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Letter: A Message from Eva Chalas, MD, of Winthrop-University Hospital

In 1999 Congress declared September Gynecologic Cancer Awareness Month. The goal of this special designation is to raise awareness among women and healthcare providers to encourage more screenings, earlier detection and increased support for gynecological cancer research.
Cancers of the uterus, ovaries, fallopian tubes, peritoneum, vagina and vulva account for approximately 80,000 cancer diagnoses in the United States each year. This is comparable to one-third the number of cases of breast cancer in this country, and because gynecological cancers are generally associated with good prognosis when they are detected in their early stages, they have not garnered as much public attention as breast cancer and other illnesses. As a result, promotion of screening, early detection and research into the prevention, diagnosis and treatment of gynecologic cancers has lagged behind that of other diseases.

Screening and Prevention

The only gynecologic cancer for which there is currently an effective screening test is cervical cancer. Additionally, in 2006 a vaccine, which can prevent 70 percent of cervical cancer cases by protecting women from the Human Papilloma Virus (HPV), was approved by the FDA. As a result of the new vaccine, as well as the wide-spread use of the Pap test, rates and mortality of cervical cancer have markedly decreased over the past five decades. In the long run, this should translate into a lower risk of cervical cancer diagnosis in American women.    

Challenges in Women’s Cancer Care

The most challenging and difficult group of women’s cancers to diagnose and treat are ovarian, fallopian tube and peritoneal cancers. These conditions often present with gastrointestinal symptoms, such as abdominal bloating, and can be confused with more common conditions such as irritable bowel syndrome or diverticular disease. Two-thirds of the women who are diagnosed with these conditions are already at Stage III or Stage IV of the disease, when it has already spread extensively throughout their abdomen or into the liver or chest. If women and their healthcare providers are aware of and watchful for the signs and symptoms, this could lead to earlier diagnosis and intervention.
The most common gynecologic cancer is uterine cancer. The majority of these cases are linked to obesity, and with more than 60 percent of Americans currently overweight or obese, the United States is facing greater risk of this – and many other cancers that have been linked to obesity. Because uterine cancer causes abnormal vaginal bleeding or discharge, most women are diagnosed in the early stage of the disease and have a very good chance of being cured.

Life-long Vigilance is Key!

Incidence of cancers increases as we get older, so women who have gone through menopause are at higher risk of cancer than when they were younger. Unfortunately, many women stop going to the gynecologist for check-ups after menopause because they mistakenly believe that they no longer need to be under a gynecologist’s care. This is not true! It is imperative that every woman is aware of her body and an advocate for her health, and that she reports any changes that are of concern to her to her healthcare providers.
Through teamwork, open communication with members of their healthcare team and proper evaluation of persistent symptoms, women can improve their chances of alleviating any concerns or detecting a dangerous medical condition in its early stages.
If cancer is diagnosed, involvement of a cancer specialist (gynecologic oncologist) is vital, and has been shown to be associated with better outcomes. So let’s work together to make a difference!

Signs and Symptoms:Ovarian Cancer

Symptoms should be new in onset (present for less than one year) and occur more than 12 times per month:
Bloating, abdominal distension
Pelvic or abdominal pain
Difficulty eating or feeling full quickly
Urinary symptoms (frequency or urgency)

Uterine Cancer
Abnormal vaginal bleeding or discharge

Cervical and Vaginal Cancers
Abnormal vaginal bleeding or discharge
Pelvic pain or pain on intercourse

Vulvar Cancer
Abnormal vaginal bleeding or discharge
Presence of a lump or mass on the vulva
Pain or itching of the vulva
 Dr. Eva Chalas, MD,
Chief of Gynecological Oncology and Director of Clinical Cancer Services
at Winthrop