BIO 226W
Nazareth College

Women's Cancers: Vaginal, Fallopian Tube, and Ovarian

                                                  

Vaginal Cancer

          Vaginal Cancer is a very rare form of cancer, making up only 1-2% of gynecological malignancies (3). 

          Vaginal Cancer can be separated into two types. Type One, also know as squamous cell, is usually found in woman between the ages of 60 and 80. Type Two, or adenocarcinoma, effects women between the ages of 12 and 30. If a woman's mother took DES while pregnant with them, they are most susceptible to this type of cancer (4). For more information on DES, click here

          The symptoms of Vaginal Cancer are fairly ambiguous. They include bleeding and discharge not related to menstruation, and painful urination or intercourse. If any of these symptoms are suspected, the doctor will do several procedures to test for cancer. First, he or she will conduct a pelvic exam looking for lumps. They will also take a Pap Smear to identify abnormal cells, and take a biopsy of the tissue if necessary. Once Vaginal Cancer has been positively diagnosed, treatments may vary. One type of treatment is surgery. Laser surgery may be used to pinpoint the tumor, and in severe cases, a vaginectomy may be necessary. Chemotherapy and radiation are also used to combat the disease (4).

           The disease is very curable if found in the early stages. For diagnosable purposes, the cancer is divided into six stages. Briefly, the first stage (Stage 0) includes carcinoma in situ, and no lymph node or distant metastasis. Stage I includes a tumor confined to the vagina and no lymph or distant metastasis. Stage II is where the tumor invades the paravaginal tissue, but not the pelvic wall, and no metastasis. Stage III is tumor, pelvic, or lymph metastasis invading the paravaginal tissue, but no distant metastasis. Stage IVA includes any invasion of the mucosa of the bladder or rectum, extends beyond the pelvis, or any regional lymph  invasion, without distant metastasis. The final stage, Stage IVB includes all of the above as well as distant metastasis (3).

 

Fallopian Tube Cancer

          Fallopian Tube Cancer is also very rare, making up 1% of gynecological malignancies. There are only approx. 1,500 cases worldwide (5). Since it is extremely rare, many things are unknown about this particular type of cancer, and it is often treated as ovarian cancer because of the organ's relative proximity.

                                        

          Symptoms include abdominal pain that is relieved by bleeding and a watery discharge (2).

          Like Vaginal Cancer, this cancer is also separated into stages. Stage 0 is defined as in situ cancer, with no spreading. In Stage I, tumor growth is limited to the tubes. Stage II includes extension to the pelvis. Stage III includes all of the above, but also with spreading outside of the pelvis. The final stage, Stage IV, also includes distant metastasis (8).

          Treatment of Fallopian Tube Cancer includes a hysterectomy if the woman is past child bearing years, and chemotherapy (click here for detailed info) and radiation if she wishes to be otherwise treated. 

          Due to the rarity of the condition, prognosis results are unclear, however it has been determined that the cancer is best treated when found in the earlier stages, and that treatment has a fairly high success rate (8).

 

Ovarian Cancer

          Ovarian Cancer is the fifth leading cause of all cancer deaths. It kills more women than all gynecologic cancers combined. It occurs in one out of every 57 women (6). 26,700 women are diagnosed every year, and 14,000 die annually (7). 

          Symptoms of the disease include pelvic or abdominal pressure, pain, bloating, swelling or discomfort; gastrointestinal upsets like gas, nausea and indigestion; frequent or urgent urination in absence of infection; unexplained changes in bowel habits; unexplained weight gain or loss; pain during intercourse, continued or unexplained fatigue or shortness of breath (1). Although there are many symptoms of Ovarian Cancer, symptoms don't appear until the disease is very developed, making it hard to diagnose in early stages (4). Once diagnosed, the American Cancer Society offers a list of questions that you should ask your doctor before treatment:

What Should You Ask Your Doctor About Ovarian Cancer?

It is important for you to have honest, open discussions with your cancer
care team. They want to answer all of your questions, no matter how trivial
you might think they are. Here are some questions to consider: 

What type of cancer do I have? 
Has my cancer spread beyond the ovaries? 
What is the cell type, microscopic grade, and stage of my cancer?
What does that mean in my case? 
What treatments are appropriate for me? What do you recommend?
Why? 
What are the risks or side effects that I should expect? 
What are the chances my cancer will recur (come back) with the
treatment programs we have discussed? 
What should I do to be ready for treatment? 
Should I follow a special diet? 
Will I be able to have children after my treatment? 
What is my expected prognosis, based on my cancer as you view it?
Will I need a wig? 
What do I tell my children, husband, parents, and other family
members? 

In addition to these sample questions, be sure to write down some of your
own. For instance, you might want specific information about anticipated
recovery times so you can plan your work schedule. You may also want to
ask about second opinions or about experimental programs or clinical trials
for which you may qualify. 

 

          Like many other cancers, ovarian is split into stages. Stage I is where the tumor is confined to the ovaries. Stage II is both ovaries, as well as the pelvis. Stage II includes both ovaries, one or more organs in the pelvis, and spreading beyond the pelvis to such organs as the abdomen. The fourth and final stage includes both ovaries, organs in the pelvis, organs in the abdominal cavity, and distant organs such as the liver or lungs (4).

          The most popular treatment for ovarian cancer is surgery. The surgeon will remove the uterus, both fallopian tubes, and the ovaries. Depending on the stage at which the cancer is found, the woman might also be encouraged to take cancer-killing drugs, most often known as chemotherapy (1). Ovarian Cancer has a very high recurrence rate and therefore makes prognosis weak.

          There are many ways to determine whether or not you are at risk for Ovarian Cancer. Women over 50 have an increased risk across the board (7). Other risks include having two or more relatives with the disease, a family history of breast, ovarian, or colon cancer, multiple exposure to fertility drugs, being of Ashkenazi Jewish decent, have uninterrupted ovulation, or have the BRAC1 or BRAC2 gene mutation (6). For information on these genes and to learn how to get tested, click here.

          Some ways to prevent Ovarian Cancer are bearing several children, especially before the age of thirty, and taking birth control pills. The pill reduces lifetime risk by 10% for each year of pill usage (1).

For an on-line interactive survey that will determine your risk for Ovarian Cancer, click here.

 

 

                   

 

(provided by www.medem.com)

 

For care facilities in the Rochester area visit:

               The leading community-based, not-for-profit agency dedicated to delivering highly responsive prevention, education, support and wellness programs to all those affected by cancer. An enhanced support program was added in September 2000 through Gilda's Club Rochester New York.

               The James P. Wilmot Cancer Center strives to provide outstanding care for
people with cancer by offering the latest and most effective therapies in a
compassionate setting. Meaningful new modulation, prevention and therapeutic
studies are developed through an environment that nurtures innovative,
interdisciplinary cancer research. Additionally, our Cancer Center offers superior
education and training programs for students and fellows in areas related to cancer
research and clinical care.

 

For further information in your area visit:

Related Web Sites
References
  1. Brody, Jane E. "The Deadly Whisper of Ovarian Cancer." The New York Times  October 2, 2001: F6
  2. www.eyesontheprize.org/FAQ/gynca/fall_tube.html Accessed 01/24/02 
  3. www.graylab.ac.uk/cancernet/101055.html Accessed 01/24/02 (Gray Lab Cancer Research Laboratory)
  4. www.healthywomen.com/cancer Accessed 10/24/02 (Dr. Erzurum, M.D.)
  5. www.intelihealth.com/IH/ihtlH/WSIHW000/9103/24707.html Accessed 01/24/02
  6. www.ovariancancer.jhmi.edu/menu_understanding.cmf Accessed 02/04/02
  7. The Boston Women's Health Book Collective. Our Bodies Ourselves for the new century. New York: Touchstone, 1998.
  8. www.tirgan.com/falopia.htm Accessed 01/24/02
Created by:   Your name on 04/17/02
Biology Department
Beverly J. Brown, Ph.D.

Nazareth College
Rochester, New York

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