EASONS

HEALTH & WELLNESS
related cancers such as fallopian or peritoneal), as well
as those with a strong family history of breast cancer, are
typically referred to a genetic counselor who can determine
whether they would benefit from testing for genes like
BRCA1 and BRCA2 that put them at a higher risk for the
disease.
The majority of women with ovarian cancer don’t
actually carry those mutations, but having such mutations
increases ovarian cancer risk significantly. According to
the National Cancer Institute, 11 to 17 percent of women
who inherit the BRCA2 mutation and up to 39 percent
of women with the BRCA1 mutation will develop ovarian
cancer by age 70, compared to 1.3 percent of women in the
general population. Carriers are usually advised to undergo
risk-reducing surgery, which typically involves removal
of the ovaries and fallopian tubes after they are finished
with childbearing. On the medical side, researchers are
increasingly trying to target treatment to specific genetic
mutations for a more individualized approach. Recent
research has also led to the understanding that most of what
we call “ovarian cancer” actually originates in the fallopian
tubes.
Cervical and endometrial cancers
Cervical cancer is even less common than ovarian,
though recent research suggests that rates are on the rise.
“We have better screening techniques for cervical cancer—like
the Pap smear—and it’s also potentially preventable, thanks
to the HPV vaccine,” says Dr. Hansen. The majority of the
approximately 13,000 cases of cervical cancer diagnosed
nationally each year are caused by the human papilloma virus
(HPV), she says, and the Centers for Disease Control and
Prevention now recommends that all females—and males—
receive the vaccine when they are 11 to 12 years old. (HPV
is transmitted sexually and can also lead to vulvar, vaginal,
penile, anal, and oropharyngeal cancers). Unfortunately,
says Dr. Hansen, approximately 50 percent of people who
are eligible haven’t had the vaccine. Regular Pap smears
and annual pelvic exams are critical for the early detection
and prevention of cervical cancer. When a Pap smear
reveals abnormal cells (also known as cervical dysplasia),
the gynecologist removes those cells and thus eliminates
the chance of them ever developing into cancer. “And
most cervical cancers, if diagnosed early, can be cured,” Dr.
Hansen says.
Endometrial cancer is the most common of the
gynecologic cancers with about 60,000 new cases diagnosed
annually. There are two types of endometrial cancer, says
Dr. Hansen. One is high-grade and, like ovarian cancer,
tends to be aggressive. But the vast majority of endometrial
cancer cases, she says, are low-grade and the result of
hyperstimulation of the endometrial lining.
“Endometrial is the fastest growing type of gynecologic
cancer,” says Dr. Hansen. “As society gets more obese, we
are seeing more endometrial cancer occur and in younger
women than we had seen before.” She explains that adipose
(or fatty) tissue results in the production of extra estrogen,
which stimulates the endometrial lining. Obesity, in fact,
is a well-established risk factor for endometrial cancer.
According to Dr. Hansen, for women whose endometrial
cancer is diagnosed early, surgery is often the only treatment
they’ll need. Treatment typically involves a minimally invasive
hysterectomy including removal of the tubes and ovaries.
The most common sign of endometrial cancer is
postmenopausal bleeding. “Any change in bleeding is
something to talk to your gynecologist about,” she says,
noting that abnormal bleeding could also be a sign of cervical
or ovarian cancer. Benign causes, such as polyps, can lead to
abnormal bleeding, too, so this symptom is not always cause
for alarm, she adds, but you should still consult your doctor.
Dr. Hansen stresses the importance of regular gynecologic
check-ups.
Educating future physicians
Teaching was an integral part of Dr. Hansen’s fellowship
training, and one of the reasons she was attracted to Saint
Francis was because it provided her with the opportunity to
continue teaching residents and medical students. “I help
teach the residents who are part of the Ob/Gyn residency at
Saint Francis Hospital, as well as medical students from some
of the local medical schools like Quinnipiac and UConn, and
I really like that part of my job,” the doctor says. Residents
and medical students accompany her on her rounds and join
her in the operating room. “I hope that as I’m here longer, I
will move into a more defined role in resident and medical
student education,” she says.
Lori Miller Kase is a freelance writer living in Simsbury.
Photographer Seshu Badrinath of Avon specializes in
intimate, natural portraits of families and children;
seshuphotography.com
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Seasons of West Hartford • SPRING 2017