Women: Listen to Your Body

Monday, February 11, 2013 - 2:58pm
Clinical Chief of Gynecologic Oncology, Clinical Chair, Division of Surgical Subspecialties

Understanding the relatively rare and lesser known gynecologic cancers can help you recognize warning signs that often mirror other, more common ailments. Fallopian tube, vulvar and vaginal cancers are highly treatable with early diagnosis. A preemptive approach to any sign of irregularity is a critical step in early detection. Educate yourself on your health history and pay close attention to what is normal for your body.

Vaginal Cancer

The Stats:
Carcinoma of the vagina is relatively uncommon, affecting only 1- 2 percent of women in the U.S. each year. There are two types of vaginal cancer, squamous cell carcinoma usually found in women between the ages of 60 and 80 and adenocarcinoma usually found in women between the ages of 12 and 30. 

Risk Factors:
Squamous cell carcinoma originates in the skin lining of the vagina and is usually caused by a history of genital or venereal warts due to the human papilloma virus (HPV), a sexually transmitted disease. Another risk factor is a history of vaginal radiation therapy. Adenocarcinoma of the vagina has been associated with exposure to diethylstilbestrol (DES). This drug was given to women from 1945 until the early 1970s to prevent miscarriage, premature labor and related complications of pregnancy. The daughters of women who used DES while pregnant have about 40 times the risk of developing clear cell adenocarcinoma of the lower genital tract than unexposed women. 

Warning Signs and Symptoms:
The most common symptoms associated with cancer of the vagina are abnormal vaginal bleeding and discharge, painful urination and pain during intercourse.

Vulvar Cancer

The Stats:
Vulvar cancer is rare and accounts for about 4 percent of all gynecological cancers and typically affects women later in life. Vulvar cancer usually develops slowly over a period of years and may begin as precancerous changes that can be treated before they become cancer. This condition is called vulvar intraepithelial neoplasia (VIN) or dysplasia. Because it is possible for VIN or dysplasia to develop into vulvar cancer, treatment of this condition is very important.

Risk Factors:
The most common risk factor for developing vulvar cancer is a history of genital or venereal warts caused by HPV. Other risk factors include smoking, age, melanoma and atypical moles. 

Warning Signs and Symptoms:
It is recommended that you perform a vulvar self-exam on a monthly basis. If lumps, bumps or lesions are found you should seek medical attention. There may be severe burning, itching or pain in vulva or the skin may look white and feel rough. Pelvic pain or pressure may also be present.

Fallopian Tube Cancer

The Stats:
Primary fallopian tube cancer is the rarest and accounts for only about 1 percent of all gynecologic cancers. While other gynecologic cancers may spread to the fallopian tubes, it is rare for cancer to develop there. Between 1,500 and 2,000 cases of fallopian tube cancer have been reported worldwide, with just approximately 300 of those cases in the U.S. The common age of fallopian tube cancer patients is 60 - 64, but can continue to occur in women who are in their early- to mid- 80s.

Risk Factors:
Given its rarity, the causes and risk factors for developing primary fallopian tube cancer are not clearly defined. There has been some association of the cancer with chronic infection and inflammation of the fallopian tubes due to untreated sexually transmitted diseases. There are several genetic mutations that have been reported in anywhere from 16-43 percent of women with primary fallopian tube cancer. The mutations involve the hereditary breast and ovarian cancer genes, and particularly BRCA1. If you are diagnosed with this disease you should undergo thorough family history assessment, and be offered genetic counseling. Also, if you carry a BRCA mutation, rigorous screening for fallopian cancer should be considered to increase chances for early detection.

Warning Signs and Symptoms:
The most common symptoms are vaginal bleeding, vaginal discharge and pelvic pain. As a general rule, any vaginal bleeding in postmenopausal women should be quickly and carefully evaluated. Blood tinged vaginal discharge that does not respond to antibiotic treatment may signify the presence of cancer. Finally, pelvic pain may occur because of trapped fluid blocking and distending the fallopian tube.