Pink Prescriptions - September 2023
Show Your Body Some Love: Knowledge is Power When it Comes to Cervical Cancer, Ovarian Cancer, and Fibroid Tumors
September 2023 Issue — Pink Prescriptions
Show Your Body Some Love:
Knowledge is Power When it Comes to Cervical Cancer, Ovarian Cancer, and Fibroid Tumors
A woman’s health can be complicated, especially when it comes to the complex and intricate reproductive system. While this is the place in a woman’s body where miracles happen, it is also a place where things can go very wrong. We are addressing a few of these maladies this month, learning more about Cervical Cancer, Ovarian Cancer and Fibroid Tumors. Knowledge is power, and we encourage you to read on to learn what local experts have to teach us about these conditions.
By Dr. Tracy Blusewicz | Advanced Women's Care of the Lowcountry
Ovarian Cancer runs in my family. What types of screenings should I be looking for? What can I do to reduce my risk?
I wish I had an answer that there was an easy way to screen for ovarian cancer, but unfortunately, there is no reliable way when a woman doesn’t have any symptoms. This leads to ovarian cancer typically being detected in the later stages of progression, making ovarian cancer the fifth most common cause of cancer deaths in women. Often diagnosis is delayed due to vague symptoms or misdiagnosis since the symptoms are common to other medical issues like irritable bowel syndrome, constipation, stress, etc.
BUT ovarian cancer is rare with 19,710 estimated cases in 2023, which makes ovarian cancer account for approximately only 1 percent of all new cancer cases in the U.S.
Paying attention to your body and knowing what is normal for you is a key factor in detecting ovarian cancer, especially don’t ignore symptoms if they persist more than two weeks. Common symptoms include feeling full after eating only a few bites or loss of appetite, weight loss without dieting, bloating, distention of the abdomen causing the waist to feel too tight, or if you feel something hard in your abdomen. Also, increased urinary frequency and pressure on the bladder that’s not a UTI, diarrhea, constipation, or rectal pressure. Finally, pain in the abdomen or pelvis should be further evaluated. If you are experiencing symptoms like these it is always best to follow up with your doctor for an exam, possible ultrasound, blood work, or CT scan.
There are women who are more at risk for ovarian cancer: Women with Lynch Syndrome and the BRCA 1/2 mutation are associated with up to a 66 percent lifetime risk of ovarian cancer.
Women with a family history of ovarian, breast, pancreatic, colon, uterine, stomach, or prostate cancer should talk to their doctor about possible genetic testing for inheritable cancer risk. If a woman tests positive for certain genetic mutations, then risk-reduction surgeries can be performed, like removing the fallopian tubes or ovaries when childbearing is complete. Women who have used birth control pills for five or more years are at less risk for ovarian cancer, as are women who have given birth and breast fed. Having a tubal ligation puts a woman at less risk for ovarian cancer, as does having a healthy weight, not smoking, and following a healthy diet.
Nine in ten women with ovarian cancer have no significant family history, so all women should get routine, regular pelvic examinations and be aware of their body’s symptoms. You should always remember that self-care and watching out for your health is one of the most important things you can do.
Tracy Blusewicz, M.D., F.A.C.O.G., compassionate, genuine bedside manner has earned her the trust of many women for their health care needs. She can be contacted at Advanced Women’s Care of the Lowcountry | The Medical Spa 843-341-9700; www.awclc.com
By Eve A. Ashby, DO, FACOOG, Beaufort Memorial Lowcountry Medical Group
What are the pros and cons of getting the HPV (Human Papillomavirus) vaccine, and what is your advice on making a decision?
The HPV vaccine (called Gardasil) protects against high-risk types of the HPV virus which is sexually transmitted. Because it’s found on the scrotum, even a condom cannot completely protect transmission. Certain strains of this virus have been shown to cause cervical and penile cancer, venereal warts (condyloma), various types of genital cancers, anal and oropharyngeal (throat) cancer. Taking this vaccine, ideally before becoming sexually active, can help prevent abnormal Pap smears and many cancers affecting both men and women, with the most recent version protecting against nine of the most high-risk types of HPV.
The biggest “pro” of getting the vaccine is patients will have some protection should they decide to become sexually active because usually their partner won’t even know he is a carrier. It is estimated that 80 percent of sexually active people have been exposed to HPV, usually when they start having sex. While often our bodies fight this virus, sometimes it can lead to the cancers mentioned. Most Pap smears don’t screen for HPV unless they are abnormal however in women over 30, HPV screening can be done in addition to a Pap smear.
The side effects of getting the vaccine are usually mild and relate to pain and redness or swelling at injection site, fever, headache, fatigue, nausea, and muscle or joint pain. Rarely, a person might have an allergic reaction (hives, swelling, shortness of breath) and would require immediate treatment.
It’s hard to think about vaccinating a child against a sexually transmitted infection (STI) but I always point out that we don’t hesitate vaccinating babies against hepatitis which can also be sexually transmitted. This vaccine is just done during adolescence so that the maximal protection is afforded to them in adulthood.
Who should take the HPV vaccine?
It is recommended to give the first dose to females and males at 11-12 years of age (can be as early as 9, if indicated) and recently has been approved up to age 45. If given at a young age, only two shots are needed, if started at age 14, then three shots are needed. There are some children who may not be candidates, but your provider will screen for these situations. I also personally recommend it for older women who may be starting a new sexual relationship after being in a long-term monogamous relationship, since a new partner means potential exposure to different HPV subtypes. In addition, patients who already have abnormal Pap smears can opt to get the vaccine, but it will not cure the current infection, as currently there isn’t a treatment available.
Eve A. Ashby, DO, FACOOG, is a board-certified gynecologist with Beaufort Memorial Lowcountry Medical Group in Beaufort and Okatie. Dr. Ashby is also an Assistant Professor and Regional Director of Medical Education for A.T. Still University School of Osteopathic Medicine.
By Kirsten J. Nelson, M.D., Savannah Vascular Institute
Two-thirds of Women have Fibroids. Are You One of Them?
What are fibroids?
Fibroids can be a debilitating complication, and if you suffer from them, it’s easy to understand how true this can be. Fibroids are benign, non-cancerous growths in, or on the walls of, the uterus and are the most common tumors within the female reproductive system. Although all women are susceptible to developing uterine fibroids, several studies suggest African American women have a higher prevalence for fibroids, with 80-90% being diagnosed with the condition. Additional factors that contribute to a higher risk for fibroids include higher estrogen levels, excess body weight, a higher consumption of sugary foods, red meat, and alcohol, especially beer.
What are the symptoms of fibroids?
• Heavy menstrual periods • Pelvic Pain • Back Pain
• Frequent Urination • Infertility • Painful Intercourse
• Constipation
How do I know if I have fibroids?
Your doctor or gynecologist may discover one or more fibroids during a routine physical exam. Fibroids often cause the uterus to become larger, which means your doctor may notice if your uterus is enlarged and might even feel the fibroids. The simplest and quickest way to look for fibroids is through a pelvic ultrasound. Other diagnostic tests may include CT Scans and MRIs.
What are my treatment choices?
If you do not have symptoms, treatment is probably unnecessary.
Your physician may want to continue to monitor your condition. If you do have symptoms, several options are available such as medications, Endometrial Ablation, Myomectomy, Hysterectomy and Uterine Fibroid Embolization (UFE).
What is Uterine Fibroid Embolization (UFE)?
UFE is a minimally invasive procedure that blocks the blood flow to the fibroid(s), causing the fibroid to shrink and alleviating symptoms. UFE is a low-risk procedure that is an alternative to traditional surgery. With an added special pain management protocol, pain and discomfort are minimal, and recovery time is reduced to days instead of weeks or months.
How is Uterine Fibroid Embolization performed?
UFE is performed by an interventional radiologist, a board-certified physician specializing in minimally invasive, targeted treatments performed using X-rays and other imaging techniques to see inside the body and treat conditions without surgery.
Does Uterine Fibroid Embolization work and is it safe?
UFE is a safe and proven fibroid treatment, having been performed on hundreds of thousands of women over the past 20 years. UFE helps alleviate symptoms, such as heavy menstrual bleeding, and bulk symptoms, including pelvic pain and pressure, urinary frequency, and constipation. Ninety percent of women show significant improvement in symptoms and quality of life after UFE.
Every woman is unique, and before making decisions on what course of treatment to pursue for fibroids, she should discuss the variety of surgical and non-surgical fibroid treatment options in detail with her physician.
Dr. Kirstin Nelson, a Board-Certified Interventional Radiologist with Savannah Vascular Institute, has been performing uterine fibroid embolization (UFE) for more than 15 years, at Savannah Vascular’ s main office in Savannah and now, the new office in Bluffton, which is equipped with a state-of-the-art procedure room. She has a passion for helping women reclaim their life from fibroids. For more information call 912-352-8346.
Dr. Shelby Griffith | Riverside Women’s Care,
an Affiliate of Hilton Head Regional Physician Network
What are the current guidelines for Pap smear screenings?
The ASCCP, or American Society for Colposcopy and Cervical Pathology creates the Pap smear guidelines all OB/GYNs use. Pap smears begin at 21 years old and are every 3 years until the age of 30. At 30, they are every 5 years until 65. If at any point you have an abnormal Pap smear this timing will change, therefore you should discuss what timing is best for you with your OB/GYN.
What are the risks for cervical cancer?
The most important risk factor for cervical cancer is HPV, or Human Papilloma Virus. It is transmitted sexually, and it is so common, most people will get it at some time in their lives. Most people who have HPV will not develop cervical cancer, but greater than 95 percent of cervical cancers are related to HPV. There are not treatments for HPV, but there is a vaccine to help prevent it. Other important risk factors include having multiple sexual partners, high risk sexual partners, smoking, contracting other STIs, having HIV/AIDSs, low socioeconomic status, less than 3 full-term deliveries, and less than 20 years old at time of first delivery.
Dr. Shelby Griffith is a board eligible OB/GYN physician joining Riverside Women’s Care who is passionate about caring for women of all ages and all walks of life. Dr. Griffith is accepting new patients. Call (843) 580-3608 for an appointment or visit. www.hiltonheadregional.com.