Frequently Asked Gynecologic Cancer Questions

Gynecologic cancer is any cancer that starts in a woman’s reproductive organs. This includes cervical, ovarian, uterine, vaginal and vulvar. About 89,000 women are diagnosed with gynecologic cancer annually in the United States.

Gynecologic oncology physicians at The University of Kansas Cancer Center are experts in screening, early detection and treatment of gynecologic cancers.

 What causes itching and pain in my external genitalia?
Julia Chapman, MD
Julia Chapman, MD

These symptoms can arise with or without a noticeable lump, sore or discoloration. Common causes of pain and itching include infection, contact dermatitis, chronic skin conditions, menopausal thinning of the skin and even cancer. Infections, such as candidiasis (yeast), bacterial vaginosis and genital human papillomavirus (HPV), can cause itching. A biopsy may be necessary, even if your physician does not see a lesion. It is also important to know if the symptoms are recent or something you’ve experienced for a time.

If you have a lump, sore or discoloration (red, brown, black, white) you will need a biopsy. A biopsy should be performed on any hyperpigmented (dark), firm/thick, ulcerative lesion or any lesion that does not respond to treatment or worsens during treatment. A biopsy will enable your gynecologist or family physician to determine if you have a skin condition that can be treated with medication (eczema, lichen sclerosus) or if you have a more serious condition (vulvar dysplasia, Paget’s disease or squamous cell cancer).

 Why am I experiencing painful intercourse?
Dineo Khabele, MD, Director, Division of Gynecologic Oncology, The University of Kansas Cancer Center
Dineo Khabele, MD

Up to 50 percent of all postmenopausal women experience irritation, soreness, pain and vaginal dryness with intercourse. This may happen long after hot flashes subside. As women age, the skin inside the vagina and along the vulva becomes more sensitive to irritants (wipes, body fluids, dyes, soaps). Without estrogen the lining becomes thin, pale and dry. The area is more sensitive to chemicals and overgrowth of normal bacteria and there may be an odorous discharge. In up to 25 percent of women, oral estrogen does not relieve these symptoms. Your family physician or gynecologist may prescribe medications, such as estrogen or moisturizers. 

 Should I be concerned about vaginal bleeding after menopause?
Andrea Jewell, MD
Andrea Jewell, MD 

Bleeding after going through menopause should always be evaluated by a gynecologist or family physician. Other abnormal bleeding, such as that after intercourse or between periods in premenopausal women, should also be evaluated. Fortunately, for most women, the bleeding is due to benign causes such as vaginal atrophy, infection or endometrial polyps. However, abnormal bleeding is the most common symptom of endometrial and cervical cancers. It should always be evaluated with ultrasound and a biopsy. If cancer is present, early detection and treatment is the best way to improve your overall survival.

 What is causing my chronic bloating and constipation? My doctor said it’s reflux.  
Lori Spoozak, MD
Lori Spoozak, MD

The most consistent warning sign that women experience upon their initial presentation with ovarian cancer is vague abdominal symptoms. Often, symptoms leading up to a diagnosis have gone on for several weeks and are overlooked or mistaken for other conditions by their physician.

If you experience any of these warning signs more than 12 times in a month, ask your physician to check for ovarian cancer. Symptoms include bloating, urinary symptoms, abdominal or pelvic pain and feeling full after eating quickly. Ovarian cancer is not a silent killer. Women must learn to listen to the signals their body gives them.