Battling Female Cancers

By Levi Downs, M.D.

Each year in the United States, more than 80,000 women are diagnosed with a cancer of the reproductive organs (cervix, uterus, ovaries, and so on), also known as a gynecologic cancer. Fortunately for those suffering from these diseases, gynecologic cancers' risk factors, detection methods, and prevention strategies have become better understood recently.

The most common gynecologic cancer is endometrial, which develops in the uterus lining. A telltale sign is irregular bleeding, even after menopause. Although the causes of endometrial cancer are unclear, my colleagues and I think that it may develop from minor abnormalities of the uterus, such as an increased growth of the organ's inner lining.

A woman's chances of developing endometrial cancer increase as she matures. About 95 percent of women with endometrial cancer are 40 years old or older. Especially at risk are women who take estrogen, are postmenopausal, are obese, or have a history of breast cancer or of high blood pressure.

The deadliest gynecologic cancer attacks the ovaries. While a woman is most likely to survive ovarian cancer if it is found early and treated before it has spread outside the ovary, the disease usually has no symptoms. Only 25 percent of ovarian cancers are diagnosed at this key early stage.

Comedian Gilda Radner is perhaps the most well-known victim of ovarian cancer. She took advantage of the publicity her illness attracted to alert others of indicators of the dangerous disease. Now many people know that women with two or more close relatives who have had ovarian or breast cancer may be at high risk for developing ovarian cancer.

Current research in reducing the risk of ovarian cancer has been promising. One study demonstrated that oral contraceptive pills, in particular those containing the hormone progestin, can cut the risk of ovarian cancer by 50 percent.

One of the most preventable and treatable types of cancer is cervical cancer.

As ovarian cancer is today, cervical cancer at one time was one of the most common causes of cancer death for American women. New screening methods to detect the cancer at its earliest and most treatable stage have significantly reduced the number of deaths from the disease in this country.

To help prevent cervical cancer, researchers are working to identify certain risk factors. University researchers such as myself and my colleague Ramakrishnan Sundaramhave focused on the sexually transmitted disease human papillomavirus (HPV), which appears to increase a woman's risk for cervical cancer. Currently, one topic under investigation is the role that HPV plays in blood vessel formation, which is essential for the development of cervical cancer.

To detect and to help prevent a gynecologic cancer, women need to have a regular Pap smear test and pelvic exam beginning at age 18 or when they become sexually active. The Pap test can detect HPV infection and pre-cancers of the cervix. During a pelvic exam, the doctor will check the ovaries and uterus for any abnormalities in size or shape. Even women who have had their uterus removed and those past menopause still need to have regular Pap tests, to ensure their best health.