Abdominal bloating, pelvic pain, early satiety or feelings of fullness while eating, and spotting after menopause are considered to be some early signs of gynaecologic cancers. “These signs are often ignored as minor inconveniences until they advance,” said Dr Stephanie Ricci, the newly appointed female gynaecologic oncologist at Cleveland Clinic Abu Dhabi.
Ricci has treated cancer patients for six years at the US-based Cleveland Clinic. She notes that awareness around gynaecologic cancers in the UAE is equally low to women in the United States. “Women take some of the warning signs of cancers quite lightly and do not schedule regular appointments with their gynaecologist. Most of these cancers are more likely to be cured if they are discovered early,” says Dr. Ricci.
She has stressed that women must pay attention to even the slightest change or irregularities in their body and visit a doctor for complete investigation.
Common signs of gynaecologic cancer include pelvic pain or pressure, vaginal bleeding or discharge, itching or burning of the genitals, increased urination, constipation or diarrhea, and bleeding or spotting after menopause.
Cervical cancer is the fourth most common cancers, uterine cancer is the sixth and ovarian the eighth most common cancer in women globally. Risk factors include family history, age and obesity.
Dr. Ricci says that she has seen many patients with advanced disease at Cleveland Clinic Abu Dhabi. “Women are not being diagnosed early enough because they are referred to different physicians for their symptoms, which delays treatment,” she said.
“There are very few female gynaecologic oncologists in the UAE and such cancers can go undetected without the right multidisciplinary expertise. Another important factor contributing to such advanced disease here is that women often stop seeing their gynaecologist after they have had children.”
The expert added, “For women who have reached menopause, it is very important that they see a doctor if they are bleeding again. Patients believe that a little spotting post menopause is not concerning, but this is never normal and can be a sign of endometrial cancer, which begins in the inner lining of the uterus. This cancer is curable if found at an early stage. Once metastatic, the recovery rate drops significantly.”
According to Ricci, the ways to reduce risk of gynaecologic cancers are: annual examination with pap smears, investigating issues of pelvic pain, abdominal bloating and abnormal menstruation, and scheduling a mammogram and colonoscopy based on health history and age.
“Your doctor can order further tests, including genetic testing, and recommend a treatment plan with the right diet and lifestyle changes to reduce the risk of cancer or prevent it altogether,” she said.
“Advancements in not only treating but also diagnosing these cancers means that patients have better outcomes and a faster recovery,” said Ricci. "For patients with endometrial cancer, we can do a minimally invasive laparoscopic hysterectomy, and a sentinel lymph node mapping to determine whether the cancer has spread, and they can go home the same day.”
“The incisions are small and the surgery is completed in less than two hours. Immunotherapy, where we take advantage of a person’s own immune system to help kill cancer cells, is also emerging as a viable treatment option for patients with ovarian, cervical, and endometrial cancer,” Ricci pointed out.
Dr. Ricci has recently joined the oncology team at Cleveland Clinic Abu Dhabi as first female and US Board Certified gynecologic oncologist of the hospital. Her experience and expertise include diagnosing and treating cancers of the female reproductive system, including uterine, ovarian, vaginal, cervical and vulvar cancers.