By KAREN DIAS-MARTIN
For Montclair Local
Editor’s note: This series will be written by practitioners in Summit Medical Group (SMG) on health-related topics. This one is by Dr. Karen Dias-Martin, gynecologist at Summit Medical Group in Glen Ridge, NJ. Dr. Dias-Martin will appear on the 2019 list of New Jersey’s Top Doctors. She has lived in Montclair with her family for 25 years.
Almost every woman I see is concerned about gynecologic or breast cancer, and I understand why. Most of us know someone — a family member, friend, or coworker — who has been diagnosed. But I tell my patients the same thing I tell my friends: I wish they wouldn’t worry so much.
Take gynecologic cancer for instance. If you play by the rules the odds are well in your favor. Every year there are some 95,000 cases of gynecologic cancer in the U.S. But if you come in for a regular physical exam, get the recommended screenings, get vaccinated against human papillomavirus or HPV (if you are eligible) and do not smoke, your risk decreases significantly. And if cancer does develop, we will likely catch it in the earliest stages.
We are fortunate today to have so many advanced screening tools. The Pap smear, which detects cervical and vaginal cancer, is one of the easiest, most effective, and safest tests available. A yearly mammogram can also help detect breast cancer early. Summit Medical Group offers convenient walk-in screening mammograms without an appointment or prescription in several locations. I tell my patients all they have to do is show up!
Another advance in recent years is the development of the HPV vaccine, which has been shown to significantly reduce the risk of cervical cancer.
That goes for appointments too. Even if you are not due for a Pap smear, come in for an annual physical exam. During a pelvic or vaginal exam, I can feel or see abnormalities that are associated with cancer. I recently diagnosed three patients with early vulvar cancer after a simple exam.
Some patients tell me they think a yearly visit is overkill. But I urge them to reconsider. Most women do not hesitate to pop in for a mole check and they can see the spots on their skin. Do you really know what is happening — or what it looks like — down there? If you get a clean bill of health after your appointment, and most patients do, you can simply relax and enjoy the rest of the year!
Of course, it is also important to stay attuned to any changes that may occur throughout the year. Here is what you need to know about the five most common gynecologic cancers:
Cervical cancer, which typically shows up during midlife, is highly preventable. Pap tests can detect precancerous changes before they turn into cervical cancer. According to the CDC, as many as 93 percent of cervical cancers can be prevented by screening and being vaccinated against HPV.
Ovarian cancer is the second most common gynecologic cancer and also the most serious. Women generally do not have symptoms until the disease progresses. Unfortunately, a Pap test, physical exam, or pelvic ultrasound is not helpful in finding early disease. Rather than the typical pelvic pain or bleeding that is associated with most gynecologic cancers, the majority of women I see with ovarian cancer present with abdominal pain or gastrointestinal symptoms. Discuss any changes in bowel habits or menstrual periods with your physician.
Uterine cancer is one of the easier cancers to detect because women generally present with a telltale sign: abnormal vaginal bleeding. If you have already been through menopause, and begin bleeding again, visit your doctor right away.
Vaginal cancer is rare and typically found in women over age 60. Like cervical cancer, vaginal cancer can be detected with a Pap smear and is more likely to develop if you have a history of HPV. Signs include abnormal bleeding, vaginal lumps, or pain during sex.
Vulvar cancer, which affects the external genitalia, is also uncommon. The average age of diagnosis is 68 years. Most women develop an itchy lump or sore. If you are still uncomfortable after treating a yeast infection or trying several creams for the itchy area, visit your physician.
Developing a good relationship with your family medicine physician or gynecologist is key. Ask yourself these questions. Would I feel comfortable telling my doctor intercourse is painful or that my bowel movements are oddly colored? I see my patients as partners, and they can ask me anything. With regular visits and open communication, we can reduce the risk of gynecologic cancer together as a team.