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3 A WOMAN S GUIDE TO UNDERSTANDING GYNECOLOGIC CANCERS The more tuned in you are to your body, the better your chances of catching gynecologic cancers early and getting the treatment you need. I n 2003, Jenny Allen began feeling persistent pain and pressure in her abdomen and noticed that her periods were more frequent than usual. So she went to her gynecologist for a check-up. I was a little nervous, because I had a friend who d been diagnosed with ovarian cancer, says Jenny, a writer and the mother of two. I didn t want my doctor to think I was neurotic, so I probably downplayed my symptoms. Jenny s doctor reassured her that ovarian cancer is relatively rare, and that her symptoms were most likely due to perimenopause, which occurs before menopause begins. Jenny, who was 48 at the time, was relieved, especially when a pelvic ultrasound and later, a colonoscopy detected no issues. I felt like I had done my due diligence, Jenny says. I was so angry. If I had been more persistent, we might have caught the ovarian cancer earlier. Still, her symptoms continued. She told her gynecologist about them two years later when she went in for a routine Pap test. I wasn t doubling over in pain, Jenny says, 3 of 15 9/12/18, 3:36 PM

4 Jenny Allen but that didn t make the symptoms any less noticeable. When her Pap test revealed a few abnormal cells, Jenny had more tests, which showed that she had Stage I uterine cancer, the fourth most common cancer in women behind breast, lung and colorectal cancers. The treatment for uterine cancer varies, depending on the type and how far it has spread. Options include surgery, chemotherapy and radiation. Jenny had surgery to remove her uterus. That s when her doctor discovered a tumor on her right ovary, which turned out to be ovarian cancer, a disease that affects about 20,000 U.S. women each year. Though it accounts for only 3 percent of all cancers in women, it causes more deaths than any other cancer of the female reproductive system. 20,000 Each year about 20,000 women in the U.S. learn they have ovarian cancer. When it s caught early, treatment works best. Jenny s ovarian cancer was Stage II. I was so angry, she says. If I had been more persistent, we might have caught it earlier. Instead, after recovering from her hysterectomy, Jenny saw a gynecologic oncologist a doctor specially trained in women s reproductive cancers who prescribed four months of chemotherapy. 4 of 15 9/12/18, 3:36 PM

5 PREVENTING GYNECOLOGIC CANCERS: THE MYTHS AND THE REALITY Jenny s abnormal cells were found during a routine Pap test, which is unusual. Typically, the Pap test is used to screen only for cervical cancer. (A screening test looks for a disease when a person doesn t have symptoms. When a person has symptoms, diagnostic tests are used to find the cause.) One of the biggest misconceptions women have is that the Pap test screens for ovarian or other reproductive cancers, says Sherri Stewart, Ph.D., an expert in gynecologic cancers at the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention. The Pap test is a great screening tool for cervical cancer. It helps prevent this cancer by finding precancerous changes, so they can be treated. It also helps find this cancer early, when treatment works best. The Pap test helps prevent cervical cancer by detecting That s why doctors recommend that all women 21 to 65 get screened routinely for cervical cancer. 5 of 15 9/12/18, 3:36 PM

6 precancerous changes. It also helps find this cancer early, when treatment works best. Sherri Stewart, Ph.D. Most cancers don t have screening tests, so we are lucky we have both the Pap and human papillomavirus (HPV) tests to screen for cervical cancer, Dr. Stewart says. That s especially true given that the disease affects 12,500 women in this country each year. The human papillomavirus (HPV) test can be used to screen for cervical cancer beginning at age 30, either with the Pap test or by itself. Certain strains of HPV can increase the risk of cervical cancer, as well as vulvar and vaginal cancers. HPV infection can also lead to cancers of the penis in men and cancers of the anus and back of the throat in both men and women. That s why the HPV vaccine is recommended for girls and boys starting as early as age 9. Currently, there is no good way to screen for uterine or ovarian cancers. Nor is there a screening test for the less common vulvar or vaginal cancers, which account for 6 to 7 percent of all gynecologic cancers in the U.S. each year. Still, there are ways to catch these cancers at an early, treatable stage. 6 of 15 9/12/18, 3:36 PM

7 GYNECOLOGIC CANCERS ARE NOT SILENT Many women assume that ovarian and other reproductive cancers are silent killers, meaning they don t cause any symptoms. The truth is, these cancers do have symptoms and warning signs, Dr. Stewart says. So you really should get to know your body and what s normal for you. It s also crucial to learn the symptoms for each gynecologic cancer and to stay alert to unusual symptoms that persist for more than two weeks. Here are symptoms to watch for: unusual vaginal bleeding or discharge, which can be symptoms of cervical cancer. unusual vaginal bleeding (heavier or more frequent periods and bleeding after menopause or after sex); or pelvic pain and pressure, all of which can be warning signs of uterine cancer. feeling bloated or too full too fast when eating; a change in bathroom habits (urinating more frequently or urgently or having constipation); unexplained abdominal or back pain or pressure; or abnormal vaginal bleeding or discharge. All of these can be warning signs of ovarian cancer. If something doesn t seem right with your body, trust yourself and see your doctor. Just as important: Don t panic. Chances are slim 7 of 15 9/12/18, 3:36 PM

8 that cancer is at the root of the symptoms. But it is important to find out what is causing them just the same. 8 of 15 9/12/18, 3:36 PM

9 THE TENDENCY TO MINIMIZE 21 to 65 Women 21 to 65 should get screened regularly for cervical cancer. Ask your doctor about how often you should get screened using the Pap test, the HPV (human papillomavirus) test or both. Of course, many of us are apt to brush off unusual symptoms, attributing them to hormones gone haywire, perimenopause or soreness brought on by too-vigorous a workout, among other things. Dee Mahler Castillo assumed she was experiencing the usual ins and outs of menopause when she noticed occasional spotting and cramping several years ago, symptoms that continued for about six months. I blew it off, because I felt healthy, says Dee, 58. Luckily, she happened to see a public service announcement by the CDC s Inside Knowledge: Get the Facts About 9 of 15 9/12/18, 3:36 PM

10 Gynecologic Cancer campaign on the symptoms of gynecologic cancers. I saw the ad once, and I thought: Hmmm. Spotting and cramping. Yeah, I feel that way, Dee says. When she saw the ad a second and third time, she asked herself, Why would these symptoms be going on for so long, especially when I m already in menopause? That s when she went to her doctor. Tests revealed that Dee had very early stage uterine cancer. It was like being smacked in the face, Dee says. As women, we are so busy being caretakers for others that we ignore our own stuff. That s why I m so grateful for that commercial. We caught the cancer at such an early stage that I didn t need chemo. You can believe that I take my body and my symptoms more seriously now. If you feel unsure about what s going on with your body, Dr. Stewart suggests you use the Inside Knowledge Symptoms Diary to track your symptoms. I wish I d been more relentless in pursuing my symptoms, says Jenny, who has been cancer-free and healthy for 13 years. Most of all, I wish I d taken myself more seriously. I tell other women what one doctor told me: Follow the symptoms and follow the pain until you get to the source. WATCH THE VIDEOS TO LEARN ABOUT GYN CANCERS 10 of 15 9/12/18, 3:36 PM

11 Gynecologic Cancers: In Brief GYNECOLOGIC CANCERS: IN BRIEF Knowing the warning signs of gynecologic cancers can be lifesaving. Take control of your health. Ovarian Cancer: In Brief OVARIAN CANCER: IN BRIEF Ovarian cancer has warning signs. The important thing is to know what they are, listen to your body and see a doctor if you notice anything unusual. 11 of 15 9/12/18, 3:36 PM

12 CERVICAL CANCER: IN BRIEF Did you know that getting screened regularly for cervical cancer can prevent this disease? Knowledge is power. Uterine Cancer: In Brief UTERINE CANCER: IN BRIEF Knowing the symptoms of uterine cancer and paying attention to your body helps you find this cancer early, when treatment works best. 12 of 15 9/12/18, 3:36 PM

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