Seven Warning Signs of Gynecologic Cancer
When to Call Your Doctor

More Information
• Pictures of the Normal Reproductive System, and Abnormalities
• Symptoms of Ovarian Cancer
• CA 125 Blood Test
 • The HPV Test - Is it for You?
From Other Web Sites
• Vulvar Self-Exam
• Abnormal Uterine Bleeding
• Pelvic Pain
• Irritable Bowel Syndrome
 • Vaginal Self-Exam
• Causes of Back Pain

by Laura Dolson

"Early Detection, Early Detection!" The cancer watchwords we hear again and again. Anyone who has had a brush with cancer in themselves or a loved one knows how important it is to find cancer early. Yet, thinking about cancer causes conflicting emotions that can sabotage our intentions. We know we should check our breasts regularly - and yet who wants to look for a potentially deadly disease? Looking for something we don't want to find? Some part of our brain says "this does not compute!".

Yet, somehow we must find ways to help reason overcome fear. A regular scheduling of Pap smears - make the appointment a year in advance! A routine of doing breast self-exams so that becomes a habit you don't think about as much. And an attitude of prompt response to the warning signs of cancer. To do this last, of course, we need to know what to look for.

A word about Pap tests and other screening procedures: Although knowing the symptoms cancer can cause is important, nothing can substitute for the screening tests we have available: the annual pelvic exam, which should include the Pap test, bimanual exam, and recto-vaginal exam. These tests have the potential to detect cancer before it causes symptoms. Women at high risk for certain cancers may be advised to have other screening procedures, such as a transvaginal ultrasound test or CA 125 blood test.

Something to keep in mind: The vast majority of the time, these symptoms are caused by something benign. So how can we know when to get medical attention without alarming ourselves unnecessarily? Remind yourself of this: WHATEVER THE REASON for your symptom, you deserve to know what is causing it.

Warning Sign #1 - Abnormal Bleeding - Uterine cancer is the most common of all gynecologic cancers. However there IS an "up side": most uterine cancer has an obvious warning sign - abnormal bleeding. Cervical, vaginal, and (more rarely) ovarian cancer can also have bleeding as a symptom. Fallopian tube cancer is a rare cancer, but bleeding is one of the main symptoms. Most of the time, this bleeding occurs in post-menopausal women, where any bleeding should be reported to a doctor without delay. Endometrial hyperplasia, which can be a precursor to uterine cancer, also causes abnormal bleeding.

Bleeding between periods - Women in their childbearing years, and particularly in the years before menopause, sometimes experience anovulatory menstrual cycles, which can cause bleeding between menstrual periods. If you have more than 2 or 3 of such cycles, it should be reported to your doctor.

Sometimes bleeding after menopause or between periods happens as a result of minor trauma, such as sexual intercourse or douching. This can be a sign of cervical or vaginal cancer. A pattern such as this should be reported to your doctor right away.

Heavy Menstrual Periods - Occasionally, endometrial hyperplasia or uterine cancer can cause extra-heavy menstrual periods. Notify your doctor of any sudden change in your periods which continues for more than one or two cycles. (Although not usually a sign of cancer, sudden very heavy bleeding requiring a change of sanitary protection more than once per hour, which happens more than once or lasts more than 24 hours should be reported.)

Non-cancerous causes of bleeding: fibroid tumors, hormones such as oral contraceptives, adenomyosis, polyps, inflammation on the cervix, thyroid problems, bleeding disorders, and many others.

Warning Sign #2 - Pelvic Pain - Pelvic pain is defined as abdominal pain below the level of the naval (umbilicus). Because the female reproductive system is fairly crowded in the pelvic area (sharing it with the urinary and lower intestinal systems), tumors can produce pressure on other structures and cause pain. Sometimes this pain might show up with certain movements, or sexual intercourse. Persistent pelvic pain of unknown cause should always be reported to your doctor, including pain with intercourse. Note: Pain associated with menstrual periods ("cramping") is not a warning sign of cancer.

Non-cancerous causes of pelvic pain: ovulation, benign cysts or tumors, pelvic inflammatory disease, endometriosis, diverticulitis, ulcerative colitis, appendicitis, and many more.

Warning Sign #3 - Gastrointestinal Disturbances - Tumors or swelling pressing on the digestive system can cause symptoms such as constipation, diarrhea, nausea, indigestion, gas, or a constant feeling of "fullness", regardless of the last meal. However, most sources of digestive discomfort are within that system (intestines, colon, etc). Any change in bowel habits or the above symptoms that lasts more than 2-3 weeks should be reported to your doctor.

Warning Sign #4 - Urinary Disturbances - Again, because of the proximity of the female reproductive system to the bladder and urethra, tumors or swelling can cause symptoms similar to urinary tract infections - burning or pain with urination, urgency, difficulty urinating, and "bladder spasms". Report these symptoms to your doctor promptly.

Warning Sign #5 - Abdominal Swelling - One of the primary symptoms of ovarian cancer is abdominal bloating or swelling (usually caused by ascites), or a realization that clothes are too tight in that area. Sometimes this can be part of the normal premenstrual period, but if the symptom persists, report it to your doctor.

Warning Sign #6 - Changes in the Vulva or Vagina - Lumps, bumps, sores, or thickening should be reported to your doctor, as should areas of color change. Additionally, if you have vulvar or vaginal itching, burning, bleeding, or unusual discharge, get it checked out, as these also can be signs of cancer or precancerous changes. It is a good idea to be familiar with how your vulva looks normally, so you can recognize changes if they occur. Round bumps on the vulva, vagina, or cervix are most often benign cysts, such as Bartholin's or Gartner's cysts, but a doctor should check them to be sure.

Warning Sign #7 - Low Back Pain - Less commonly, low back pain can signal ovarian or uterine cancer, or other abnormalities in those organs. There are many non-cancerous conditions that cause low back pain.

If you have any of these symptoms, don't become overly alarmed. DO see your doctor. If you don't feel that your symptoms have been explained to your satisfaction, seek another opinion. There are stories of women with cancer who's non-specific symptoms (such as those above) were not taken seriously enough. If necessary, see a gynecologic oncologist. This is your body, and your life.

Pass the word *** Save a life!

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Copyright © 2001 by Laura Dolson. All rights reserved.

The material on this page and Web site is for informational and educational purposes only, and should not substitute for medical advice. Anyone having questions about the application of information appearing here to a specific person or situation should obtain advice from a qualified physician.