Mayo Clinic experts answer 4 questions about gynecologic cancer

By Jessica Saenz

It's estimated that more than 115,000 people with female reproductive organs in the U.S. will develop one of the five main types of gynecologic cancer in 2022, according to the American Cancer Society. Although gynecologic cancer is not as common as other types of cancer, everyone with female reproductive organs is at risk.

Awareness of your body and cancer screenings can help you and your health care professional find gynecologic cancers early when they are most treatable.

Here's what you should know:

1. What are gynecologic cancers?

They start in the female reproductive organs.

Gynecologic cancer is an umbrella term for cancers that begin in the female reproductive organs. This includes cancers of the uterus, ovaries, cervix, vagina and vulva. Gynecologic cancers also can form in the tissues that surround your ovaries and fallopian tubes, as well as the peritoneum, which is the tissue that lines the abdominal wall and covers most organs in the abdomen.

Depending on how aggressive they are or when they are discovered, gynecologic cancers also can spread to other parts of the body, such as the lymph nodes, bladder, digestive system and lungs.

Some types are more common than others.

Endometrial cancer, a cancer that forms in the lining of the uterus, is the most common type of cancer in people with female reproductive organs. "Endometrial cancer is the fourth most common cancer in women in the United States," says Paul Magtibay, M.D., a Mayo Clinic gynecologic oncologist. "Unfortunately, the rates of this cancer are actually rising because obesity is one of the risk factors for this disease."

After uterine cancer, the most common gynecologic cancers are ovarian cancer, which includes fallopian tube cancer and cervical cancer. "Cervical cancer rates in the United States, fortunately, have dropped dramatically, thanks to Pap smears and HPV testing," says Dr. Magtibay. Vaginal and vulvar cancers are rare, he adds.

2. What are the symptoms of gynecologic cancers?

Symptoms vary by type, and they're not the same for everyone.

Each type of gynecologic cancer has unique symptoms, but abnormal vaginal bleeding, or discharge and pelvic pain or pressure, are common symptoms of cancers of the uterus, ovaries, cervix and vagina. Symptoms such as rashes, itching, burning, pain and color changes in the vulva are only found in vulvar cancer. Early satiety, which means feeling full after eating a small amount of food, and persistent bloating are more common in ovarian cancer, according to the Centers for Disease Control and Prevention.

Because symptoms can vary from person to person, if you notice any changes or symptoms that are out of the ordinary for you, discuss them with your health care professional.

Symptoms can be subtle, so it's important to be attuned to your body.

Symptoms of gynecologic cancer are often overlooked or dismissed as normal. "It's very important that people stay attuned to their bodies," says Dr. Butler. Noting abnormal changes can help you and your health care professional detect gynecologic cancers early.

Dr. Magtibay says this is true for ovarian cancers, which are known to fly under the radar.

"Recent data shows that women have symptoms of ovarian cancer in early stages." He adds that, in addition to early satiety and persistent bloating, changes in your bowel or bladder functions can be early indicators of ovarian cancer.

3. Who is at risk for gynecologic cancers?

Anyone with female reproductive organs.

Gynecologic cancers can affect anyone with female reproductive organs, and the risk increases with age. Additional factors, including obesity, tobacco use, hypertension, HPV infection, and family and personal history of cancer also might put you at an increased risk for certain types of gynecologic cancer. If your family has a history of Lynch syndrome or BRCA1 and BRCA2 mutations, you also might be at an increased risk for uterine and ovarian cancer.

Although these types of cancer can develop in all races and ethnicities, Dr. Butler says cancer experts are seeing an increase in aggressive endometrial cancers in certain populations.

"For reasons we don't fully understand, we are seeing a rise in certain very aggressive subtypes of uterine cancer in Hispanic and Black communities. These types of uterine cancer are less common, but when they do occur, they have higher death rates," says Dr. Butler.

You can make changes to reduce your risk.

Some risk factors for gynecologic cancer might not be in your control, but you can reduce your risk by:

• Quitting tobacco use.
• Achieving or maintaining a healthy weight.
• Talking to your health care professional about the HPV vaccine if you haven't received it and if you are 45 years old or younger.
• Staying up to date with your Pap screenings.
• Talking to your health care professional about your lifestyle to determine your risk and how to reduce it.
• Learning about your family medical history, and if you have hereditary cancer risk, talking to a genetic counselor.

4. How are gynecologic cancers treated?

Treatment can include surgery, radiation, chemotherapy or drug therapy.

"Most of the time, treatment for gynecologic cancers involves surgery. But it may also involve radiation therapy and chemotherapy, or a combination of all three," says Dr. Magtibay.

In addition, some gynecologic cancers can be treated with oral or IV drugs. Depending on the location, stage, aggressiveness and genetic abnormalities in your gynecologic cancer cells, targeted drug therapy, hormone therapy and immunotherapy might be added to your treatment plan.

Dr. Magtibay adds that PARP inhibitors, a newer drug therapy for ovarian cancer, are especially promising for treating ovarian cancers with a BRCA1 or BRCA2 genetic mutation, which are often more aggressive. Learning if you have this mutation might take some investigation.

"It's very important that every patient who receives a diagnosis of ovarian cancer or fallopian tube cancer gets genetic testing and counseling," says Dr. Magtibay.

Treatment sometimes requires care from a team of experts.

Gynecologic cancers can be complex and affect far more than just the organ where they began. That's why it's important to seek care from a center that specializes in complex cancer treatment, especially if:

• Your cancer has spread beyond your reproductive organs.
• You are in your child-bearing years and hope to conceive one day.
• You have other conditions like diabetes, hypertension or heart disease.
• You need palliative support for advanced disease or to improve your quality of life.

"Be mindful of the type of institution you go to," says Dr. Butler. "If you have the opportunity, go to a National Cancer Institute-designated comprehensive cancer center for diagnosis. We know that women have improved outcomes when they go to nationally accredited institutes because these institutes follow guidelines and provide the best evidence-based care for women."

---

Awareness of symptoms, better treatments and vaccines are improving survival for people diagnosed with gynecologic cancers. If you are diagnosed with one of these cancers, quality cancer care is available.

"Find a health care professional with whom you feel comfortable discussing something abnormal and have your annual checkups so we can keep you healthy," says Dr. Butler. "Listen to your body, advocate for yourself and know that we are here to help you."

Learn more

Learn more about gynecologic cancer, including cervical cancer, ovarian cancer, uterine cancer, vaginal cancer and vulvar cancer, and find a gynecologic cancer clinical trial at Mayo Clinic.

Read these articles:

• "Dear Mayo Clinic: Ovarian cancer symptoms and treatment options."
• Got a cervix? Be aware of cervical cancer."
• "Dear Mayo Clinic: Adults up to age 45 and at risk for HPV infection can get vaccine."
• "Dear Mayo Clinic: Genetic abnormalities and cancer risk."

Also watch these videos:

• "Mayo Clinic Q&A' podcast: Dr. Kristina Butler discusses screening cervical cancer."
• "Mayo Clinic Minute: 3 things women should know about gynecologic cancer