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live in good health Doctor's Get a pelvic exam every year. "Like having a general physical by your regular doctor, it's a way to make sure everything looks healthy," says Rose. Exams should include a Pap smear, a pelvic exam, a bimanual exam (a physician feels on top of the pelvis for masses) and a recto-vaginal exam (a physician feels behind the uterus and recto- vaginal septum for masses or other signs). Orders By Kelsey Bewick There's no time to be hush-hush about what's going on "down there" when gynecological cancers are on the rise. Dr. Stephen Rose, gyneco- logical oncologist at UW Health offers five easy tips for knowing your body and staying aware of your gynecological health From the Expert To remain vigilant about your health, awareness is key. Dr. Rose offers the basics on the five major gynecological cancers Uterine Cancer What it is: The most common type of uterine cancer is endometrial cancer, which is found in the lining of the uterine cavity. If detected early, uterine cancers are very curable. Common symptoms: Vaginal bleeding, including bleeding after menopause or irregular bleeding after age 40. Know your risk factors. Risk factors for developing uterine and ovarian cancer include: never being pregnant, early onset of menarche (when girls start menstruating) and late menopause. Obesity and diabetes are additional risks for endometrial cancer. For both cervical cancer and vulvar cancer, smoking and exposure to the HPV virus increase your risk. Rose also says that some women have a genetic predisposi- tion to ovarian cancer, specifically if they have strong family histories of breast and ovarian cancers. Talk about the embarrassing stuff. Sometimes a doctor may not ask the questions that could embar- rass patients while patients can be reluctant to bring certain issues up. "Anything that is a little out of the ordinary, even if it's embarrassing … can be important," says Rose. Cervical Cancer What it is: Cancer of the cervix—the opening into the uterus—is gener- ally caused by the HPV virus and is screened for with a Pap smear. Common symptoms: Vaginal bleeding, especially bleeding or spotting after intercourse, a clear watery vaginal discharge, back pain and leg swelling. Keep track of your menstrual cycle. While an irregular cycle isn't often a red flag for cancer in younger women, those over 40 should take note. Abnormal bleeding can be a sign of uterine cancer. "For women approaching menopause, if your periods are irregular you definitely want to bring that up with your doctor," Rose says. Get it checked. If something is both- ering you, or if you're presenting any symptoms, Rose says be safe. Listen to your body, talk to your doctor (remember: even about the embar- rassing stuff!) and get checked. Ovarian Cancer What it is: Cancer of the epithelium (or surface) of the ovary. Common symptoms: Once called "The Silent Killer" because it was thought that symptoms didn't present until later stages, doctors now know to stay aware of early symptoms such as abdominal bloating and pain, pelvic pressure, frequent urination, constipa- tion and diarrhea. Vulvar Cancer What it is: A rare cancer of the skin on the outside of a woman's bottom or the perineum, labia minora and labia majora. Common symptoms: Bleeding, a lump or mass on the vulva and irritation of a certain area of the vulva. Vaginal Cancer What it is: An extremely rare cancer of the top of the vagina. Common symptoms: Pain with intercourse and bleeding after intercourse. 12 BRAVA Magazine September 2011