1. Welcome and thank you for joining us. I’m [insert your name/title]
Welcome and thank you for joining us. I’m [insert your name/title]. Today I’m going to tell you about the five main types of gynecologic cancer. These are cancers of the female reproductive system.
This presentation highlights information from the Inside Knowledge: Get the Facts About Gynecologic Cancer campaign, a Centers for Disease Control Prevention initiative. GFWC and the CDC’s Inside Knowledge campaign became partners last year. So we are sharing the campaign’s messages and resources to help you understand more about these cancers that affect women. Knowledge is power – especially when it comes to our health!
Inside Knowledge: Get the Facts About Gynecologic Cancer A Centers for Disease Control and Prevention Campaign

2. What We Will Discuss
Part I. What You Need to Know About Gynecologic Cancers Part II: Recognizing the Warning Signs Part III: Prevention, Screening, and Treatment Part IV: Inside Knowledge and GFWC
Today we’re going to talk about what you need to know about gynecologic cancers. Then I’ll provide information on warnings signs, prevention and screening, and how you can become involved in raising awareness.

3. What You Need to Know About Gynecologic Cancers
But first – what you need to know.

4. Gynecologic Cancer
Gynecologic cancer is any cancer that starts in a woman's reproductive organs.
These cancers begin in different places within a woman's pelvis.
There are five main types of
gynecologic cancers:
Ovarian
Uterine
Cervical
Vaginal
Vulvar
Here you can see a diagram of a woman’s reproductive organs. Any cancer that starts in these organs is called a gynecologic cancer. There are five main types: cervical, ovarian, uterine, vaginal, and vulvar. As a group, they’re referred to as gynecologic cancer. But each is unique, with different signs, symptoms, and risk factors.

5. How Many Women Are Affected?
In the U.S. in 2009 (the last year for which data are available), more than 84,000 women were diagnosed with a gynecologic cancer.
Nearly 28,000 died from a gynecologic cancer in 2009.
Of the five main gynecologic cancers:
Most common – Uterine
Least common – Vaginal
Most preventable – Cervical
Deadliest – Ovarian
How many women are affected by gynecologic cancer?
In 2009, more than 84,000 American women learned they had a gynecologic cancer, and nearly 28,000 women died from one.
Of the five main gynecologic cancers,
Uterine is the most common;
Vaginal is the least common;
Cervical is the easiest to prevent; and
Ovarian kills more women than any other gynecologic cancer.
Ovarian cancer is very hard to recognize and diagnose at an early stage, when treatment might be more effective. I’ll discuss prevention and detection a little later.

6. Who Gets Gynecologic Cancer?
All women are at risk; risk generally increases with age.
Each gynecologic cancer is unique.
Risk factors differ from cancer to cancer.
Cervical: HPV (human papillomavirus) infection
Ovarian: age 50+; having certain genetic risk factors; having several close relatives with ovarian or breast cancer; being of Eastern European Jewish background
Uterine: age 50+, hormone replacement therapy using estrogen alone
Vaginal: age 50+, exposure to HPV
Vulvar: exposure to HPV
All women are at risk for gynecologic cancer. Risk generally increases with age, especially for ovarian, uterine, and vaginal cancer.
Exposure to or infection with HPV – the human papillomavirus – increases risk for cervical, vaginal, and vulvar cancers. HPV usually goes away on its own. If it doesn’t, it can cause these cancers.
Some genetic risk factors can raise the risk for ovarian and uterine cancers. Risk for these cancers may also be increased if you have several family members on either your mother’s or your father’s side who have had ovarian cancer or breast cancer.
Since each gynecologic cancer is different, risk factors also differ by cancer.

7. Recognizing the Warning Signs
Now let’s talk about recognizing the warning signs of gynecologic cancer. The Inside Knowledge campaign tells women to ‘pay attention to their bodies and know what’s normal for you.’

8. Recognize Symptoms Gynecologic cancers have warning signs.
Pay attention to your body so you know what is normal for you.
When gynecologic cancers are found early, treatment can be most effective.
Gynecologic cancers have warning signs, but some are hard to recognize, especially early on, and especially those related to ovarian cancer. That’s why it’s so important to know your body and be able to recognize when something is not normal for you.
When gynecologic cancers are found early, treatment works best.

9. The Warning Signs
This chart shows symptoms of the five main types of gynecologic cancer.
Here are a few things worth noting about this:
Symptoms can be vague and may not seem as if they are related to gynecologic cancer, such as having back pain.
Symptoms may not be the same for every woman.
If you have unusual bleeding or discharge, see a health care provider right away.
If you have any of the other symptoms and they last for two weeks or longer, go to a doctor and find out what’s causing them.
It’s probably not gynecologic cancer, but find out for sure.
The only way to know what’s causing them is to see your health care provider.

10. Cervical Cancer Symptoms
Early on, cervical cancer may not cause signs and symptoms.
In later stages, cervical cancer may cause bleeding or discharge from the vagina that is not normal for you.
Now let’s discuss the warning signs for each of the five main types of gynecologic cancer, beginning with cervical cancer.
The most common symptom of cervical cancer is vaginal bleeding or discharge that is not normal for you.
For cervical cancer, symptoms may not appear until the later stages.
That’s why getting a regular Pap test to screen for cervical cancer is important. More about that later.

11. Ovarian Cancer Symptoms
Ovarian cancer may cause:
Vaginal bleeding or discharge that is not normal for you.
Pelvic pain or pressure.
Back pain.
Bloating or feeling full quickly while eating.
A change in bathroom habits, such as having to urinate more often than normal and more urgently; and being unusually constipated; or having diarrhea that persists.
Ovarian cancer may cause symptoms that don’t seem to be gynecologic in nature, such as back pain or feeling bloated or full quickly when eating. Ovarian cancer symptoms are not always easy to recognize, especially early on. Symptoms differ from woman to woman, but these are the most common:
Unusual vaginal bleeding or discharge
Pelvic pain or pressure
Back pain
Bloating – or feeling full quickly while eating
A change in bathroom habits, like having to go more often or more urgently, or being constipated or having diarrhea
Remember – these are of concern only if they persist for 2 weeks or longer.

12. Uterine Cancer Symptoms
Uterine cancer may cause these signs and symptoms:
Vaginal discharge that is not normal for you.
Abnormal vaginal bleeding – because of how heavy it is or when it happens, such as after menopause; between periods; or any other bleeding that is longer or heavier than normal for you.
Pain or pressure in your pelvis.
Uterine cancer can cause these things:
Vaginal discharge that is not normal for you.
Abnormal vaginal bleeding – because of how heavy it is or when it happens, such as after you have gone through menopause, between periods; or any other bleeding that is longer or heavier than what is normal for you.
Pain or pressure in your pelvis.

13. Vaginal Cancer Symptoms
Most vaginal cancers don’t cause symptoms at first. But if symptoms are present, they can include:
Vaginal discharge or bleeding that’s not normal for you.
A change in bathroom habits, such as having blood in the stool or urine; urinating more often than usual; feeling constipated.
Pelvic or abdominal pain, especially when urinating or having sex.
Vaginal cancers don’t usually cause symptoms early on, but if they do, here’s a list of common symptoms.
Discharge or bleeding that’s not normal for you.
A change in bathroom habits, such as having blood in the stool or urine; urinating more often than usual; feeling constipated.
Pelvic or abdominal pain, especially when urinating or having sex.

14. Vulvar Cancer Symptoms
Symptoms of vulvar cancer may include:
Itching, burning, or bleeding on the vulva.
Skin changes, such as the vulva being redder or whiter than is normal for you, or having a rash, warts, lumps, or ulcers that don’t go away.
Symptoms of vulvar cancer may include:
Itching, burning, or bleeding on the vulva.
Skin changes, such as the vulva being redder or whiter than is normal for you, or having a rash, warts, lumps, or ulcers that don’t go away.

15. Recognize the Warning Signs
Remember – signs and symptoms don’t necessarily mean it’s cancer. But the only way to know what’s causing symptoms is to see a health care provider. Gynecologic cancers are more treatable and beatable when they are caught early.

16. Prevention, Screening, and Treatment
So now that we’ve covered the warning signs, let’s talk about gynecologic cancer prevention and screening.

17. Cervical Cancer Screening
Two tests help prevent cervical cancer or find it early:
The Pap test (or Pap smear) looks for precancers, cell changes, on the cervix that can be treated, so that cervical cancer is prevented.
Can detect cervical cancer at an early stage, when treatment works best
Recommended for all women starting at age 21.
If results are normal, you may be able to wait 3 years for the next one.
After several normal Pap tests and upon reaching age 65, your doctor may say you can stop getting the Pap test.
Women who don’t need a Pap are:
Older than 65, with a history of normal Pap test results.
Have had their cervix removed as part of a hysterectomy for a non-cancerous condition, like fibroids.
As I mentioned earlier, the only gynecologic cancer for which screening is recommended is cervical cancer.
There are two tests which help prevent cervical cancer or find it early. One you’re probably familiar with – it’s called the Pap test or Pap smear. The other is the HPV test.
The Pap test (or Pap smear) looks for precancers, cell changes, on the cervix that can be treated, so that cervical cancer is prevented.
Can detect cancerous cervical cancer at an early stage, when treatment works best
Recommended for all women starting at age 21.
If results are normal, you may be able to wait 3 years for your next Pap test.
After several normal Pap tests and upon reaching age 65, your doctor may say you can stop getting the Pap test
The only women who don’t need a Pap are:
Older than 65, with a history of normal Pap test results.
Have had their cervix removed as part of a hysterectomy for a non-cancerous condition, like fibroids.

18. Cervical Cancer Screening
Two tests help prevent cervical cancer or find it early:
2. The HPV test looks for the Human Papillomavirus — the virus that can cause precancerous cell changes and cervical cancer.
Can be used to screen for cervical cancer along with the Pap test in women 30 years and older.
Also used to provide more information when women aged 21 years and older have unclear Pap test results.
Now, about the HPV test: it looks for the virus that can cause cell changes on the cervix, which may lead to cervical cancer.
For women who are 30 and older, you can choose to have an HPV test along with the Pap test to screen for cervical cancer. If the results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may then say that you can wait up to five years for your next screening.
The HPV test is also used to provide more information when Pap test results are unclear in women aged 21 and older.

19. Cervical Cancer Prevention
The HPV Vaccine
Given in a series of three shots, it protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers.
Recommended for 11- and 12-year-old girls and for girls and women aged who did not get any or all of the shots when they were younger.
The vaccine can be given to girls beginning at age 9.
From screening to prevention…
The HPV vaccine helps protect against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. The vaccine is given in three separate doses. It’s recommended for girls 11 and 12 years old, and for females aged who didn’t get all three shots when they were younger. It can also be given to girls beginning at age 9.

20. Gynecologic Cancer Diagnosis
Tests used to diagnose gynecologic cancers include:
Transvaginal ultrasound
CA-125 blood test
Biopsies of the appropriate gynecologic organs
Genetic tests
When a woman has symptoms or if she is thought to be at high risk for some gynecologic cancers, her doctor may perform any of these tests to rule out cancer.
A transvaginal ultrasound – also called transvaginal sonography or TVS – is used to check the uterus, fallopian tubes, ovaries, and bladder for problems. A wand is inserted into the vagina that causes sound waves to bounce off organs inside the pelvis, creating a picture called a sonogram.
The CA-125 checks the blood to measure the level of a protein that may be found in high amounts in patients with certain types of cancer, including ovarian cancer. It also can be found in high amounts when other non-cancerous conditions are present, such as endometriosis, ovarian cysts, and uterine fibroids. CA-125 levels may also be used to help track how well cancer treatments are working or if cancer has come back.
A biopsy is when a doctor removes a small piece of tissue that is examined under a microscope to check for abnormal cells.
Ask your health care provider about these tests, if:
You have any unexplained signs or symptoms that last for two or more weeks.
You have a personal or family history of breast, uterine, or colorectal cancer.
You tested positive for the BRCA1 or BRCA2 gene.
Some women with a family history of cancer have genetic testing to find out if they are at increased risk for some cancers. If that is something you are considering, the first step is to get genetic counseling to help you decide if testing is right for you and to learn what test results may mean to you.
If you’ve been diagnosed with gynecologic cancer, seek treatment from a gynecologic oncologist. This is a specialist trained to treat gynecologic cancers. They’ve received obstetrician/gynecologist and oncology training. They can administer treatment, such as performing surgery or administering chemotherapy.

21. Treatment for Gynecologic Cancer
Treatment for gynecologic cancer typically may include
Surgery
Chemotherapy
Radiation therapy
Following diagnosis
Ask to be referred to a gynecologic oncologist—a doctor specifically trained to treat these women’s cancers
Find out about cancer staging
If someone you know has been diagnosed with a gynecologic cancer, suggest that they seek treatment from a gynecologic oncologist if at all possible. This is a specialist trained to treat gynecologic cancers.
Also, cancer staging tests determine the size and extent of the disease in the body. This helps the treatment team develop the best possible treatment plan, and can also help them to estimate the likely outcome or course of the disease.

22. Ask Your Health Care Provider
What is my risk for getting a gynecologic cancer?
When should I have my next Pap test?
What do my Pap test results mean?
Is the HPV test right for me?
When can I stop getting a Pap test?
Are there other gynecologic cancer tests that I need, based on my personal health and family cancer history?
I have noticed [insert any symptom you are experiencing], which is not normal for me. Could this be caused by a gynecologic cancer? If so, what should I do next?
If you have questions about gynecologic cancer prevention, screening, or treatment, talk to your health care provider. Here are some sample questions that you can ask.

23. The Inside Knowledge Campaign and GFWC

24. The Campaign’s Origins
In 2007, Congress enacted Johanna’s Law (the Gynecologic Cancer Awareness Act).
The law is named for Johanna Silver Gordon, who died from ovarian cancer in 2000.
The law aims to increase awareness of gynecologic cancers, and their signs, symptoms and risk factors, to more effectively prevent, detect and treat these cancers.

25. Campaign Goals
The Centers for Disease Control and Prevention (CDC) launched Inside Knowledge: Get the Facts About Gynecologic Cancer in collaboration with the Dept. of Health and Human Services’ Office on Women’s Health.
The campaign has three primary goals:
Raise awareness of the signs, symptoms, risk factors, and prevention strategies related to the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar.
Encourage women to pay attention to their bodies and know what is normal for them, to increase recognition of warning signs and symptoms.
Encourage women to seek medical attention and ask about gynecologic cancers when faced with warning signs that persist.
Inside Knowledge was launched by the CDC, and has three primary goals, as described here. Raising awareness of gynecologic cancers, encouraging women to pay attention to their bodies, and encouraging women to seek medical attention when faced with a warning sign.

26. From Woman to Woman
Inside Knowledge uses a woman-to-woman approach, to:
Offer audiences the opportunity to connect with “real” women, especially survivors, who can speak about gynecologic cancer.
Reflect women’s tendency to seek counsel from friends and loved ones.
Provide important information in a straightforward but compelling manner.
All of the campaign’s materials and public service announcements (PSAs) rely on a woman-to-woman approach. This means that they use real women to raise awareness about gynecologic cancer.
The materials are also straightforward and easy to understand.
The woman featured in this ad is a from the Washington, D.C. area, and she is a survivor of ovarian and uterine cancers.

27. “Be brave. Ask questions.”
Jenny Allen is a mother, actress, writer and a real gynecologic cancer survivor. In this PSA, she tells us her story and encourages women to be brave and ask questions if they are faced with symptoms.
PLAY :30 PSA
This PSA has been seen by millions of women.

28. “Warning signs are not the same for everyone”
This is another campaign PSA entitled “I Had.” Like the PSA we just watched, this uses a woman-to-woman approach to appeal to a variety of women about the importance of recognizing the warning signs of gynecologic cancer.
PLAY :30 PSA
Several of the PSAs are also available in Spanish.

29. Free Campaign Materials
Here’s a sampling of the campaign’s print materials and PSAs. Many Inside Knowledge materials are available in English and Spanish, and all are FREE. The materials include:
Fact sheets
Brochures
Symptoms diaries
Posters

30. Free Campaign Materials
Here’s how you can order campaign materials for free online. The CDC can mail these materials directly to you for free, so that you can help educate other women about gynecologic cancers.

31. Inside Knowledge and GFWC
The CDC works with GFWC to:
Disseminate Inside Knowledge resources to GFWC clubs nationwide.
Share survivors’ stories at events, meetings, conventions, and in Clubwoman magazine.
Provide members with tools to educate women
in their communities.
GFWC began its collaboration with Inside Knowledge in GFWC entered into this partnership committed to sharing campaign messages and resources throughout our membership across the country. We’re working with CDC on a number or projects; our plans for the future include developing a toolkit for our members.

32. Inside Knowledge and GFWC
As a GWFC member, you can help educate women about gynecologic cancer:
Provide Inside Knowledge materials to other GFWC members, colleagues, friends, and family.
Host a workshop for friends about gynecologic cancer, using Inside Knowledge resources.
Share campaign resources with local media and encourage them to use the materials.
Now that you know where to find materials for free online, here are some ways you can share them.

33. Inside Knowledge and GFWC
You can also use Inside Knowledge resources during key holidays and women’s health observances:
National Cervical Cancer Awareness Month (January)
Mother’s Day (May)
National Gynecologic Cancer Awareness Month (September)
National Ovarian Cancer Awareness Month (September)
Let’s encourage women to get the facts and the Inside Knowledge about gynecologic cancer.

34. Contact Us
To see or hear PSAs, order materials, and learn more, please visit
For additional information
about Inside Knowledge, please contact
(202)
If you have any questions about this presentation or Inside Knowledge, please contact Alexandra Vaughn – here’s her contact information.