Women’s Reproductive Cancers

Womens Reproductive Cancers

Also called: GYN Cancers, Female Cancers, Gynecologic Cancers

Reviewed By:
Mark Oren, M.D., FACP
Martin E. Liebling, M.D., FACP

Summary

Also called gynecologic cancers, women’s reproductive cancers are characterized by an overgrowth of abnormal cells in the reproductive system. Endometrial cancer, which starts in the inner lining of the uterus (womb), is the most common female reproductive cancer. Other types of female reproductive cancer include ovarian cancer, cervical cancer, vaginal cancer, vulvar cancer and uterine carcinoma.

The cause of women’s reproductive cancers remains unknown. However, several risk factors have been identified, such as smoking, use of birth control pills and certain types of human papillomavirus (HPV). Except for cervical cancer, there is no recognized method for preventing gynecologic cancers. Women can often decrease their odds of developing this group of diseases by avoiding known risk factors and obtaining regular gynecological examinations.

The symptoms of women’s reproductive cancers vary depending on the type, location and severity of the cancer. One of the most common first symptoms is abnormal uterine bleeding. Other symptoms may include irregular vaginal discharge and abdominal or pelvic pain.

Some early female reproductive cancers can be detected through routine screening tests, such as the Pap smear. However, many of the cancers do not have any early screening tests and may not be detectable until the cancer has progressed to a more advanced stage.

Women experiencing symptoms of reproductive cancers should immediately notify their physician. Diagnosis of all women’s reproductive cancers begins with a medical history, followed by a pelvic examination. A gynecologist, a physician who specializes in the female reproductive system, often performs these examinations. The gynecologist examines the uterus, ovaries and surrounding organs for potential problems.

In most cases of suspected cancer, a biopsy (the surgical removal of tissue for microscopic analysis) follows the examination. Other tests that may be used to diagnose reproductive cancers include an x-ray, colposcopy and ultrasound. Possible treatments for women’s reproductive cancers include surgery, radiation therapy and chemotherapy.

Each year, about 78,000 women in the United States are diagnosed with cancers affecting the reproductive organs, according to the American Cancer Society. The prognosis for women’s reproductive cancers depends on the type of cancer, location, and severity of the disease. Other factors that affect the outlook for recovery include the woman’s age, general health and risk factors.

About reproductive cancers

Cancers that originate in the female reproductive system are called women’s reproductive or gynecologic cancers. Cancer occurs when damaged DNA promotes growth of malignant cells in a particular site in the body. For instance, endometrial cancer, the most common female reproductive cancer, is caused by the abnormal growth of cancerous cells in the endometrium (the inner lining of the uterus). Other women’s reproductive cancers include:

  • Ovarian cancer
  • Cervical cancer
  • Vaginal cancer
  • Vulvar cancer
  • Uterine sarcoma

In addition to being named according to their primary site (the organ or tissue in which cancer first appears), cancers are further classified by the cell’s appearance under a microscope. For instance, the two main types of cervical cancer include:

  • Squamous cell carcinoma. Cancer composed of cells that resemble the thin, flat squamous cells that line the endocervix (the part of the cervix that is closest to the uterine body).
  • Adenocarcinoma. Cancer that develops from the gland cells that produce mucus in the endocervix.

Each year, approximately 78,000 women in the United States are diagnosed with cancers affecting the reproductive organs, according to the American Cancer Society.

Cancer can affect any of the following parts of the reproductive system:

  • Ovaries. Two female reproductive organs that produce eggs (ova) and the reproductive hormones estrogen and progesterone.
  • Uterus. Commonly called the womb, the uterus is the major female reproductive organ in which the fetus lives during gestation.
  • Endometrium. The inner lining of the uterus.
  • Cervix. The lower end of the uterus that opens into the vagina.
  • Vagina. Also called the birth canal, the vagina is a flexible, muscular tube that connects the uterus to the vulva.
  • Vulva. The female external genital organs that open into the vagina.

The prognosis (predicted outlook for survival) of cancer depends on the type, location and stage of the cancer. The stage indicates the extent of the disease, or how widespread the cancer is in the body.

A cancer specialist such as a gynecological oncologist is best equipped to treat gynecologic cancers. This is a board-certified obstetrician-gynecologist (ObGyn) who has an additional three to four years of specialized training in treating gynecologic cancers.

When choosing an ObGyn oncologist, patients should inquire if this specialized training was received from an American Board of Obstetrics and Gynecology-approved program. Such programs include training in the biology and pathology of gynecologic cancers. They also include training in the various forms of treatment for these diseases, including surgery, radiation, chemotherapy and experimental treatments.

Types and differences of reproductive cancers

The three most common reproductive cancers in women are:

  • Endometrial cancer. This type of female reproductive cancer occurs when the cells of the endometrium, the inner lining of the uterus (womb), grow out of control. According to the American Cancer Society (ACS), endometrial cancer is the most common female reproductive cancer in the United States. In 2007, there will be nearly 40,000 newly diagnosed cases of endometrial cancer and the disease will cause about 7,400 deaths. Obesity is one of the greatest risk factors for developing endometrial cancer.
  • Endometrial cancer usually affects women between 60 and 70 years old. This condition is commonly called uterine cancer. However, it is important to note that endometrial cancer is merely a type of uterine cancer and that other, less common uterine cancers, such as uterine sarcoma, do exist. When detected and treated at an early stage, endometrial cancer has a very high (up to 94 percent) recovery rate.

  • Ovarian cancer. This type of female reproductive cancer originates in a woman’s ovary, and may affect both ovaries. The ovaries are two female reproductive organs that produce the hormones estrogen and progesterone as well as eggs (ova). They are located in the pelvis on either side of a woman’s uterus. The ovaries contain three types of tissue: the epithelial, germ cell and stromal. The majority of ovarian cancers begin in the epithelial cells located in the tissue that covers the ovaries. This cancer is known as epithelial ovarian cancer.

    Ovarian cancer is the eighth leading cancer among women, and the fifth leading cause of female cancer deaths, according to the ACS. Ovarian cancer claims more lives than any other women’s reproductive cancer. An estimated 22,500 new cases of this disease will be diagnosed in the United States in 2007 and the disease will be responsible for about 15,000 deaths.

    When detected and treated at an early stage, the five-year survival rate of ovarian cancer is 94 percent. However, the disease is difficult to detect and less than 20 percent of all cases are detected in the earliest stage. In most cases, ovarian cancer is diagnosed only after the tumor growth has spread to tissues and organs beyond the ovaries.

  • Cervical cancer. This type of female reproductive cancer is characterized by the presence of many abnormal, malignant (cancerous) cells in the cervix (the bottom part of the uterus). The human papillomavirus (HPV), a sexually transmitted disease (STD), is responsible for the majority of cervical cancer cases. More than 90 percent of cervical cancers originate in the lining of the cervix. These cells do not appear suddenly. Rather, healthy cervical cells develop unusual precancerous changes over time, which can eventually turn into cancer.

    Cervical cancer typically occurs during midlife, with half of patients diagnosed between the ages of 35 and 55 years. The ACS estimates that approximately 11,000 cases of invasive cervical cancer will be diagnosed in the United States in 2007. It was once a leading cause of death among females, but only 3,600 American women are expected to die of this disease in 2007. Certain populations, such as Vietnamese American, black and Hispanic women, have an increased likelihood of developing cervical cancer, according to the Centers for Disease Control and Prevention (CDC). The five-year survival rate of cervical cancer is 73 percent. When the disease is detected and treated in the early stages, the five-year survival rate increases to 92 percent.

Other, less common types of gynecologic cancers include:

  • Vaginal cancer. This type of female reproductive cancer occurs when the cells of the vagina grow out of control. There are many different types of vaginal cancer. However, approximately 85 to 90 percent of these cancers are squamous cell carcinomas that originate in the vagina’s epithelial lining. These cancers, which typically occur near the cervix in the upper part of the vagina, do not appear suddenly. Instead, healthy cells develop unusual precancerous changes over time, which can eventually turn into cancer.

    Vaginal cancer is rare. According to the ACS, it accounts for only 3 percent of all gynecological cancers. An estimated 2,100 new cases of this disease will be diagnosed in 2007 in the United States. The disease is expected to claim nearly 800 lives in the same year. If detected and treated in its beginning stages, the five-year survival rate for vaginal cancer is 73 to 96 percent.

  • Vulvar cancer. Also called cancer of the vulva, this type of female reproductive cancer typically affects the inner edges of a woman’s labia majora or minora (folds of tissue that surrounds the vagina). Occasionally, vulvar cancer originates on the clitoris (a very sensitive tissue in the vagina that swells with blood when sexually stimulated) or inside Bartholin glands (small glands that produce mucus and are located on both sides of the vaginal opening). According to the ACS, more than 90 percent of vulvar cancers are squamous cell carcinomas, which typically form slowly over the course of several years.

    Vulvar cancer accounts for 4 percent of gynecological cancers and 0.6 percent of all female cancers in the United States, according to the ACS. The ACS estimates that approximately 3,500 vulvar cancers will be diagnosed and nearly 900 patients will die of this condition in the United States in 2007. When detected early, vulvar cancer is highly curable. When the lymph nodes have not been affected, the five-year survival rate of this disease is 90 percent.

  • Uterine sarcoma. Cancers that originate in the connective tissues of a woman’s uterus are called uterine sarcomas. Connective tissues may include fat, muscle, bone and fibrous tissue (the material that composes ligaments and tendons). The most common type of uterine sarcoma is carcinosarcoma, which begins in the endometrium and has features of carcinomas and sarcomas. It is important to note that noncancerous tumors called benign uterine fibroid tumors may also develop in the connective tissues of a woman’s uterus. These masses are not related to uterine sarcomas.

    Although the ACS estimates that 40,000 new cases of uterine cancer will be diagnosed in 2007 in the United States, uterine sarcomas will only account for 2 to 4 percent of the new cases. Endometrial cancers will account for the remainder of new cases.

According to the ACS, the estimated number of new cases of women’s reproductive cancers in 2007 is as follows:

Cancer TypeEstimated Cases in 2007
Endometrial39,080
Ovarian22,430
Cervical11,150
Vulvar3,490
Vaginal2,140
Uterine sarcoma800 to 1,600
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