Gynecologic Cancer

Cervical Cancer

There are 2 types of tests used for cervical cancer screening; the Pap Test (or Pap Smear) and the HPV test. The Pap test can identify early changes in cells in order to treat them before they become cancer, and it can help identify cervical cancer in its early stages when it’s easier to treat. The HPV, or human papilloma virus, test can help find certain infections that lead to changes in cells and potentially cancer. HPV infections are common and sometimes go away by themselves without causing any problems.

According to the U.S. Preventive Task Force and the American Cancer Society Guidelines, all women should be screened for cervical cancer at the age of 21. It is recommended that women between the ages of 21 and 29 have a Pap test every 3 years, and should not be tested for HPV unless it is needed after an abnormal Pap test result. Women 30 to 65 years of age should have both a Pap test and an HPV test every 5 years, though a Pap test alone every 3 years is also appropriate.

Generally, women over the age of 65 who have had regular screenings with normal results should not be screened for cervical cancer. However, women who have been diagnosed with cervical pre-cancer should continue to be screened. Additionally, women who have had their uterus and cervix removed in a hysterectomy and don’t have a history of cervical pre-cancer or cancer don’t need to be screened. Women who are at high risk for cervical cancer may need to be screened more often.

Diagnosis

If a Pap smear test comes back abnormal, your gynecologist may perform a colposcopy, in which a colposcope, or a lighted instrument attached to magnifying binoculars, is used to examine your cervix. Your gynecologist can also perform a biopsy at the same time, which involves removing a small section of the surface of the cervix to examine under the microscope. If abnormal cells are found or if a diagnosis is not clear after a colposcopy, your gynecologist may recommend minor surgery, called a cone biopsy or conization, to remove more tissue from the cervix. Cone biopsy can be used to confirm a diagnosis and also for treatment to remove any precancerous or cancerous cells.

Your gynecologist may also order imaging tests, such as an x-ray, CT scan or MRI to determine if the cancer has spread, or metastasized, beyond the cervix to other parts of the body.

Ovarian Cancer

Early detection of gynecologic cancers greatly increases treatment success. While there has been a lot of research to develop a screening test for ovarian cancer,there hasn’t been much success so far. The 2 tests used most often to screen for ovarian cancer are — transvaginal ultrasound (TVUS) and the CA-125 blood test – both have limitations. TVUS is a test that uses sound waves to look at the uterus, fallopian tubes, and ovaries using an ultrasound wand. This can help detect a mass, but can’t determine if the mass is cancer. CA-125 is a protein in the blood and many women with ovarian cancer have high levels of CA-125. However, common conditions other than cancer can also cause high levels of CA-125.

The best thing women can do is be diligent about getting regular women’s health exams. Also, visit your doctor if you notice any changes in your body or potential symptoms, including abdominal swelling or bloating, pelvic pressure or abdominal pain, difficulty eating or feeling full quickly, and/or urinary symptoms like having to go urgently or more frequently. While many of these are symptoms of conditions other than cancer, it’s important to be open and honest with your doctor if you experience any changes in your body or habits.

Genetic Testing

BRCA1 and BRCA2 are human genes that produce proteins that produce tumor suppressor proteins, which help repair damaged DNA. These proteins help ensure the stability of the genetic material of cells. When either of these genes, BRCA1 or BRCA2, are mutated, cancer may develop. Specific inherited mutations of BRCA1 and BRCA2 tend to increase the risk of female breast and ovarian cancers.

Community Care Physicians offers genetic testing to help women determine if you are considered higher or lower risk for ovarian cancer. Some women face inherited risk for ovarian cancer due to genetic mutations, specifically the presence of a BRCA1 and BRCA2 mutation. BRCA1 and BRCA2 are human genes that produce proteins that product tumor suppressor proteins, which help repair damaged DNA. These proteins help ensure the stability of the genetic material of cells. An altered, or mutated, BRCA1 or BRCA2 gene increases the likelihood that cancer will develop. The most common types of cancers associated with BRCA alterations are ovarian cancer and breast cancer.

In December 2013, the United States Preventive Services Task Force recommended that women who have family members with breast, ovarian, fallopian tube, or peritoneal cancer be evaluated to see if they have a family history that is associated with an increased risk of a harmful mutation in one of these genes.

When an individual has a family history that is suggestive of the presence of a BRCA1 or BRCA2 mutation, it is preferred to first test a family member who has cancer if that person is still alive and willing to be tested. If that person is found to have a harmful BRCA1 or BRCA2 mutation, then other family members may want to consider genetic testing for BRCA1 and BRCA 2 mutations. If it is not possible to confirm the presence of a harmful BRCA1 or BRCA2 mutation in a family member who has cancer, it is appropriate for those who have a family medical history of cancer (but no cancer themselves) to potentially be tested.