September is Gynecologic Cancer Awareness Month. Since 1999, the Foundation for Women’s Cancer has promoted ongoing awareness and education about gynecologic cancers with a month of events and community programs. At Roswell Park, doctors and interdisciplinary teams work year-round to help women become more aware of the different gynecological cancers, providing support with resources and strategies to prevent and lower risks for these cancers.
The American Cancer Society estimates that in 2017 there will be about 61,380 new diagnoses of cancer of the uterus. These cases include endometrial cancer, the most common gynecologic cancer, which occurs most often in women age 55 and older. Other, less-common cancers of the female reproductive tract include ovarian, cervical, vulvar and vaginal cancer.
“One of the best things a woman can do is to schedule annual visits with her gynecologist,” says Dr. Stacy Akers, Staff Physician in the Department of Gynecologic Oncology at Roswell Park, and a Clinical Instructor of Gynecology & Obstetrics at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.
Routine gynecological visits also rank high on the list of priorities for the American Cancer Society, which recommends the following testing:
- Cervical cancer testing should start at age 21.
- Women between ages 21 and 29 should have a Pap test every three years.
- Women between ages 30 and 65 should have a Pap test plus an HPV (human papillomavirus) test every five years. This is the American Cancer Society’s preferred approach, although the ACS also advocates having just a Pap test every three years if the HPV test is not available.
- Women over 65 who have had regular cervical cancer testing with normal results over the past ten years should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.
- A woman who has had a total hysterectomy (removal of her uterus and cervix) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.
- A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
“Women need to be proactive in their prevention of gynecological cancers,” says Dr. Akers. “Report any abnormal vaginal bleeding to your doctor immediately, especially bleeding after menopause. And if you have a family history of these cancers, be sure to make your doctor aware, as you may need to be tested more often.”
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Making healthy lifestyle choices can also play an important role in reducing your risks.
Quitting smoking, for example, has been shown to reduce risks for HPV-related cancers, including cervical cancer. To support smokers who want to kick the habit, Roswell Park’s free cessation program, Just Breathe, offers group support, professional guidance and effective quitting strategies to all Roswell Park patients and their families. For more information, call 1-800-ROSWELL (1-800-767-9355).
A healthy diet and regular exercise also play a role. “Endometrial cancer is associated with obesity and excess estrogen production. Changing to healthier eating habits and integrating daily exercise in your life can greatly reduce your risks,” says Dr. Akers. “Even small changes — walking further distances when you park your car, taking the stairs and remembering to get up and stretch when you sit for long periods of time, as well as reducing sugar and unhealthy fats in your diet — can help you practice positive preventative health habits that can reduce risks.”
For women 26 and younger, Dr. Akers recommends the HPV vaccine. HPV, or human papillomavirus, continues to cause many preventable cancers around the world. Transmitted by skin-to-skin contact — not necessarily through sexual contact only — it’s believed that HPV may infect more than 80 percent of adults in the U.S. at some point in their lives. Roswell Park has been leading the effort to offer the HPV vaccine to young adults as part of a national effort to reduce rates of HPV-related cancers.
“Roswell Park supports cancer prevention with education, outreach and resource programs,” says Dr. Akers. “We have an advantage in that we can take care of our patients every step of the way, from diagnosis through treatment and follow-ups,” says Dr. Akers. “We’re very proud of what we can do to reduce risks with early detection, and we also offer treatment options not available elsewhere, such as photodynamic therapy (PDT) and intraperitoneal chemotherapy. Ultimately, our goal is to provide optimal quality of life for all our patients who may be at risk for or who are dealing with a gynecologic cancer.”