompanied by pruritus (itching). Skin discoloration may also be an early sign of vulvar cancer. Fortunately, vulvar cancer is treatable and has a good prognosis when diagnosed early.

If you notice any of the signs and symptoms mentioned above, we recommend scheduling an appointment with your OB-GYN

What if I have a family history of gynecologic cancer?

In some cases, family history of any of these cancers, especially ovarian, is an important risk factor to be aware of. Please let your doctor know if this is the case. We may refer you to our cancer genetics program for genetic counseling and to consider genetic testing. Our genetic counselors are committed to your needs and approach each patient with compassion and the latest information available.

Dr. Vaagn Andikyan and Dr. Mitchell Clark specialize in the diagnosis and treatment of gynecologic cancers. They are accepting patients at the Women’s Specialty Center at Stamford Health.