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More than 71,000 women in the United States are diagnosed with a cancer affecting the reproductive organs each year, according to the National Cancer Institute. These cancers can include endometrial, ovarian and cervical among others. Some of these cancers are more difficult to detect and treat than others, but advances are being made to help if you are facing one of these diseases.
Baylor offers a comprehensive approach to diagnosing and treating women with gynecologic cancer. Physicians on the medical staff at Baylor work with other health care specialists to treat and heal the whole woman.
Cancer is when cells in the body change and grow out of control. To help you understand what happens when you have cancer, let's look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and die when your body does not need them any longer.
Cancer is made up of abnormal cells that grow even though your body doesn't need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can even spread to other parts of the body (metastasis).
Cancer that starts in cells of the cervix is called cervical cancer.
The cervix is the lower, narrow part of the womb (uterus). It's located between the bladder and the rectum. It forms a canal that opens into the birth canal (vagina), which leads to the outside of the body.
Precancerous cells on the cervix are the first sign that cervical cancer may develop. These cells can be seen on a Pap test. They are cells that look abnormal, but are not yet cancer. The appearance of these cells may be the first sign of cancer that will grow years later. Treating these precancer cells can prevent cancer from growing. Precancer cells of the cervix often don’t cause pain or other symptoms. This is why regular cervical cancer screening is so important.
Squamous intraepithelial lesions (SIL) is a term that refers to abnormal changes in the cells on the surface of the cervix. Changes in these cells can be divided into 2 categories:
Low-grade SIL. This refers to early changes in the size, shape, and number of cells that form the surface of the cervix. They may go away on their own or, with time, may grow larger or become more abnormal, forming a high-grade lesion. These changes may also be called mild dysplasia or cervical intraepithelial neoplasia 1 (CIN 1).
High-grade SIL. This means there are a large number of precancer cells, and, like low-grade SIL, these changes involve only cells on the surface of the cervix. The cells often do not become cancerous for many months, perhaps years, but without treatment, they will become cancer. High-grade lesions may also be called moderate or severe dysplasia, CIN 2 or 3, or carcinoma in situ.
If abnormal cells on the surface of the cervix are not found and treated, over time they can spread deeper into the cervix, or to other tissues or organs. This is then called cervical cancer, or invasive cervical cancer. Cervical cancer occurs most often in women younger than the age of 50. Most cervical cancer is squamous cell carcinoma or adenocarcinoma.
The death rates for cervical cancer have declined sharply as Pap screenings have become more prevalent. Today, most cervical cancer is found in women who have not had regular screening.
Cervical cancer is one of the few types of cancer that doctors know how to prevent. There are two key ways to prevent cervical cancer:
Get regular Pap tests. These are done to find and treat any precancerous cells as soon as possible.
Prevent precancer cells. You can do this by avoiding contact with the human papilloma virus (HPV), getting an HPV vaccine, and not smoking.
Cervical cancer occurs in the cervix, which is in the lower part of the uterus. It is caused by several types of the human papillomavirus (HPV) that spreads through sexual contact.
If initial tests and exams strongly suggest that you have ovarian cancer, you’ll likely have other tests. These tests help your healthcare providers learn more about your cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of your body. The test results help your healthcare providers decide the best ways to treat the cancer. If you have any questions about these or other tests, be sure to talk with your healthcare team.
The tests you may have can include:
Positron emission tomography (PET) scan
This test is done to see if the cancer has spread to your lungs.
This test is used to look for cancer throughout your body. Your healthcare provider puts a small amount of a radioactive sugar into your blood. He or she does this by putting a needle into one of the veins on your arm or hand. Over about an hour or so, it’s taken up by active cells in your body that need a lot of energy. This includes cancer cells. A special camera then scans your body to look for collections of the sugar. These show up as “hot spots” on the scan. They may be a sign of cancer.
For this test, you’re put into a deep sleep. Your healthcare provider puts a long, lighted tube into your rectum and colon. Colonoscopy is used to see if cancer has spread to the colon or rectum, or if the cancer might have started in the colon itself.
You’re put into a deep sleep for this test. Your healthcare provider then makes a small cut in your abdomen (belly). He or she then puts a long thin tube into the cut. This tube sends pictures to a computer screen. This lets your healthcare provider look closely at your ovaries and the inside of your abdomen. In rare cases, your healthcare provider can use small tools through the tube to take out tissues samples if he or she sees spots that may be cancer. This test helps your healthcare provider see if and how far the cancer has spread.
Your healthcare provider will talk with you about which tests you'll have. Make sure to get ready for the tests as instructed. Ask questions and talk about any concerns you have.
Ovarian cancer occurs in the ovaries, the female reproductive organs that produce eggs. It usually occurs in women over 50, but can affect younger women as well.
Uterine (Endometrial) cancer is a cancer that occurs in the uterus, an important female reproductive organ.
If your healthcare provider thinks you might have vaginal cancer, certain exams and tests will need to be done to be sure. Diagnosing vaginal cancer starts with your healthcare provider asking you questions. You will be asked about your medical history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam. This will include an exam of your vagina and other organs in the pelvis to check for tumors or lumps.
You may have one or more of these tests:
Colposcopy. This test uses a tool called a colposcope to closely examine the cervix and vagina. If abnormal tissue is found, a small piece of it may be removed so it can be checked for cancer cells. This is called a colposcopic biopsy.
Pap test. This is also called a Pap smear. A swab is wiped on the cervix to pick up cells. The cells are then checked under a microscope. They’re checked for any signs of cancer or precancer, infection or inflammation.
Computed tomography (CT) scan. This test uses a series of X-rays and a computer to make images of the body. A CT scan is more detailed than regular X-rays. They help show where the cancer is growing and if it has spread to other parts of your body. A CT scan can help find cancer in the chest, abdomen, and pelvis.
Magnetic resonance imaging (MRI). This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and tissues in the body.
Positron emission tomography (PET) scan. For this test, a radioactive sugar is injected into the bloodstream. Cancer cells use more sugar than normal cells, so the sugar will collect in cancer cells. A special camera is used to see where the radioactive sugar is in the body. A PET scan can sometimes spot cancer in different areas of the body, even when they can’t be seen by other tests. It can also show if cancer treatment is working.
Biopsy. A biopsy is when small pieces of tissue from the vagina are taken and looked at with a microscope. The tissue is checked for cancer.
When your healthcare provider has the results of your tests, he or she will talk with you about next steps. Your provider will talk with you about other tests you may need if vaginal cancer is found. This may include repeating the biopsy or more tests. Make sure you understand the results and what follow-up you need.
Cancer of the vagina is rare and usually occurs in women over 60. An infection of the human papillomavirus (HPV) may also increase your chances of developing vaginal cancer.
Talking with healthcare providers about cancer can be overwhelming. It can be hard to take in all of the information. It helps to be prepared. Make a list of questions and bring them to your appointments. Write the answers down in a notebook. Make sure you ask how the treatment will change your daily life, including your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be, and what the risks and possible side effects are. You may also want to ask a friend or family member to go with you. He or she can take notes and write down the answers, and also ask questions you may not think of. You can also ask your healthcare provider if you can record the conversation.
Below are some questions to ask during your appointments.
What kind of vulvar cancer do I have?
What is the grade and stage of my cancer?
Has the cancer spread anywhere else in my body?
What are my treatment choices?
What treatment do you think is best for me? Why?
What side effects should I expect?
How long will side effects last?
Will treatment affect my sex life? How? For how long?
Will I be able to have children after treatment?
What are the goals of the treatment you’re recommending?
What is the success rate of this treatment for my type and stage of vulvar cancer?
What is the life expectancy for someone with my stage of cancer receiving this treatment?
Are there any clinical trials that I can apply for?
Will my health insurance cover treatment?
Will there be costs I have to pay?
What can I do to get ready for treatment?
Will I have to stay in the hospital? For how long?
How long will the surgery take?
What will you do during the surgery?
Will you have to take out lymph nodes?
What will recovery be like? How long will it take?
What is the length of the treatment period?
How long will each treatment take?
Where do I have to go for the treatment?
Who will give me the treatment?
Does someone need to go with me during treatments?
Can I take my other medicines during treatment?
Are there side effects that I need to call you about?
How do I reach you after hours and on weekends?
What can I do to ease the side effects?
Should I change my diet? What foods can't I eat?
Will I be able to go to work and be around my family?
Are there support groups nearby that I can join?
How will I feel after the treatment?
How will my body look and work after treatment?
What type of follow-up will I need after treatment?
Who will I need to see for my follow-up care?
What long-term side effects do I need to watch for?
How will we know if treatment worked?
What are the risks of the cancer coming back?
Vulvar cancer is cancer of the vulva, a woman's external genitals. This is a very rare form of cancer.
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