Commentary by Dr. Erin M. Lips
September is Gynecologic Cancer Awareness Month, which is recognized every year as a chance to raise awareness. Two of these cancers are cervical and ovarian cancer.
Cervical cancer is a disease that is usually caused by infection with human papillomavirus, or HPV. Most precancerous changes and early cervical cancers do not cause symptoms, but they can be detected on routine health screening with Pap smears. Pap smears and HPV tests are performed during some pelvic exams. Guidance about frequency of Pap smears varies based on age and history of prior abnormal testing, so ask your doctor about how often you should have yours done. If the Pap smear results are abnormal, the next step is a colposcopy procedure done in the office. This involves a pelvic exam, looking at the cervix with a magnifying glass and taking several biopsies. More advanced cervical cancers can cause irregular vaginal bleeding, pelvic pain or pain and bleeding after intercourse. When more advanced, these cancers are usually diagnosed through a pelvic exam and biopsy.
There is no screening test yet for ovarian cancer, and unfortunately, the symptoms can be vague and may not occur until the cancer is in an advanced stage. The earlier the cancer is diagnosed, the better the outcomes. Symptoms can include bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, constipation and increased urinary frequency. Usually, a pelvic exam is performed, and imaging is done with a pelvic ultrasound or a CT scan.
Ovarian cancer can look like small or large masses in the pelvis and abdomen but can also cause increased fluid inside the abdomen. Typically, the first step is surgery to remove the masses and several lymph nodes to obtain a diagnosis and stage. The next step depends on the type of ovarian cancer, but most are treated with chemotherapy. Most people with ovarian cancer or a close family relative with ovarian cancer should have genetic testing done to determine whether they or their family members are at risk for ovarian and other types of cancers.
Cervical and ovarian cancers are diagnosed and treated very differently. Speak with your doctor to ensure that you are staying up to date on proper screening with pelvic exams, Pap smears and HPV tests. Do not hesitate to report new or different vaginal bleeding, bloating, constipation or pelvic pain to your doctor.
Dr. Erin M. Lips is an OB/GYN at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel