Forgotten Female Cancers: Ovarian And Cervical Cancer
By Dr. Jean Peliska, Oncology
Over the past decade, more and more women have become better informed about female cancers. Breast cancer, in particular, has declined dramatically due to greater public education and increased self-examination.
There are two additional female cancers which women need to educate themselves about. These are ovarian cancer and cervical cancer. While each can be fatal, each can be treated. Like breast cancer, it is important to know the warning signs, to receive regular examinations and to begin early treatment when detected.
Ovarian Cancer
Each year, more than 20,000 American women are diagnosed with ovarian cancer -- the second most common female cancer. Despite this high occurrence, ovarian cancer has a low detection rate. This is largely due to its vague and often confusing symptoms. The most common of these include swelling, bloating, constipation, cramps or other pelvic discomfort. Many women misread or simply ignore these symptoms. As a result, most ovarian cancer is not detected until it is in an advanced stage of growth.
If a doctor suspects ovarian cancer, one of two tests is usually administered: a CT or CAT scan, which is an x-ray procedure that provides detailed cross-sections of the body; or an ultrasound which produces a picture by bouncing harmless high-frequency sound waves off the organs of the body.
Treatment of ovarian cancer is more radical than for other cancers, primarily because it is not detected until its later stages and thus requires extensive surgery. If tumors are present, a surgeon will take a biopsy, which requires the complete removal of the ovary suspected to have cancer. If cancer is found, the surgeon removes the other ovary, the fallopian tubes and the uterus. Since ovarian cancer typically strikes women over fifty, child bearing is usually not an issue.
For younger women with ovarian cancer who still desire children, surgeons will try to remove as little reproductive tissue as possible. If the tumor is detected early and has a slow rate of growth, only one ovary may need to be removed. However, if the cancer has affected other reproductive organs, such as the uterus and fallopian tubes, they too must be removed. Increasing a patient's chance of survival is always the primary objective.
Since ovarian cancer is known to spread quickly to other organs, samples of the liver, diaphragm and surrounding lymph nodes are normally taken for review. Follow-up treatment may include chemotherapy and/or radiation therapy, depending on the extent of the cancer.
No specific contributing factors have been identified for ovarian cancer, although heredity may play a small part in its development. As a woman, if both breast and ovarian cancer are common on your mother's side of the family, you may be more likely to develop ovarian cancer.
Cervical Cancer
Cervical cancer, if detected early, is one of the most curable female cancers. Nearly 13,000 women are diagnosed with cervical cancer each year. Its detection has been made easier with the use of a Pap smear -- a simple test in which cells are collected from the cervix for viewing under a microscope. Done on an annual basis, the Pap smear can detect cervical cancer in its earliest and most treatable stage.
Unlike ovarian cancer, there are several contributing factors involved with cervical cancer. Sexual intercourse at an early age, multiple sexual partners, and the number of sexual partners your partner has had are just a few. Cervical cancer generally affects women in their 40s and 50s, though younger women in their 20s and 30s can develop precancerous lesions as well.
As with ovarian cancer, cervical cancer does not generally present any symptoms in its early stages. More advanced cervical cancer may cause bleeding after intercourse, bleeding between periods and pelvic discomfort. If cervical cancer is suspected, further examination and a biopsy are done. If cancer is believed to be early, a conization can be performed. This procedure involves the surgical removal of the inner layer of the cervix. If the cancer is more advanced, a hysterectomy would be performed. This involves the removal of the cervix as well as the uterus. If a woman is pregnant when cervical cancer is found and the condition of the mother and baby are favorable, the baby is delivered at 28-32 weeks gestation and the surgery can then be safely performed. Chemotherapy and radiation treatment may be recommended depending on the severity of the cancer and its stage of growth.
Prevention and Treatment
The most important factor in preventing and treating cervical and ovarian cancers, as with all cancers, is a yearly exam. An annual pelvic exam and Pap smear can be lifesaving. Between the ages of 18-65, women should have an annual pelvic exam for three consecutive years. If no problems are foreseen, subsequent pelvic exams can be scheduled once every three years or more frequently if recommended by your physician. Regular check-ups with your gynecologist are extremely important, since early detection is crucial to curing both kinds of cancer.
Remember, ovarian cancer is very difficult to detect. Be sure to report any symptoms such as cramps, bloating, pelvic discomfort and constipation to your doctor, even if they seem minor.
Annual exams with your gynecologist help, but there are 364 other days during which your doctor can't easily monitor your health condition. This is where your job begins. Be aware of how you are feeling. There's no need to be paranoid, yet you need to pay close attention to how your body is functioning. If necessary, track any unusual or abnormal activities you experience. Be in tune with your body -- you know how it feels better than anyone else.
If you have any questions or concerns about either ovarian or cervical cancer, call your gynecologist, doctor or local medical clinic.
Jean Peliska, M.D., is board certified in internal medicine and is board eligible in medical oncology and hematology. Her office is located at Milwaukee Medical Clinic's Good Hope Road Center, 3003 W. Good Hope Road, Milwaukee, 352-3100.
