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RadioMD Presents: HER Radio | Original Air Date: March 26, 2015
Hosts: Michelle King Robson and Pam Peeke, MD

Dr. Pam Peeke, New York Times' best-selling author and founder of the Peeke Performance Center and Michelle King Robson, leading women's advocate, entrepreneur and founder of EmpowHER.com host the show everyone's talking about. It's time for HER Radio.

PAM: Hi, everyone. I'm Dr. Pam Peeke. Michelle's off today.

There are 10 critical symptoms that women should never ignore. We've got that list and we have the "go to" expert, Dr. Julian Schink who's going to help us understand what those symptoms are all about.

Dr. Schink is Chief, Department of Obstetrics, Gynecology and Women's Health at Spectrum Medical Group in Grand Rapids, Michigan. Their website is SpectrumMedical.org.
Dr. Schink, welcome to HER Radio.

D: Thanks for having me.

P: So, we've got 10 of these symptoms to plow through here. Let's just start up. I'll tee them up here.

D: Okay.

P: Number one, abnormal vaginal bleeding or discharge. What should a woman do?

D: Well, first of all, women are going to say, "What is abnormal? What's the difference between normal and abnormal?" because menstruating women will have vaginal bleeding on a regular basis—monthly basis. So, what's abnormal? First of all, post-menopausal bleeding is abnormal. Menopause is defined as a year of no periods. So, if a woman, once she's gone through the menopause and as many of your listeners know, it's often associated with hot flashes and so on, when a year has gone by without any periods, if a woman starts having vaginal bleeding, that is abnormal and absolutely requires a visit to the doctor.

P: Right. And that, with the discharge. So, that means "get ye to the gynecologist". Don't question it like so many women do. They just sit there and they go, "Mmm. I'll just wait." The second symptom that you should always pay attention to: unexplained weight loss.

D: That's right. It can be a sign of a cancer. Colon cancer, for instance, or any of the GI cancers are associated with unexplained weight loss. So, we all know, and I know that a common topic on talk radio and in the newspaper is "How do I lose weight?" Well, you lose weight by working really hard at it and limiting how many calories you take in and how hard you work out.

P: Right.

D: If you lose weight without trying, you need to see your physician.

P: Something's up. The other thing, too, is hyperthyroidism, too, also kicks in there and you don't even know it. You get a little buzzy and you're running around and dropping a little bit, too.

Alright. Number three in these symptoms you don't want to ignore. Can't stay away from the bathroom. What's that about?

D: Well, if you're getting up, especially if you're getting up at night more than you ever did before, and to me, really the trigger there is three times a night or more, something's not quite right there. That could be a sign of diabetes. If it's associated with diabetes, it tends to be also associated with being really thirsty and you sort of feel of like you're doing it to yourself. You drink, drink, drink. You're always thirsty and you're always going to the bathroom. As a gynecologist, the things that we think about, though, are large pelvic masses that actually press on the bladder and make the bladder, essentially, smaller and so it fills up quickly and you feel full and an urge to go. Then, when you go, there's isn't necessarily that much there, but you have to go very frequently.

P: Okay. Then, urinary tract infections and all that, too, at the same time, but you're going for the big stuff. Yikes! Number four: a bloated belly or pain in your pelvis or abdomen.

D: Right. That really is one of the red flags of ovarian cancer and 90+% of women, some would say 95% of women with ovarian cancer, have symptoms and often those symptoms are discounted. It doesn't mean everyone who feels bloated has ovarian cancer, by any means. But, if it's new. Your pants are tighter and you didn't gain a lot of weight and it's not making sense, this is the symptom that comes and doesn't go away, right? It's not the coming and going, "Oh, geeze. I ate too much pizza and now I feel bloated." This is, "Boy, one, two, three weeks..."

P: Well, with all this Angelina Jolie breast cancer gene, ovarian cancer talk out there, I know a lot of women area really talking this up--the ovarian cancer issue. So, this is an important symptom, that bloated belly and pain in the pelvis. Number five...

D: Angelina Jolie. She really has done a lot to raise awareness.

P: Huge. Huge. Oh, my god. Constant fatigue?

D: Constant fatigue can be a sign of hypothyroidism, but it also can be a sign of an occult malignancy—a cancer that hasn't been diagnosed. Ovarian cancer is one of those, gastrointestinal cancers are another. This is fatigue that doesn't go away. You get rest, you go to bed. You got 8 hours of sleep. You get up and go, "Oh, geeze. I'm still tired."

P: Yes. This is why this is important. How about number six: swollen leg.

D: One swollen leg is a lot worse than two, in my book. So, if you have one swollen leg, that means that either you have a blood clot or something inhibiting the circulation to that leg, either the blood circulation or the lymphatic circulation to that leg. That has to be explained. Unfortunately, some of those causes are cancers.

P: Yes.

D: If you have a blood clot and you haven't been on a trans-Atlantic plane flight or you don't have a family history of blood clots or some other reason to have them, you've got to the get to the bottom of that. That is really something you have to figure out quickly.

P: And, it's pretty obvious, too. How about no appetite or a feeling of being full?

D: Well, so that feeling of being full is also a sign that there's something wrong within the abdominal cavity. As gynecologists, the first thing that we think about is ovarian cancer because this is one of those four symptoms that patients with ovarian cancer frequently complain about. It's just sometimes called "early satiety". You eat a little bit and "Oh, I'm full already." You really need to pay attention to that.

P: Would you do me a favor? Just quickly tell us the four main symptoms of ovarian cancer. You mentioned one. Feeling full.

D: So, feeling full; bloating; the pelvic pain; and then, pain with intercourse.

P: Oh.

D: That is one.

P: Okay. And all of those make sense.

D: Yes. There's trouble there.

P: How about this one? Number eight: feeling queasy, having nausea or fighting indigestion.

D: So, again, kind of a variation on number seven which is "no appetite or feeling full". If there's no space in your abdomen, either because there's fluid pressing on the stomach or a tumor pressing on the stomach, you're going to get reflux up your esophagus. You're going to have indigestion from that. You're stomach's not going to empty well.

P: Got you. So, you've got to be on top of that. We're almost done. Vulva problems, including color changes, itching or burning. So, how common is this and what does it really signify?

D: Well, so, certainly itching of the vulva can be a common sign just of a yeast infection or an allergic reaction, but particularly in more elderly women who have not had that problem before, they need to pay attention because itching can be a sign of either a cancer or a pre-cancerous abnormality. There aren't supposed to be new growths or textures, significant changes on the vulva. That's a sign that there's something growing there that does not belong.

P: What if someone is younger than an elderly person? Does it mean the same thing?

D: Well, it's less concerning for cancer, but pre-cancer abnormalities also itch and they can take 10-20 years to become cancers. You don't want to ignore them for all those 10-20 years until it becomes a cancer.

P: You've got it. Well, then, number 10 goes hand in hand. Pain in the pelvis, abdomen or back. You know, this really speaks to everything else that you just helped us with when we were looking at these 10 symptoms that women cannot ignore.

HER listeners, we've been talking to Dr. Julian Schink who's helped us understand these symptoms. Pay attention to them. His website is SpectrumMedical.org.

I'm Dr. Pam Peeke with Michelle King Robson.Follow us on Twitter. Like us on Facebook and stay well.