What is endometrial cancer? The wake of Gwen Ifill’s death at age 61

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BY  MIA DE GRAAF FOR DAILYMAIL.COM

Gwen Ifill, the respected PBS news anchor who died on Monday, was diagnosed with endometrial cancer less than a year ago.

The 61-year-old, who was best known as the NewsHour co-anchor, passed away surrounded by her family in a hospice in Washington.

The respected newscaster had moderated two vice-presidential debates, between John Edwards and Dick Cheney in 2004; and between Sarah Palin and Joe Biden in 2008.

Earlier this month PBS announced she would be taking time off for health reasons but gave no details.

Having kept the state of her health private, the news of her death on Monday sent shockwaves across the nation.

Hours later, her brother revealed Gwen was diagnosed with endometrial cancer at some point between the end of 2015 and the beginning of 2016.

Here we explain the symptoms of endometrial cancer, and how it differs to the four other gynecological cancers.

ENDOMETRIAL CANCER

Endometrial cancer, also called uterine or womb cancer, starts in the lining of the uterus.

It can spread, infecting the cervix, the outer lining of the womb, the ovaries, the fallopian tubes, the vagina, and the vulva.

Most sufferers will experience some tell-tale symptoms before the cancer develops, allowing it to be caught early.

However, unlike cervical cancer, standard tests (like pelvic exams and Pap tests) do not easily detect endometrial cancer.

The majority of women diagnosed with endometrial cancer (about 90 percent) have abnormal vaginal bleeding.

Some may experience a change in their periods (from heavy to light or vice versa), bleeding between periods, bleeding after menopause, or discharge tinted with blood.

These symptoms are not specific to cancer, but doctors advised seeing an ob-gyn to be safe.

Meanwhile some women may not see blood in their discharge, but rather a change in consistency. This should also be a warning sign, the American Cancer Society warns.

Other symptoms include pelvic pain and inexplicably losing weight.

As with many other cancers, if you feel a lump or mass, you should see your doctor.

Women most at-risk of contracting endometrial cancer are over 55, in late menopause, have never given birth, are infertile, are obese, have diabetes, have high blood pressure, or are on estrogen treatment or tamoxifen therapy.

An ultrasound is the most common test to detect endometrial cancer.

The next step is an endometrial biopsy, removing a piece of endometrium using a suction tube, to be tested.

In the case of a cancer diagnosis, CT, MRI and PET scans can then be used to see whether the disease has spread.

Finally blood tests can be carried out to detect whether a woman has a decreased blood count, since the cancer can cause anemia.

Treatments include surgery to remove the uterus, radiation therapy, and chemotherapy.

OVARIAN CANCER

Ovarian cancer is where the disease originates from the cells in and around the ovary.

The ovaries form part of a woman’s reproductive system, storing her supply of eggs.

Each month an egg is released into the womb, ready for fertilisation.

Ovarian cancer is the fifth most common cause of cancer death in women and accounts for more deaths in the UK than all of the other gynecological cancers combined.

If diagnosed at an early stage, the outcome is good.

However, because some of the symptoms of ovarian cancer are similar to those seen in more common conditions, it can be difficult to diagnose.

As a result, vast swathes of patients are not diagnosed until the disease has spread, increasing the likelihood they will succumb to the disease.

In addition, it is important to note, most tumours found on the ovaries are not cancerous, but benign.

One in five ovarian masses found in women still having their periods are cancerous.

That figure rises in post-menopausal women to one in every two tumors.

In the majority of cases, ovarian cancer affects women over the age of 50.

The key early signs and symptoms to be aware of are:

  • persistent pelvic and abdominal pain

  • persistent bloating

  • difficulty eating and feeling full quickly

  • urinary symptoms – a need to pass water more often than usual

These symptoms should raise concerns if they are frequent (happen more than 12 times a month), are persistent and new, not normal for you.

It is likely that these symptoms may not be a sign of ovarian cancer, but many patients experience the symptoms in the early stages of their disease.

Approximately one in every two women will develop ovarian cancer in their lifetime.

Though the cause of the disease isn’t yet properly understood, age and having a family history of ovarian cancer, increases a woman’s risk.

Two in 10 cases are thought to be linked to the inherited ‘faulty’ BRCA gene.

Carriers of the faulty BRCA1 or BRCA2 genes, like Hollywood star Angelina Jolie, are also at greater risk of developing breast cancer.

CERVICAL CANCER

Cancer of the cervix – the neck of the womb – affects women of all ages, but is most common in those aged 30 to 45 years old.

The disease is largely preventable, with screening programmes where women have regular smear tests, detecting pre-cancerous cell, which indicate an increased risk of cancer if they remain untreated.

In the future the HPV vaccine will prevent most forms of cervical cancer, but until a time when all women have had the vaccination, screening will remain to play a vitally important role.

As with all gynaecological cancers, the sooner cervical cancer is diagnosed, the better a woman’s chances of survival.

Important early symptoms are:

  • any unusual bleeding from the vagina, particularly after sex, or after the menopause when your periods have stopped

  • persistent vaginal discharge that is blood-stained or smells unpleasant

Nearly all cervical cancers are caused by the common, sexually transmitted infection, the human papillomavirus (HPV).

Most women will have HPV at some point in their lives, though for most the virus clears up of its own accord.

But, where the virus doesn’t go away, there is a risk of abnormal cells developing, which could morph into cancer over time.

To lessen the risk of developing the disease

  • go for cervical screening when invited

  • have the HPV vaccine, if offered

  • if you smoke, try to quit

  • use a condom to reduce the risk of contracting HPV

Even if you have had the HPV vaccine and have a normal cervical smear result, it is vital you raise symptoms with a doctor.

VULVAL CANCER

Vulvar cancer is one of the rarest forms of the disease, with around 1,000 cases diagnosed in the UK each year.

Eighty per cent of those are in women aged over 60, while the pre-cancerous form of the condition – vulval intraepithelial neoplasia – tends to be diagnosed in those aged 30 to 50.

Symptoms of vulval cancer include:

  • a lasting itch pain or soreness

  • thickened, raised, red, white or dark patches on the skin of the vulva

  • an open sore or growth on the skin

  • burning pain when passing urine

  • vaginal discharge or bleeding

  • a mole on the vulva that changes shape or colour a lump or swelling in the vulva

While all these symptoms can also be a sign of other, more common conditions, it is vital to see your GP if any persist.

The HPV vaccine is among the greatest protection available to the disease, as many forms of vulval cancer are triggered by the virus.

VAGINAL CANCER

Vaginal cancer is a very rare form of the disease, with just 250 cases diagnosed in the UK each year, according to The Eve Appeal.

As with all gynaecological cancers, it is most common in older women, in this case those over 60, while it is extremely rare in those aged under 40.

A condition called vaginal intraepithelial neoplasia, where there are changes to the cells in the lining of the vagina, can mean you’re at increased risk of the disease.

The condition only triggers cancer where it is not treated.

Cervical screening smear tests can help detect any changes in the cells in the lining of the womn.

And the HPV vaccine offers protection as vaginal cancer can be caused by the HPV virus.

Early symptoms of vaginal cancer are:

  • bleeding when you are not having a period or bleeding after the menopause – this is the most common sign

  • you may have bleeding after sex

  • vaginal discharge that smells or is blood stained – around three in 10 women have this symptom

  • pain during sex

  • a lump or growth in the vagina that your or your doctor can feel

  • a vaginal itch that won’t go away

As many as one in two women with vaginal cancer will have no symptoms at all.

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