Gynecologic Cancer: Facts, Symptoms, and Treatments

Any woman or person with a female reproductive system is at risk for gynecologic cancer. Gynecologic cancer describes a group of cancers that develop in the female reproductive system – including external and internal organs. There are many types of gynecologic cancer, and each type is unique and may have different warning signs. September is Gynecologic Cancer Awareness Month which provides an excellent opportunity to learn the facts, warning signs, and treatments for this group of cancers.

The American Cancer Society estimates that, in the U.S. more than 110,000 women will be diagnosed with a type of gynecologic cancer in 2022.

Types of gynecologic cancer

There are five major types of gynecologic cancer:

• Endometrial (or uterine) cancer – the most common type – with an estimated 66,000 new cases in the U.S. in 2022.
• Ovarian cancer is expected to affect about 20,000 women in the U.S.
• Cervical cancer, with an estimated 15,000 cases in the U.S.
• Vulvar cancer – affects the outer female genital organ – and is projected to impact 6,500 women in the U.S.
• Vaginal cancer, which is rare and makes up 1% to 2% of gynecologic cancer.

Each type of gynecologic cancer is different and is named based on the part of the female reproductive system where it starts. For example, ovarian cancer begins in the ovaries, and cervical cancer begins in the cervix.

Other cancers fall under the gynecologic cancer category but are very rare. Some include gestational trophoblastic disease, primary peritoneal cancer, and fallopian tube cancer.

What causes gynecologic cancer?

Different factors can cause each type of gynecologic cancer. Generally, cancer occurs when cells grow uncontrollably and spread – this can be due to gene defects or environmental effects. Gynecologic cancer develops when these uncontrolled growths happen in the female reproductive organs.

Scientists don’t know the exact cause of most types of gynecologic cancer, but they found the following links that may increase your risk:

• Being older.
• Being obese.
• Having a family history of gynecologic cancer or breast cancer.
• Taking estrogen therapy.
• Having received hormone therapy for a previous cancer.
• Having been exposed to diethylstilbestrol (DES).
• Smoking.
• Having been infected with the human papillomavirus (HPV).
• Giving birth later in life.
• Having a weakened immune system.

For example, exposure to HPV and smoking may increase your risk of cervical cancer. Obesity and taking the hormone estrogen may make you at a higher risk of developing endometrial cancer. If you have never given birth or had children later in life, you may be at increased risk of ovarian cancer.

More research is being done to better understand the causes of gynecologic cancer.

Gynecologic cancer symptoms to watch for

Gynecologic cancer symptoms differ depending on the affected body part and whether the tumor has spread.

Some symptoms to watch for with endometrial cancer may include:

• Unusual vaginal bleeding such as bleeding between your menstrual periods or after menopause.
• Vaginal discharge that is bloody or not bloody.
• Pain or pressure in your pelvis.
• Feeling a mass.
• Unintentional weight loss.

For ovarian cancer, some warning signs may include:

• Frequent or urgent need to urinate.
• Constipation.
• Pelvic or belly pain.
• Feeling full quickly, bloating, or having trouble eating.

You may not have any signs or symptoms in the early stage of cervical cancer. More advanced cervical cancer may produce warning signs such as:

• Bleeding after vaginal sex or bleeding after menopause.
• Longer and heavier menstrual periods.
• Abnormal vaginal discharge.
• Pelvic pain or pain during sex.

Some warning signs for vulvar cancer may include:

• Itching in the outer part of your genitalia that does not get better.
• A lump or open sore in the vulva (it may look like a wart or feel rough).
• Burning or pain in the vulva.
• Skin changes – a change in skin color or texture – or thickening in the vulva.
• Vaginal bleeding in between your menstrual periods.

Symptoms of vaginal cancer may become more noticeable as the tumor becomes larger or has spread to nearby tissue. These include:

• Unusual vaginal bleeding or bleeding after sex.
• Abnormal vaginal discharge.
• Pain in your pelvis or painful sex.
• Pain when you’re urinating.
• Feeling a mass or lump in your vagina.

Although these signs and symptoms may be caused by conditions other than gynecologic cancer, you should see a healthcare provider immediately if you notice these changes or anything different in your body.

How is gynecologic cancer treated?

Once gynecologic cancer has been diagnosed, your treatment options depend on the type of cancer and whether the tumor has spread.

The most common treatment options for gynecologic cancer are:

• Surgery: This is usually the primary treatment for most gynecologic cancers. Surgery may remove the tumor or the entire organ depending on how far the cancer has spread.
• Chemotherapy: These are drugs that destroy cancer cells or slow the growth of cancer. They can be given through your veins or pills you take by mouth.
• Radiation therapy: This treatment uses high-energy x-rays that help kill cancer cells. It can be given together with chemotherapy or alone after surgery.
• Targeted therapy: These drugs attack the cancer cells without harming normal cells. They tend to have different side effects than chemotherapy and are not appropriate for all types of gynecologic cancer.
• Immunotherapy: This treatment helps boost your immune system to identify and kill cancer cells. Immunotherapy may not be used for all types of gynecologic cancers.

Clinical trials are other treatment options that your healthcare provider may talk to you about. Scientists use clinical trials to evaluate whether a new treatment or medication is effective or safe.

Early detection and prevention are the best ways to reduce your risk of gynecologic cancer. Get your gynecologic exams regularly, including Pap tests and HPV tests. Some prevention measures include being physically active, avoiding HPV infection, receiving the HPV vaccine, and avoiding smoking. Pay attention to changes in your body. Talk to your healthcare provider about anything new you notice, if you have concerns about symptoms, or if you have a family history of gynecologic cancer.