Gynecologic Cancer
Gynecologic cancer covers five main diseases of the female reproductive system. All of them can be treated, and treatment is most straightforward when it starts early.
About gynecologic cancer
Gynecologic cancer includes five main types of cancer affecting the female reproductive system: cancers of the vagina, cervix, uterus, vulva and ovaries. Every woman is at some risk, and that risk increases with age.
Screening is the most useful thing you can do. A regular Pap test can catch changes in the cervix before they become cancer, or find cancer while it is still small and confined. Keeping those appointments is worth more than almost anything else on this page.
All types of gynecologic cancer can be treated, both to reduce symptoms and to lower the chance of recurrence. What your treatment looks like depends on your overall health and on the type, location and stage of your cancer. The most common treatments are radiation therapy, chemotherapy and surgery, and they are often used together because they work well in combination.
Surgery is common in gynecologic cancer, removing the cancerous tissue directly. For cancers inside the body, a surgeon may perform a hysterectomy, removing the uterus and cervix, and may remove lymph nodes as well to keep cancer from spreading. Chemotherapy works differently from the other two: the medication travels through the whole body rather than treating one area. Your medical oncologist sets the dosage and schedule.
Signs and symptoms
Symptoms vary from person to person depending on the type, stage and location of the cancer. Any of the following is a good reason to schedule an examination.
- Abnormal vaginal bleeding or discharge
- Pelvic, abdominal or back pain
- Bloating
- Frequent urination
- Persistent constipation or diarrhea
- Itching or burning in the vulva
- A change in the color of the vulva
When to call
These symptoms have many possible causes, most of them not cancer. But they are worth a conversation. If something has changed and hasn't resolved, contact your primary care physician — early evaluation is what makes treatment straightforward.
How we treat it
Radiation therapy uses measured doses of radiation to kill cancer cells and stop them from growing or spreading. The radiation damages the cells' ability to multiply, and because cancer cells cannot repair that damage the way healthy cells can, they die off while normal tissue heals over a short period. There are two forms, and many treatment plans use both.
External Beam Radiation Therapy
A machine outside your body directs concentrated beams of radiation at the tumor, affecting the cancer cells and only a small amount of surrounding healthy tissue. This is usually the backbone of treatment for cervical and uterine cancers, given as a series of short daily appointments.
Brachytherapy
Internal radiation. In a minor procedure, small applicators or tubes are placed next to the tumor, and your radiation oncologist places a small amount of radioactive material inside them. Because the source sits right against the target, brachytherapy delivers a high dose exactly where it is needed and very little anywhere else. It is frequently used to complete a course of external beam treatment.
Radiation Combined with Chemotherapy
For many cervical and some uterine cancers, chemotherapy is given during the radiation course to make the radiation more effective. Your radiation oncologist and medical oncologist plan this together so the schedules line up.
What treatment involves
Treatment begins with a planning session called simulation, which maps the exact area to be treated using a CT scan. Small marks are placed on your skin so you can be positioned the same way at every appointment.
External beam treatments are typically given once a day, Monday through Friday, over several weeks. Each session takes only a few minutes and is painless. If brachytherapy is part of your plan, it is scheduled separately, usually toward the end of the course, and your team will explain exactly what each of those appointments involves beforehand.
You will see your radiation oncologist regularly during treatment. These cancers are treated in a private and sensitive area of the body, and no question or symptom is too awkward to raise — there is usually something we can do about it.
Possible side effects
Side effects are usually temporary and typically resolve shortly after treatment ends. Tell your care team about any discomfort — managing it is part of the treatment, not an interruption to it.
- Fatigue that builds gradually through treatment
- Loose stools, cramping or more frequent bowel movements
- Bladder irritation, or burning with urination
- Skin irritation in the treated area
- Vaginal dryness, irritation or narrowing
- Changes in menstrual periods, or early menopause in women still menstruating
Caring for yourself during treatment
- Rest when you need to, and don't hesitate to ask for help.
- Follow your care team's advice — and ask when anything is unclear.
- Tell us about every medication, vitamin and supplement you take.
- Eat a balanced diet and drink plenty of fluids.
- Treat skin in the treatment area gently: no sun, no hot or cold packs, and only lotions your team has approved.
- Lean on support groups, family and friends. Coping is part of treatment.
Trusted resources
- National Cervical Cancer Coalition — www.nccc-online.org
- National Ovarian Cancer Coalition — www.ovarian.org
- Ovarian Cancer Research Alliance — www.ocrahope.org
- SHARE Cancer Support — www.sharecancersupport.org
- Foundation for Women's Cancer — www.foundationforwomenscancer.org
- RT Answers (American Society for Radiation Oncology) — www.rtanswers.org
Clinical background adapted from materials by the American Society for Radiation Oncology (rtanswers.org) and the American Cancer Society.
Cancers We Treat
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Talk with a board-certified radiation oncologist about whether radiation therapy belongs in your treatment plan.