1. Gynecologic Cancers Presented by: Michael Goodheart, MD Assistant Professor Gynecologic Oncology The University of Iowa Hospitals & Clinics Understanding, Preventing and Recognizing Gynecologic Cancers

2. Topics to Review: Risk factors Symptoms Diagnosis and Treatment Prevention

3. What are gynecologic cancers? There are five types of gynecologic cancers: Cervical Ovarian Uterine Vaginal Vulvar

4. Cervical Cancer In 2013, about 12,340 women will be diagnosed with cervical cancer Good news: Very preventable High cure rate with early diagnosis Vaccine is available

5. Risk Factors for Cervical Cancer HPV infection Smoking A suppressed immune system Infections with STDs Multiple sexual partners Early age at first sexual encounter

6. HPV Infections and Cervical Cancer Many cervical cancers are caused by the human papilloma virus, or HPV. Most sexually active men and women will be infected with HPV at some time in their life All females and males between the ages of 11 and 26 are eligible for the HPV vaccine – Gardasil – Cervarix

7. Symptoms of Cervical Cancer Bleeding between periods Bleeding after sexual intercourse Low back pain

8. Diagnosis/Treatment of Cervical Cancer Diagnosis: Pap test Colposcopy Biopsy Treatment: Hysterectomy-radical with lymph node removal by a GYNECOLOGIC ONCOLOGIST Radiation with chemotherapy

9. Prevention of Cervical Cancer HPV vaccine Discretion….. Continued routine Gyn care

10. Uterine Cancer In 2013, about 49,500 women will be diagnosed with uterine cancer Good news: Highly curable when detected early

11. Uterine Cancer Risk Factors Age: Uterine cancer increases with age Genetics: Lynch Syndrome and mismatch repair genes

12. Uterine Cancer Symptoms Vaginal bleeding after menopause Bleeding between periods Abnormal, watery or blood-tinged discharge

13. Diagnosis/Treatment of Uterine Cancer Diagnosis: Pelvic exam Biopsy from the uterus Treatment: Surgery by a GYNECOLOGIC ONCOLOGIST!! Hormone treatment Radiation sometimes with chemotherapy

14. Prevention of Uterine Cancer Do not ignore bleeding after menopause Testing for Lynch syndrome – Family history of colon cancer – Family history of uterine cancer

15. Vaginal & Vulvar Cancer In 2013, about 2,890 women will be diagnosed with vaginal cancer In 2013, about 4,700 women will be diagnosed with vulvar cancer Good news: Both are very rare cancers Both have a high cure rate when detected early

16. Vaginal/Vulvar Cancer Risk Factors Age: these cancer increases with age Skin irritation

17. Symptoms of Vaginal or Vulvar Cancer Abnormal bleeding Unusual vaginal discharge Vaginal or vulvar mass Pelvic pain Vulvar irritation Vulvar or vaginal ulcer

18. Diagnosis/Treatment of Vaginal/Vulvar cancer Diagnosis: Pelvic exam Biopsy from the area Treatment: Surgery by a GYNECOLOGIC ONCOLOGIST!! Radiation sometimes with chemotherapy

19. Prevention of Vaginal/Vulvar cancer Do not ignore bleeding after menopause Continue routine Gyn care

20. Ovarian Cancer In 2013, about 20,000 women will be affected by ovarian cancer Problems: Symptoms tend to be vague Difficult to detect in early stages

21. Ovarian Cancer Risk Factors Age: Ovarian cancer increases with age Genetics: Certain types of ovarian cancer can be hereditary (ie. BRCA1 & BRCA2) Family history: A first degree relative with ovarian cancer, increases your risk

22. Symptoms of Ovarian Cancer Pelvic pain or pressure Abdominal or back pain Bloating Loss of appetite or feeling full quickly Changes in bowel or bladder habits Sudden weight gain or loss Constant fatigue Persistent indigestion or nausea

23. Diagnosis/Treatment of Ovarian Cancer Diagnosis: Pelvic exam Blood work CT scan or ultrasound Treatment: Surgery by a GYNECOLOGIC ONCOLOGIST!! Chemotherapy

24. Prevention of Ovarian Cancer Removal of tubes and ovaries in BRCA carriers

25. Am I feeling normal? Gynecologic cancer symptoms aren’t always specific to your reproductive system. Be alert for: Chronic or severe fatigue Sudden weight gain or loss Fever Pain GI problems

26. If you remember only a few things from tonight… Many of the symptoms of gynecologic cancers are vague Many of these symptoms are also present in much less serious conditions Many of these symptoms are easy for a busy woman to ignore Many of these symptoms can be investigated by your friendly Gynecologist

27. Thank you! www.uihealthcare.org/womenshealth UI Women’s Health Center: 319-356-2294 Iowa River Landing: 319-467-2000