Gynecologic cancers affect thousands of women each year, yet many remain difficult to detect in their earliest stages. Symptoms can be subtle, easily mistaken for routine changes, and often overlooked.
According to Dr. Radhika P. Gogoi, a member of the Gynecologic Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute, awareness and proactive care are critical -- and so is seeking expert guidance when concerns arise.
“Second opinions are a best practice in oncology,” Dr. Gogoi said. “In my practice specifically, I often see patients seeking a second opinion because they want more information about their diagnosis and treatment options and potentially access to the latest clinical trials, especially for complex or aggressive cancers.”
What are gynecologic cancers?
Gynecologic cancers include malignancies that affect the female reproductive system. These include cervical, fallopian tube, gestational trophoblastic disease, ovarian, uterine (endometrial), vaginal and vulvar cancers.
One of the biggest difficulties, Dr. Gogoi noted, is that early symptoms can mimic common experiences many women already have.
“It can be difficult to catch gynecologic cancers early, because the symptoms can be similar to more common illnesses,” she said. “But it’s important to pay attention to what is normal for you and what is not normal.”
Common warning signs can include:
- Abnormal vaginal bleeding or discharge.
- Feeling full quickly, bloating, difficulty eating, abdominal or back pain.
- Pelvic pain or pressure.
- Urinary urgency or frequency and sometimes constipation.
- Vulvar itching, burning, pain, tenderness or visible skin changes.
“It’s important to see a gynecologist routinely, but also to see one when the symptoms are out of the ordinary or persist,” Dr. Gogoi said.
Screening recommendations: What women should know
Screening guidance depends on cancer type and personal risk factors. Start with an individualized risk assessment and discuss timing and frequency with your doctor.
“It’s important for every woman to understand her personal risk and talk with her doctor about when to begin screening and how often to be screened,” Dr. Gogoi said.
Here are some of the most common gynecologic cancers:
Cervical cancer
For cervical cancer, routine screening is well established.
- Women ages 21 to 29 should receive a Pap test every three years.
- Women ages 30 to 65 should receive a Pap test combined with HPV testing every five years.
Fallopian tube and ovarian cancer
Ultrasounds or other imaging tests, such as MRI, may be of value to evaluate for ovarian or fallopian tube cancer.
Uterine (endometrial) cancer
For those who have family members who have had colon or endometrial cancer, genetic testing is important to understand if they have the genetic mutation that increases their risk of endometrial or ovarian cancer.
Dr. Gogoi added that patients with Lynch syndrome -- a hereditary condition that increases the risk of endometrial and ovarian cancer -- will require regular surveillance with endometrial biopsies and ultrasounds.
“If there is a family history of certain cancers, it’s important to go to your gynecologist if you’re having any issues, understand your family history, and receive genetic counseling,” Dr. Gogoi said.
Vulvar cancer
There is currently no standard screening for vulvar cancer. Because of this, Dr. Gogoi stressed the importance of routine visits to the gynecologist for exams, as well as being aware of the symptoms such as skin changes, masses or itching on the vulva.
The role of HPV
Human papillomavirus (HPV) plays a significant role in several gynecologic cancers, particularly cervical, vaginal and vulvar cancers.
“It is spread by sexual contact,” Dr. Gogoi said. “Most people are asymptomatic from this virus, and it usually goes dormant, but for those patients where the virus is active, it can cause genital or penile warts, precancerous changes or even cancer.”
Because of this link, HPV testing is part of recommended cervical cancer screening.
“The HPV vaccine is an excellent strategy to decrease the risk and is available starting at the age of 9. HPV vaccination has been shown to decrease the risk of developing cervical cancer,” she said.
A team-based approach to treatment
Dr. Gogoi said that at Karmanos, patients benefit from a multidisciplinary model designed specifically for gynecologic oncology care.
“You don’t just see one doctor -- you’re cared for by an entire team of experts dedicated solely to treating gynecologic cancers,” she said.
That team includes gynecologic oncologists, radiation oncologists, radiologists, pathologists, pharmacists, specialized nurse practitioners, dietitians, social workers and genetic counselors.
“We present cases at our weekly tumor board and discuss pathology and treatment options,” she said. “Each of our experts work together with you and your family to design a personalized treatment plan.”
This collaborative structure supports increasingly personalized cancer care.
Today’s treatment landscape includes:
- Targeted therapies, like antibody drug conjugates.
- Immunotherapy that helps the immune system recognize and fight cancer.
- Refined radiation techniques that focus on the tumor while sparing healthy tissue.
- Advanced surgical approaches designed for faster recovery and fewer complications.
- Genomic tumor testing that allows doctors to tailor treatment to the biology of each patient’s cancer.
- Access to clinical trials testing novel approaches to treating gynecologic cancer.
“These advances mean many patients receive treatments that are more effective, safer and better tolerated than those available decades ago,” Dr. Gogoi said.
Karmanos also offers extensive access to clinical trials with new therapies that might not be available anywhere else. These trials are research studies that evaluate new cancer treatments, diagnostic tools, surgical techniques and prevention strategies.
“As an NCI-designated comprehensive cancer center, we study tomorrow’s standard of care today,” she said.
Karmanos has one of the most robust clinical trials programs in the U.S., with studies available for all cancer types, all stages (I – IV) -- and even clinical trials for patients who have had a number of prior therapies.
Why second opinions can change the course of care
For patients facing a new cancer diagnosis, uncertainty can be overwhelming. Dr. Gogoi said second opinions often provide clarity and, in some cases, new options.
“I often see patients seeking a second opinion because they want more information and access to the latest treatments, especially for complex or aggressive cancers,” she said. “Sometimes they seek a second opinion to make sure they are on the right treatment plan.”
Karmanos has built a streamlined second-opinion program designed to reduce common barriers.
“Many centers offer second opinions, but the process can break down due to paperwork, delays or confusion,” Dr. Gogoi said. “We’ve removed those barriers.”
When a patient calls Karmanos or submits a request online, patient navigators gather medical records and insurance authorizations. An oncology nurse contacts the patient ahead of the visit to review key details. Within seven days of the request, patients meet with a cancer expert, prepared to discuss personalized recommendations.
The impact can be significant. Second opinions at Karmanos sometimes uncover additional treatment options -- and occasionally even a change a diagnosis. Patients may gain access to advanced surgeries, targeted therapies, leading-edge radiation techniques and innovative clinical trials.
“We are dedicated to finding more effective and safer cancer-fighting drugs,” Dr. Gogoi said. “Many cancer drugs approved by the FDA were available to Karmanos patients years earlier through our trials.”
Continuing care beyond treatment
Support at Karmanos doesn’t end when active treatment concludes. After a defined period of remaining cancer free, many patients transition to the Women’s Wellness Clinic for survivorship care, ongoing screenings and support for menopause symptoms and long-term health.
For women navigating gynecologic health concerns -- whether routine screening, new symptoms or a recent diagnosis -- Dr. Gogoi’s message is clear: Pay attention to your body and seek expert input when something feels off.
To request a second opinion, visit karmanos.org/secondopinion, or call 1-800-KARMANOS.