What Women Need to Know About Cervical Cancer
Dr. Roberts ( Gynecologic Oncologist with UPMC Women’s Cancer Center) talks about cervical cancer. She explains what happens in a woman’s body with cervical cancer, the risk factors involved in receiving a diagnosis, and the signs and symptoms that would prompt a woman to seek treatment.
Featuring:
To Book Appointment with Maureen Roberts, MD
Maureen Roberts, MD
Maureen Roberts, MD is a Gynecologic Oncologist with UPMC Women’s Cancer Center.To Book Appointment with Maureen Roberts, MD
Transcription:
Amanda Wilde (Host): CErvical cancer can be a risk for every woman, but most cervical cancers can be stopped before they happen. Today we're talking about what women need to know about cervical cancer with Dr. Maureen Roberts, gynecologic oncologist with UPMC women's cancer. This is Healthier You a podcast from UPMC. See, I'm Amanda Wilde. Welcome to the podcast, Dr. Roberts.
Dr Maureen Roberts: Hi, Amanda. Thank you for having.
Amanda Wilde (Host): It's great having you here. What happens in a woman's body with cervical cancer?
Dr Maureen Roberts: So cervical cancer is a cancer that occurs, as you said in a woman and involves the cervix, which is the lower part of the uterus. most often we think about it when we talk about women in labor and their cervix dilates to have babies. it's one of the most preventable cancers. . But unfortunately each year in the United States there's still about 13,000 new cases diagnosed and about 4,000 women still die of the disease annually. While it can be diagnosed on routine exam and while early and asymptomatic, it's often diagnosed when women present with symptoms of the disease, or symptoms that are related to the disease once it is spread outside the cervix.
Risk factors could include things like a lack of regular screening such as a pap smear. Women can get HPV infections or exposure. They have higher risks if they use tobacco, and any type of immune suppression such as medications taken for other medical conditions that weaken your immune system. Fortunately, it is not considered a hereditary or genetic disease.
Amanda Wilde (Host): So other than noting signs and symptoms, what can women do to prevent getting cervical cancer?
Dr Maureen Roberts: So basically those are the ones that are main, really thing is, HPV infection, which is a sexually transmitted infection that most people, the vast majority, 50 to 80% are exposed to at some point in their life. Tobacco use is actually a very significant risk factor, and like I said, any type of immune suppression or medical conditions, whether it be for a history of a transplant, rheumatoid arthritis, or like HIV, etcetera.
Amanda Wilde (Host): So are there signs and symptoms we would see if we did have early stages cervical cancer?
Dr Maureen Roberts: So in my office, often when I see women that are ultimately diagnosed with a cervix cancer, they may have presented reporting vaginal bleeding, or abnormal bleeding. For example, when they're not expecting their period bleeding between cycles, maybe it's bleeding after sex or postmenopausal bleeding if they're past the age of menopause. Some women also report either vaginal, pelvic, or lower abdominal pain, and they also may report a change in, or new or foul smelling vaginal discharge. They can be kind of vague as you can imagine. All those things don't equal cancer, but those are probably the most common signs and symptoms that I hear.
Amanda Wilde (Host): So all those things should prompt women to seek treatment?
Dr Maureen Roberts: Certainly at least evaluation from either their gynecologist or a provider that provides their gynecologic care so that they can be worked up further as appropriate.
Amanda Wilde (Host): Now, is there anything women can do to prevent getting cervical cancer ? cancer
Dr Maureen Roberts: So yeah, this is what's really exciting about this type of cancer In particular, there really are two major tools, to help either catch a pre-cancer, or better yet, Possibly prevent the cancer altogether. One is a routine pelvic exam with pap smear and HPV testing. This is often performed by a gynecologist or a gynecology provider, such as like a nurse practitioner or PA. But it can also be done by your primary care provider if they are comfortable performing a pelvic exam. The other is HPV vaccination, so over 90% of cervix cancers, and the most common ones are caused by the HPV virus. Pretty well proven. And like I mentioned before, it's sexually transmitted and so most people will be exposed at some point in their life.
It truly affects everyone, not just women. The vaccine is safe, nearly a hundred percent effective in studies, in reducing the high risk HPV that causes cancer, and it truly is the best thing we have to reduce. Rates of cervix cancer. in fact, a recent study I think just came out last month that showed a 65% drop in cervix cancer rates, in the 2000, like, I think it was 12 to 2020. In women in their twenties who are the first to have really gotten the vaccine, implemented in their age group. It's approved by the FDA for both men and. Ages nine to 45.
And though while we do recommend it in children ages nine to 11 or so prior to the onset of sexual activity and thus HPV exposure, individuals may still find benefit if they did not receive it when they were younger. And so the best thing is to discuss with your provider to see if you're still eligible for HPV vaccination, if you never received it.
Amanda Wilde (Host): I have read that HPV vaccines prevent other cancers as well as cervical cancer. Is that true?
Dr Maureen Roberts: So that is what we're thinking. We think that HPV is a virus that mediates other types of cancer, you know, including the lower anal tract, anal cancer, lower colorectal cancers, as well as head and neck cancers, such as, throat and mouth and upper esophagus. And so, though I cannot personally speak to those cancer reduction risks as a GYN oncologist, I definitely think that there's benefit that we are learning and we are discovering every day. And that affects all ages and genders.
Amanda Wilde (Host): Can you talk about UPMC's particular approach in caring for women with cervical cancer from initial diagnosis to treatment and survivorship, like the woman's journey through your system once she's diagnosed?
Dr Maureen Roberts: Of course. I think what I would want patients to really understand is that if you are diagnosed or someone you know is diagnosed with a cervical cancer and you are coming through the UPMC system, and hopefully any healthcare system, it's most important that you realize that you are not alone. Here at UPMC, we have a large network of providers, services and support, that will help guide you through your treatment journey. Sometimes these are medical providers, like gynecologic oncologists, radiation oncologists, medical oncologists, and sometimes they are ancillary services, whether it's palliative care.
Pain management, social work, financial services, support groups, and the like. And so women here have the support of a compassionate and skilled, really multidisciplinary team of experts. And we work to develop a care plan specific to each patient, their type, their stage of cancer, and then we personalize the treatment plan, taking into consideration not just those medical factors, but also any set of symptoms and needs that she has outside of that medical realm.
Amanda Wilde (Host): What are the different treatment options?
Dr Maureen Roberts: so that's a really great question. And then largely that is determined by the stage, meaning has the cancer spread and if so, where at time of diagnosis. And so there's really three ways we tackle cancer. One being surgery. Two being chemotherapy and three being radiation. And depending on the type of cervical cancer, the type of the stage of cancer, a woman may be eligible for one, two, or all three of the above. Most commonly if it's diagnosed at, in a very early stage, meaning it's small and confined to the cervix. We often discuss surgery. If the cancer is larger or maybe there's evidence that has spread either around the cervix or to distant sites throughout the body. Typically, we address with either chemotherapy and or radiation.
Amanda Wilde (Host): Have you seen these gynecological cancer treatments evolve over the years?
Dr Maureen Roberts: Of course. I mean, I am fairly early in my career, but I've been doing this long enough to say that we are learning more about cancer biology, and cancer behavior really each and every day. And experts are working hard to develop not only new treatment strategies, but also new ways to diagnose and prevent all cancers altogether. I have had the heartbreaking experience of seeing mothers, some in the best years of their life, die from this very preventable disease. These mothers that leave families, young children behind and most give a history of a prior abnormal screening, and then either never sought or felt like they kind of didn't receive the follow-up care that they needed.
The good news is that in this regard, cervix cancer treatments have evolved in the sense that we are no longer just limited by our surgical. And chemotherapy and radiation approaches of years past. While those are very common and still widely implemented in the upfront setting because they are safe and effective, we have new treatment options, just in the last five to 10 years that use targeted therapies, immunotherapies, and different treatments to specifically attack each individual cancer cell, but also recruit a woman's immune system to fight the cancer.
Amanda Wilde (Host): That's more and more of the way of all cancer treatments, which sounds like an overall healthier approach.
Dr Maureen Roberts: It seems like it. Right. And the good news is that a lot of these cancers do seem like they are, responding to these new treatments quite well. It's a very exciting time, to be in medicine because we now have more options for our patients.
Amanda Wilde (Host): You mentioned sometimes women might not have known they had an abnormal diagnosis back there, or I'm just wondering what advice you would give to women about their role in keeping their reproductive system healthy?
Dr Maureen Roberts: I think that's my biggest, frustration this cancer that oftentimes women are coming in and they haven't seen a provider or a gynecologist in 20, 30, 40 years. but really sometimes it's just been a few years, life happens. They didn't realize that a, a. Abnormal Pap could turn into X, Y, and Z. And so they have a lot of regret in that regard. I would say that women should just really try to make it a point to take care of themselves and to see a medical provider regularly who focuses on female health. Again, it could be a gynecologist or it could be a primary care provider that also takes care of gynecologic issues.
Though you may only see them once a year, and unfortunately some women even less often, the good news is, in today's age, you're able to stay in touch with your provider year round through, internet-based patient portals, phone calls, video visits, etcetera. and so what I would strongly encourage women to do keep those annual appointments, carve out that hour appointment, 15 minute appointment, whatever it is. Get in and be seen and make sure they're up to date. In between visits, women should be able to identify changes in their own body and really speak up and feel comfortable to advocate for themself if they feel like something is new or changed.
And finally, I would say women should know their family health history Although I did mention that cervix cancer is not typically a genetic or hereditary disease. Other things such as reproductive issues, both cancerous and non-cancerous or gynecologic cancers, women may be increased risk for, maybe in the family if they just ask around.
Amanda Wilde (Host): So annual visits, visits screening and preventative treatment like the HPV vaccine are all keeping the incidence of cancer much lower than it used to be.
Dr Maureen Roberts: Exactly. It is really that easy. I know it's hard to carve out the time and to get in. . oftentimes doctors offices have wait lists and stuff but it really is that easy. This is a completely preventable disease. and I think that with highly effective screening strategies and, advances in safe and effective, treatment options, it really is reasonable to aim for a world in which Women no longer develop or die from cervical cancer.
Amanda Wilde (Host): Well, Dr. Roberts, thank you for your expertise in explaining how we can treat and even avoid cervical cancer.
Dr Maureen Roberts: Thank you so much, Amanda, for having me. It really was my pleasure.
Amanda Wilde (Host): That was Dr. Maureen Roberts, gynecologic oncologist with UPMC Women's Cancer Center. For more information, please visit upmc.com/centralpagynonc. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You a podcast from UPMC. I'm Amanda Wilde. Thanks for listening.
Amanda Wilde (Host): CErvical cancer can be a risk for every woman, but most cervical cancers can be stopped before they happen. Today we're talking about what women need to know about cervical cancer with Dr. Maureen Roberts, gynecologic oncologist with UPMC women's cancer. This is Healthier You a podcast from UPMC. See, I'm Amanda Wilde. Welcome to the podcast, Dr. Roberts.
Dr Maureen Roberts: Hi, Amanda. Thank you for having.
Amanda Wilde (Host): It's great having you here. What happens in a woman's body with cervical cancer?
Dr Maureen Roberts: So cervical cancer is a cancer that occurs, as you said in a woman and involves the cervix, which is the lower part of the uterus. most often we think about it when we talk about women in labor and their cervix dilates to have babies. it's one of the most preventable cancers. . But unfortunately each year in the United States there's still about 13,000 new cases diagnosed and about 4,000 women still die of the disease annually. While it can be diagnosed on routine exam and while early and asymptomatic, it's often diagnosed when women present with symptoms of the disease, or symptoms that are related to the disease once it is spread outside the cervix.
Risk factors could include things like a lack of regular screening such as a pap smear. Women can get HPV infections or exposure. They have higher risks if they use tobacco, and any type of immune suppression such as medications taken for other medical conditions that weaken your immune system. Fortunately, it is not considered a hereditary or genetic disease.
Amanda Wilde (Host): So other than noting signs and symptoms, what can women do to prevent getting cervical cancer?
Dr Maureen Roberts: So basically those are the ones that are main, really thing is, HPV infection, which is a sexually transmitted infection that most people, the vast majority, 50 to 80% are exposed to at some point in their life. Tobacco use is actually a very significant risk factor, and like I said, any type of immune suppression or medical conditions, whether it be for a history of a transplant, rheumatoid arthritis, or like HIV, etcetera.
Amanda Wilde (Host): So are there signs and symptoms we would see if we did have early stages cervical cancer?
Dr Maureen Roberts: So in my office, often when I see women that are ultimately diagnosed with a cervix cancer, they may have presented reporting vaginal bleeding, or abnormal bleeding. For example, when they're not expecting their period bleeding between cycles, maybe it's bleeding after sex or postmenopausal bleeding if they're past the age of menopause. Some women also report either vaginal, pelvic, or lower abdominal pain, and they also may report a change in, or new or foul smelling vaginal discharge. They can be kind of vague as you can imagine. All those things don't equal cancer, but those are probably the most common signs and symptoms that I hear.
Amanda Wilde (Host): So all those things should prompt women to seek treatment?
Dr Maureen Roberts: Certainly at least evaluation from either their gynecologist or a provider that provides their gynecologic care so that they can be worked up further as appropriate.
Amanda Wilde (Host): Now, is there anything women can do to prevent getting cervical cancer ? cancer
Dr Maureen Roberts: So yeah, this is what's really exciting about this type of cancer In particular, there really are two major tools, to help either catch a pre-cancer, or better yet, Possibly prevent the cancer altogether. One is a routine pelvic exam with pap smear and HPV testing. This is often performed by a gynecologist or a gynecology provider, such as like a nurse practitioner or PA. But it can also be done by your primary care provider if they are comfortable performing a pelvic exam. The other is HPV vaccination, so over 90% of cervix cancers, and the most common ones are caused by the HPV virus. Pretty well proven. And like I mentioned before, it's sexually transmitted and so most people will be exposed at some point in their life.
It truly affects everyone, not just women. The vaccine is safe, nearly a hundred percent effective in studies, in reducing the high risk HPV that causes cancer, and it truly is the best thing we have to reduce. Rates of cervix cancer. in fact, a recent study I think just came out last month that showed a 65% drop in cervix cancer rates, in the 2000, like, I think it was 12 to 2020. In women in their twenties who are the first to have really gotten the vaccine, implemented in their age group. It's approved by the FDA for both men and. Ages nine to 45.
And though while we do recommend it in children ages nine to 11 or so prior to the onset of sexual activity and thus HPV exposure, individuals may still find benefit if they did not receive it when they were younger. And so the best thing is to discuss with your provider to see if you're still eligible for HPV vaccination, if you never received it.
Amanda Wilde (Host): I have read that HPV vaccines prevent other cancers as well as cervical cancer. Is that true?
Dr Maureen Roberts: So that is what we're thinking. We think that HPV is a virus that mediates other types of cancer, you know, including the lower anal tract, anal cancer, lower colorectal cancers, as well as head and neck cancers, such as, throat and mouth and upper esophagus. And so, though I cannot personally speak to those cancer reduction risks as a GYN oncologist, I definitely think that there's benefit that we are learning and we are discovering every day. And that affects all ages and genders.
Amanda Wilde (Host): Can you talk about UPMC's particular approach in caring for women with cervical cancer from initial diagnosis to treatment and survivorship, like the woman's journey through your system once she's diagnosed?
Dr Maureen Roberts: Of course. I think what I would want patients to really understand is that if you are diagnosed or someone you know is diagnosed with a cervical cancer and you are coming through the UPMC system, and hopefully any healthcare system, it's most important that you realize that you are not alone. Here at UPMC, we have a large network of providers, services and support, that will help guide you through your treatment journey. Sometimes these are medical providers, like gynecologic oncologists, radiation oncologists, medical oncologists, and sometimes they are ancillary services, whether it's palliative care.
Pain management, social work, financial services, support groups, and the like. And so women here have the support of a compassionate and skilled, really multidisciplinary team of experts. And we work to develop a care plan specific to each patient, their type, their stage of cancer, and then we personalize the treatment plan, taking into consideration not just those medical factors, but also any set of symptoms and needs that she has outside of that medical realm.
Amanda Wilde (Host): What are the different treatment options?
Dr Maureen Roberts: so that's a really great question. And then largely that is determined by the stage, meaning has the cancer spread and if so, where at time of diagnosis. And so there's really three ways we tackle cancer. One being surgery. Two being chemotherapy and three being radiation. And depending on the type of cervical cancer, the type of the stage of cancer, a woman may be eligible for one, two, or all three of the above. Most commonly if it's diagnosed at, in a very early stage, meaning it's small and confined to the cervix. We often discuss surgery. If the cancer is larger or maybe there's evidence that has spread either around the cervix or to distant sites throughout the body. Typically, we address with either chemotherapy and or radiation.
Amanda Wilde (Host): Have you seen these gynecological cancer treatments evolve over the years?
Dr Maureen Roberts: Of course. I mean, I am fairly early in my career, but I've been doing this long enough to say that we are learning more about cancer biology, and cancer behavior really each and every day. And experts are working hard to develop not only new treatment strategies, but also new ways to diagnose and prevent all cancers altogether. I have had the heartbreaking experience of seeing mothers, some in the best years of their life, die from this very preventable disease. These mothers that leave families, young children behind and most give a history of a prior abnormal screening, and then either never sought or felt like they kind of didn't receive the follow-up care that they needed.
The good news is that in this regard, cervix cancer treatments have evolved in the sense that we are no longer just limited by our surgical. And chemotherapy and radiation approaches of years past. While those are very common and still widely implemented in the upfront setting because they are safe and effective, we have new treatment options, just in the last five to 10 years that use targeted therapies, immunotherapies, and different treatments to specifically attack each individual cancer cell, but also recruit a woman's immune system to fight the cancer.
Amanda Wilde (Host): That's more and more of the way of all cancer treatments, which sounds like an overall healthier approach.
Dr Maureen Roberts: It seems like it. Right. And the good news is that a lot of these cancers do seem like they are, responding to these new treatments quite well. It's a very exciting time, to be in medicine because we now have more options for our patients.
Amanda Wilde (Host): You mentioned sometimes women might not have known they had an abnormal diagnosis back there, or I'm just wondering what advice you would give to women about their role in keeping their reproductive system healthy?
Dr Maureen Roberts: I think that's my biggest, frustration this cancer that oftentimes women are coming in and they haven't seen a provider or a gynecologist in 20, 30, 40 years. but really sometimes it's just been a few years, life happens. They didn't realize that a, a. Abnormal Pap could turn into X, Y, and Z. And so they have a lot of regret in that regard. I would say that women should just really try to make it a point to take care of themselves and to see a medical provider regularly who focuses on female health. Again, it could be a gynecologist or it could be a primary care provider that also takes care of gynecologic issues.
Though you may only see them once a year, and unfortunately some women even less often, the good news is, in today's age, you're able to stay in touch with your provider year round through, internet-based patient portals, phone calls, video visits, etcetera. and so what I would strongly encourage women to do keep those annual appointments, carve out that hour appointment, 15 minute appointment, whatever it is. Get in and be seen and make sure they're up to date. In between visits, women should be able to identify changes in their own body and really speak up and feel comfortable to advocate for themself if they feel like something is new or changed.
And finally, I would say women should know their family health history Although I did mention that cervix cancer is not typically a genetic or hereditary disease. Other things such as reproductive issues, both cancerous and non-cancerous or gynecologic cancers, women may be increased risk for, maybe in the family if they just ask around.
Amanda Wilde (Host): So annual visits, visits screening and preventative treatment like the HPV vaccine are all keeping the incidence of cancer much lower than it used to be.
Dr Maureen Roberts: Exactly. It is really that easy. I know it's hard to carve out the time and to get in. . oftentimes doctors offices have wait lists and stuff but it really is that easy. This is a completely preventable disease. and I think that with highly effective screening strategies and, advances in safe and effective, treatment options, it really is reasonable to aim for a world in which Women no longer develop or die from cervical cancer.
Amanda Wilde (Host): Well, Dr. Roberts, thank you for your expertise in explaining how we can treat and even avoid cervical cancer.
Dr Maureen Roberts: Thank you so much, Amanda, for having me. It really was my pleasure.
Amanda Wilde (Host): That was Dr. Maureen Roberts, gynecologic oncologist with UPMC Women's Cancer Center. For more information, please visit upmc.com/centralpagynonc. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Healthier You a podcast from UPMC. I'm Amanda Wilde. Thanks for listening.