Overview of Female Reproductive System Cancers
Cancers can occur in any part of the female reproductive system—the vulva, vagina, cervix, uterus, fallopian tubes, or ovaries. These cancers are called gynecologic cancers.
Gynecologic cancers can spread in the following ways:
Regular pelvic examinations and Papanicolaou (Pap) tests or other similar tests can lead to the early detection of certain gynecologic cancers, especially cancer of the cervix. Such examinations can sometimes prevent cancer by detecting precancerous changes (dysplasia) before they become cancer. Regular pelvic examinations can also detect early cancers of the vagina and vulva. However, cancers of the ovaries, uterus, and fallopian tubes are not easy for doctors to detect during a pelvic examination.
If cancer is suspected, a biopsy can confirm or rule out the diagnosis. A sample of tissue from the affected organ is removed, examined under a microscope, and analyzed.
If cancer is diagnosed, one or more procedures may be done to determine the stage of the cancer. The stage is based on how large the cancer is and how far it has spread. Some commonly used procedures include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), chest x-rays, and positive emission tomography (PET). Doctors often determine the stage of cancer after they remove the cancer and biopsy the surrounding tissues, including lymph nodes.
Staging a cancer helps doctors choose the best treatment.
For all gynecologic cancers, stages range from I (the earliest) to IV (advanced). For most cancers, further distinctions, designated by letters of the alphabet, are made within stages.
Staging Cancers of the Female Reproductive System*
Cancer treatment may include surgical removal, radiation therapy, and chemotherapy, depending on the type and stage of cancer.
When cancer is first diagnosed, the main goal of treatment is to remove the cancer if possible (through a single treatment or through a combination of surgery, radiation therapy, and chemotherapy).
Chemotherapy is usually the most effective way to treat any cancer cells that have spread beyond the original site. Using combinations of chemotherapy drugs may help eliminate the original cancer and eliminate cancer cells elsewhere in the body, even when there is no sign of those cells.
For endometrial or ovarian cancer, the main treatment is surgical removal of the tumor. Surgery may be followed by radiation therapy or chemotherapy or, for endometrial cancer, hormonal therapy.
In women with cervical cancer, radiation therapy may be external (using a large machine) or internal (using radioactive implants placed directly on the cancer). External radiation therapy is usually given several days a week for several weeks. Internal radiation therapy involves staying in the hospital for several days while the implants are in place.
Chemotherapy may be given by injection, by mouth, or through a catheter inserted into the abdomen (intraperitoneally). How often chemotherapy is given depends on the type of cancer. Sometimes women have to remain at the hospital while they receive chemotherapy.
When a gynecologic cancer is very advanced and a cure is not possible, radiation therapy or chemotherapy may still be recommended to reduce the size of the cancer or its metastases and to relieve pain and other symptoms. Women with incurable cancer should establish advance directives. Because end-of-life care has improved, more and more women with incurable cancer are able to die comfortably at home. Appropriate drugs can be used to relieve the anxiety and pain commonly experienced by people with incurable cancer.