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.
Locating the Internal Female Reproductive Organs
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The most common gynecologic cancer in the United States is cancer of the uterus Cancer of the Uterus Cancer of the uterus develops in the lining of the uterus (endometrium) and is thus also called endometrial cancer. Endometrial cancer usually affects women after menopause. It sometimes causes... read more (endometrial cancer), followed by ovarian cancer Ovarian Cancer Ovarian cancer, which typically starts on the surface of the ovaries, is not usually diagnosed until it is advanced. Ovarian cancer may not cause symptoms until it is large or has spread. If... read more , then cervical cancer Cervical Cancer Cervical cancer develops in the cervix (the lower part of the uterus). Cervical cancer usually results from infection with the human papillomavirus (HPV), transmitted during sexual intercourse... read more
. Cervical cancer is not very common in developed countries because screening for cervical cancer Screening for Cervical Cancer Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more
is widely available and effective.
Gynecologic cancers can spread in the following ways:
Directly invade nearby tissues and organs
Spread (metastasize) through the lymphatic vessels and lymph nodes (lymphatic system) or through the bloodstream to distant parts of the body
Diagnosis
Regular pelvic examinations
Biopsy
Regular pelvic examinations Pelvic Examination For gynecologic care, a woman should choose a health care practitioner with whom she can comfortably discuss sensitive topics, such as sex, birth control, pregnancy, and problems related to... read more and screening for certain gynecologic cancers, especially cancer of the cervix, can lead to the early detection of these cancers. Screening for cervical cancer Screening for Cervical Cancer Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more includes the Papanicolaou (Pap) test and human papillomavirus (HPV) testing. 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 Biopsy Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more can confirm or rule out the diagnosis. A sample of tissue from the affected organ is removed, examined under a microscope, and analyzed.
Staging
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 Positron Emission Tomography (PET) Positron emission tomography (PET) is a type of radionuclide scanning. A radionuclide is a radioactive form of an element, which means it is an unstable atom that becomes more stable by releasing... read more (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.
Treatment
Surgical removal
Sometimes radiation therapy and/or chemotherapy
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 cancer Cancer of the Uterus Cancer of the uterus develops in the lining of the uterus (endometrium) and is thus also called endometrial cancer. Endometrial cancer usually affects women after menopause. It sometimes causes... read more or ovarian cancer Treatment Ovarian cancer, which typically starts on the surface of the ovaries, is not usually diagnosed until it is advanced. Ovarian cancer may not cause symptoms until it is large or has spread. If... read more , the main treatment is surgical removal of the tumor. Surgery may be followed by radiation therapy or chemotherapy or, for advanced endometrial cancer, hormonal therapy. For ovarian cancer, treatment often starts with chemotherapy, followed by surgery, followed by chemotherapy.
Treatment of cervical cancer Treatment Cervical cancer develops in the cervix (the lower part of the uterus). Cervical cancer usually results from infection with the human papillomavirus (HPV), transmitted during sexual intercourse... read more may include surgery, radiation therapy, and/or chemotherapy. Radiation therapy may be external (using a large machine) or internal (using radioactive implants placed directly on the cancer) or both. 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 and the type of chemotherapy drug used. 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 Advance Directives Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more . Because end-of-life care Hospice Care Hospice is a concept and a program of care that is specifically designed to minimize suffering for dying people and their family members. In the United States, hospice is the only widely available... read more 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.