You At Your Best

8 | YOU AT YOUR BEST | NWADG.COM/YOUATYOURBEST MARCH - ALL NATURAL | SATURDAY, FEBRUARY 24, 2018 SPECIAL TO NWA DEMOCRAT-GAZETTE Given most women's multi-tasking habits and the myriad commitments on most women's to-do lists, it's no surprise that taking time for themselves often takes a back seat. But one of the most important dates on every woman's calendar should be a well-woman exam. A primary focus of the well- woman exam is screening for female gynecological cancers. Five cancers of the reproductive system can be detected in a regular exam with your gynecologist: cervical, endometrial, ovarian and vaginal, and vulvar cancer. The good news: these female cancers have high cure rates, if detected and treated early. "Pap tests are the primary tool used to identify cervical abnormalities before they ever have a chance to become cancer," says Alexis McCollum, M.D., board certified obstetrician and gynecologist at Willow Creek Women's Clinic in Johnson. "Because we, as physicians, don't have microscopic vision, this test is invaluable in seeing problems before we could ever see them with the naked eye." Cervical Cancer Cervical cancer was once the most common causes of cancer deaths among women, until the development of the Pap test in the 1950s, which greatly enhanced early detection and cure rates. With a pap test, cells are taken from the cervix and examined under a microscope. Cervical cancer forms in the tissue of the cervix, which connects the uterus and the vagina. A slow-growing cancer, cervical cancer has few symptoms in the early stages, but can be detected through regular Pap smears. Some symptoms include bleeding, unusual discharge and pelvic pain. "Some pap tests will also screen for what's known as high-risk HPV," McCollum says. "HPV has hundreds of different strains, but only a few strains that really increase risk of cervical cancer." Thought to be primarily caused by human papmillomavirus (HPV) infection, cervical cancer rates have also fallen since the development of the HPV vaccine. This vaccine helps produce immunity to the HPV strains that are linked to cancer development. Other risk factors for cervical cancer include multiple sexual partners, beginning sexual intercourse at a young age, smoking, a weakened immune system or having had multiple children. Cervical cancer generally occurs during mid-life, between ages 20 and 50, according to the American Cancer Society (ACS) – which is why it's important to continue regular Pap tests as you age. Endometrial Cancer Endometrial cancer is caused when malignant cells develop in the lining of the uterus. A very rare form of this cancer is uterine cancer, which affects the actual uterus and is known as uterine sarcoma. Uterine sarcoma affects the muscles in or around the uterus and usually develops after menopause. The symptoms of endometrial cancer are similar to other reproductive system cancers: irregular bleeding, pelvic pain, or pain during urination or sexual intercourse. Because it begins inside the uterus, it is not generally detected through a Pap test, but instead, tissue from the endometrium must be biopsied. Certain factors can increase your risk for endometrial cancer, including early onset of menstruation, never having been pregnant, late menopause, obesity, and advancing age. Sometimes, other health conditions or treatments for these conditions can increase the likelihood of endometrial cancer, such as having polycystic ovary syndrome or diabetes; taking tamoxifen, a drug used for breast cancer treatment; or taking estrogen hormones. On the other hand, taking combination oral contraceptives (containing estrogen and progestin) has a protective effect. Regular exercise, a healthy diet, and pregnancy and breast- feeding also lower your risk. Endometrial cancer generally develops after age 40, and is the most common female reproductive cancer; in fact, the ACS estimates a woman's chance of developing this cancer during her lifetime is one in 40. Ovarian Cancer Ovarian cancer develops in the tissue of one or both ovaries, either on the surface of the ovary (known as epithelial carcinomas) or in the egg cells (malignant germ cell tumors). The ACS estimates that nine out of every 10 ovarian cancers are Epithelial ovarian tumors. A small percentage of ovarian cysts – non-cancerous growths – can develop into ovarian cancer. Although there is not a routine screening test specifically for ovarian cancer, it is usually diagnosed through a pelvic exam, an ultrasound, or blood tests. It is also typically diagnosed in late stage and does not have a high cure rate, McCollum says. Typical symptoms can include abdominal pain, bloating or a full feeling. Certain health conditions and lifestyle habits may increase the risk for ovarian cancer, including a family history of the cancer, use of fertility drugs, hormone replacement therapy, or obesity. The use of oral contraceptives, or pregnancy and breastfeeding, decrease the risk for ovarian cancer. Vaginal Cancer Vaginal cancer is not common, but it is curable when detected early. There are two primary types of vaginal cancers. Squamous cell carcinoma – representing about 70 percent of vaginal cancer cases – originates in the cells that make up the epithelial lining of the vagina. Squamous cell carcinoma develops slowly and, according to the ACS, nearly 50 percent are found in women ages 70 and older and only 15 percent of cases are diagnosed in women under 40. Adenocarcinoma begins in the glandular cells in the vagina that release mucus. This type of vaginal cancer affects younger women in their 20s and 30s. Vaginal cancer is difficult to diagnose early because many women who develop vaginal cancer do not have any obvious risk factors or early symptoms. A Pap test is the primary tool for finding vaginal cancer. Age and exposure to DES, a hormonal drug given to some women to prevent miscarriage between 1940 and 1971, are common risk factors. Dr. McCollum says she does not routinely use pap tests to diagnose this type of cancer. It is diagnosed by old- fashioned history taking and physical exam by a knowledgeable physician. Vulvar Cancer The development of malignant cells in the vulva, or external female organs, is very rare. Most vulvar cancers – similar to vaginal cancer – are squamous cell carcinomas, which begins in the skin cells with on the opening folds of the vulva (the labia) or just inside the labia at the opening to the vagina. Rarely do women with this type of cancer have symptoms, but when they do, symptoms can range from itching to bleeding to development of a lump, tenderness or a wart-like growth which must be biopsied to determine whether it is cancerous or non-cancerous. Changes to the skin of the vulva are a common Alexis McCollum, M.D., board certified obstetrician and gynecologist at Willow Creek Women's Clinic in Johnson. Why a pap smear is important Top 5 gynecological cancers

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