Gynecological Cancers: Do Your Patients Know the Warning Signs?

It may surprise you to discover that September is Gynecologic Cancer Awareness Month. If it did, you’re not alone; even though 109,000 women will be diagnosed with a gynecologic cancer this year in the United States, gynecological cancers aren’t nearly as well known as other types of cancer, such as breast cancer, and certainly aren’t as well funded. In fact, gynecologic cancers are among the cancers least funded by the National Cancer Institute and are significantly underfunded compared to many other cancers. That means it’s frequently up to women’s health care professionals to raise awareness of gynecological cancers among their patients, educate patients on how to reduce their risk of cancer, and help patients take the next step if they’ve been diagnosed. So, what do you need to know in order to raise awareness about gynecological cancers?

The first step is increasing your own knowledge of gynecological cancers. Be aware of symptoms: for example, endometrial and cervical cancers can cause abnormal vaginal bleeding; presence of a mass can indicate vulvar cancer; and abdominal bloating, bladder pressure, and decreased appetite could be symptoms of ovarian, peritoneal, or fallopian cancers. ACOG has a number of informational resources about gynecological cancers, including Practice Bulletin 168: Cervical Cancer Screening and Prevention; Practice Bulletin 149: Endometrial Cancer; and Committee Opinion 716: The Role of the Obstetrician–Gynecologist in the Early Detection of Epithelial Ovarian Cancer in Women at Average Risk. You should also be aware of your options when you suspect a patient may have gynecologic cancer. One particularly helpful resource is the Society of Gynecologic Oncology’s Seek a Specialist tool which can help you connect your patients with gynecologic oncologists.

Promoting patient awareness and education about gynecological cancers is also crucial to managing the disease. Patients may not know that being aware of their family’s history of cancer—especially in first-degree relatives—can help identify potential predisposition toward cancer, but once they do, they can speak with their physicians about whether  genetic testing is appropriate. Knowing the signs and symptoms of different gynecological cancers can also help patients be proactive with their own health and could lead to early identification of cancer. You can facilitate patient learning with ACOG’s patient education materials; which include pamphlets that explain what the specific cancer is, risk factors, screening, symptoms, and more in patient-friendly language.

Lastly, it’s important to intervene early on and educate your patients on how to decrease their risk of gynecological cancers. Some risk factors can’t be changed; for example, patients who are older, who enter menopause late, who begin menarche at an early age, and who have Lynch syndrome are all at increased risk for uterine corpus cancer. But there are a number of risk factors that physicians can help their patients control.

• Screening. Physician intervention has a huge effect on cervical cancer, the only cancer that screening and vaccination can prevent: more widespread screening has reduced the incidence of cervical cancer by more than 50% in the past 30 years.
• Diet and lifestyle. Obesity is a risk factor for many types of cancers, including gynecological cancers. By helping patients develop healthier eating habits, sufficient exercise routines, and awareness around their physical health, physicians can play an important role in helping to decrease risk of cancer and risk of death from cancer.

The more aware patients and physicians are of gynecological cancers, the better prepared we all will be to prevent and treat them. Be sure to take advantage of this year’s Gynecological Cancer Awareness Month to make a difference in the lives of your patients.

Eva Chalas, MD, is ACOG president-elect. She is a professor and vice chair of obstetrics and gynecology at New York University Long Island School of Medicine, physician director at the Center for Cancer Care, and National Surgical Quality Improvement Program surgeon cochampion at New York University Winthrop Hospital.