How important are Well Woman exams? Consider that these annual examinations of a woman’s health can help detect gynecological cancer early.
Gynecological cancer is an umbrella term for cancers of the female reproductive organs, which include the cervix, ovaries, uterus, vagina, and vulva (as well as the fallopian tubes, in which cancer is very rare).
Symptoms can vary per person, and each form of gynecological cancer has its own signs and symptoms. However, the most common symptom is abnormal vaginal bleeding or discharge.
“We ask patients to come in for their exam yearly,” said David Billings, MD, an Ob-Gyn with Trinity Health.
In addition to the physical exam, a wellness visit gives the patient the chance to discuss any questions or concerns they may have, especially if they include potential symptoms which could “help us discover cancer,” Dr. Billings said. The presence of symptoms, such as irregular bleeding (especially if post-menopausal) or a persistent itch that doesn’t go away with medicine, can lead to an Ob-Gyn looking further into it. This might include the collection of biopsies for pre-cancerous or cancerous lesions, he added.
Uterine cancer, which is cancer of the uterus, is the most common gynecological cancer that Dr. Billings sees in his office. In 2019, the American Cancer Society estimated that about 61,880 new cases of uterine cancer would be diagnosed, with roughly 12,160 women potentially dying from it.
A specific form of uterine cancer, cervical cancer is the third most common gynecologic cancer. About 13,170 new cases of invasive cervical cancer were estimated as being diagnosed in 2019 by the American Cancer Society. Once one of the most common cancer deaths for women, it is “not as prevalent now because of pap smears,” Dr. Billings noted. The Papanicolaou test, or pap smear, is a screening used to detect potentially pre-cancerous and cancerous processes in the cervix.
Women should get their first pap smear at the age of 21 and, if the results are normal, every three years thereafter. Along with the pap smear, Dr. Billings recommends HPV testing. According to the National Cancer Institute (NCI), nearly all cases of cervical cancer are caused by infection with sexually transmitted oncogenic, or high-risk, types of human papillomarvirus (HPV). “There are about a dozen high-risk HPV types, and just two of these, HPV types 16 and 18, are responsible for about 70 percent of all cervical cancers,” the NCI said on their website.
“If you have an abnormal pap smear or if you are over 30, we will test for the high-risk HPV types and other high-risk HPV viruses,” Dr. Billings added.
Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. According to the American Cancer Society, a woman’s risk of getting ovarian cancer is 1 in 78; her lifetime chance of dying from it is about 1 in 108.
There are also vaginal and vulvar cancers. The American Cancer Society estimates that about 5,350 new cases of vaginal cancer in 2019. Vaginal cancer is a potential concern if a patient’s mother took the hormone drug Diethylstilbestrol (DES), an anti-miscarriage drug, between 1940 and 1971 (roughly one case of vaginal cancer per 1,000 women whose mothers took DES during pregnancy). According to the American Cancer Society, almost half of cases of vaginal cancer occur in women who are 70 years or older.
Vulvar cancer is rare, accounting for 6 percent of gynecological cancers. About 6,070 new cases of vulvar cancer will be diagnosed in 2019, the American Cancer Society estimates. Less than 20 percent of cases are in women younger than age 50; more than half occur in women over the age of 70.
In all cases, smoking exposes people to many cancer-causing chemicals that affect the body beyond the lungs, the American Cancer Society warns on its website. “These harmful substances can be absorbed into the lining of the lungs and spread throughout the body.”
According to the Centers for Disease Control and Prevention, gynecological cancer can be treated in different ways, depending on the type of cancer and how far it has spread.
• Surgery – removal of the cancerous tissue in an operation
• Chemotherapy – treatment to shrink or kill the cancer
• Radiation – use of high-energy rays to kill the cancer
“If we find out there is cancer, we refer the patient to gynecological oncology, a specialized female cancer specialist,” Dr. Billings said, noting that after which, they follow up with their Ob-Gyn, along with seeing a radiation oncologist or medical oncologist (for chemotherapy).
Ob-Gyns Margaret Nordell, MD; Jessie Fauntleroy, MD; and Carol Schaffner, MD; and midwife Gloria Berg, CNM, are based at Health Center – Town & Country, Ste 102, 831 S Broadway, Minot. For an appointment, call 701-857-5703. David Billings, MD, is also located at that location. For an appointment, call 701-857-7394. Ob-Gyns Heather Bedell, MD; Tim Bedell, MD; Lori Dockter, PA-C; and Jennifer Johnson, MD, are based at Health Center – Medical Arts, 400 Burdick Expy E, Minot. For an appointment, call 701-857-7397. Ob-Gyn J. David Amsbury, DO, and midwife Erica Riordan, CNM, are also located at that location. For an appointment, call 701-857-7385.