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UAB OBGYN qA 1September is Gynecologic Cancer Awareness Month, and we asked Haller Smith, M.D., assistant professor in the UAB Division of Gynecologic Oncology, some questions about gynecologic cancers, the importance of awareness, how the UAB Department of Obstetrics and Gynecology is making a difference, and more.

Why is gynecologic cancer awareness so important?  

Gynecologic cancers include cancers that start in the ovary or fallopian tube, uterus, cervix, vagina, or vulva.  Awareness is critical because many of these cancers are treatable and often curable when diagnosed at early stages, but survival rates are much lower when they are diagnosed at advanced stages.  

Cervical cancer is the only gynecologic cancer that has a screening test, the Pap smear, that can find precancers or early cancers.  For all of the others, it is important that women be aware of the potential signs and symptoms and know when to see their doctor.  

What are some of the signs or symptoms of gynecologic cancers?

Be aware of the common signs or symptoms of gynecologic cancers.  Know your body and what is normal for you.  If you start to develop some of these symptoms, keep track of them and talk to your doctor about whether you need further testing.

Some of the most common symptoms to be aware of for each of the gynecologic cancers:

1. Ovarian/fallopian tube cancer: bloating, abdominal discomfort or fullness, pelvic pressure, changes in urinary or bowel habits
2. Uterine or endometrial cancer: abnormal bleeding, which can include bleeding after menopause or heavy or irregular bleeding prior to menopause  
3. Cervical and vaginal cancer: pelvic pain, irregular vaginal bleeding or bleeding after intercourse, vaginal discharge with odor
4. Vulvar cancer: persistent itching or burning, changes in color or abnormal growths of the skin around the outside vagina, including the labia or clitoris

What are some common misconceptions around gynecologic cancers?

• Ovarian cancer is often called a silent killer, but most women do have symptoms, even with early-stage cancers. The problem is that many of these symptoms are vague and can be easy to attribute to other causes, including menopause or getting older. Common symptoms of ovarian cancer can be seen above.

• Pap smears are screening tests that are intended to find cervical precancers or early cancers in asymptomatic women. They do not check for all gynecologic cancers, so it is very possible to have a completely normal Pap smear and still have uterine or ovarian cancer. They are also not meant for women who are having symptoms of gynecologic cancers, so if you are having abnormal bleeding or any of the symptoms discussed above, talk to your doctor about whether a biopsy or imaging study may be a better test for you.

• There are many misconceptions about the human papilloma virus (HPV) vaccine, but this is the most important thing you can do to protect yourself and your children from HPV-related cancers. 99% of cervical cancer is caused by HPV. It also causes many other cancers that affect both men and women, including head and neck cancers, anal cancer, vulvar and vaginal cancers, and penile cancer. The HPV vaccine is safe and effective. It is currently approved for both males and females ages nine to 26, and can be given up to age 45 for people who have not previously been vaccinated.  

What makes our faculty experts in the area of gynecologic cancer?  

All of our faculty have completed a four-year residency in obstetrics and gynecology followed by an additional three years of specialized training in the diagnosis and treatment of gynecologic cancers, including both surgical treatment and chemotherapy.

What important/ongoing research are we involved in regarding gynecologic cancers?

At UAB, we are constantly involved in a variety of research on gynecologic cancers. This ranges from developing and testing new treatments in the laboratory to clinical trials looking at how best to use new drugs or treatments to improve outcomes for women with these cancers.

If you have been diagnosed with a gynecologic cancer and are interested in participating in a clinical trial, please contact us at 205-996-4662 to see if you may be eligible.

How are we preparing future leaders in the area of gynecologic oncology?

We are very proud of our gynecologic oncology fellowship program at UAB. Our program was one of the first gynecologic oncology fellowship programs in the country and has trained many gynecologic oncologists who have gone on to become leaders in the field.

We accept two fellows per year into our three-year program. Fellows have the opportunity to participate in a variety of research projects looking at prevention, early detection, and treatment for gynecologic cancers. They also get intensive clinical training in management of gynecologic cancers, including surgical treatment and chemotherapy.