As hard as it can be to talk about cancer, the discussion can get even tougher when it comes to cancers of the gynecologic organs, said Dr. Amy Wallace, a board-certified gynecologic oncologist with Novant Health Oncology Specialists in Thomasville and Winston-Salem.

As she points out, there is often a stigma around open discussion of cancer involving the vulva, vagina, cervix, uterus, fallopian tubes and ovaries. And the secrecy, shame, and/or embarrassment can mean the signs and symptoms may go unnoticed or even ignored.

More than 114,000 women will be diagnosed with a gynecologic cancer during 2023, The American Cancer Society estimates. Wallace said it’s a topic that demands attention.

To dispel the awkwardness and to start this much-needed conversation within our community, Wallace has shared her “3 S’s of gynecologic oncology: symptoms, screenings and shots.”


When it comes to cancer treatment, early detection is key, Wallace said. It’s important for women to know what symptoms should prompt an evaluation.

“Abdominal bloating, feeling too full after eating, swelling of the abdomen, and consistent abdominal pain can be symptoms of ovarian cancer,” she said. “Bleeding after intercourse, bleeding between periods, post-menopausal bleeding (bleeding after menopause), back or flank pain, and pelvic pain are symptoms associated with cervical cancer. Post-menopausal bleeding is also a common symptom of endometrial cancer.”

When evaluating symptoms at home, Wallace said it’s important not to jump to conclusions. Instead, she said, you should schedule an appointment with your gynecologist or primary care provider.


Often times a simple screening test will be used to detect cancer or find something that may be considered precancerous. The Pap test is a cervical cancer screening test which involves collecting cells from the cervix and examining them under a microscope. Those should start at 21.

“It is very important to have regular Pap tests so that precancerous cells can be identified and treated before they progress to cervical cancer,” Wallace said. “The majority of cervical cancer is caused by what is referred to as the human papillomavirus (HPV). Fortunately, the same cells collected for the Pap test can also be used to test for HPV.”

Wallace added that it is also important to know that having a pelvic exam is not the same as having a Pap test.

HPV testing can be added for women age 30 and older. Unfortunately, there are currently no proven screening tests for ovarian or endometrial cancers. In patients who have a strong family history of gynecologic cancers, genetic counseling may be pursued and there can be a discussion of screening in these high-risk women.


Dr. Wallace’s third “S” comes in the form of a simple shot. The HPV vaccine is FDA approved to help prevent HPV-related diseases including cervical cancer. HPV is transmitted through sexual intercourse making its exposure very common. Early vaccination is the best way to safeguard yourself from the virus. The HPV vaccine has been proven to be safe and is recommended by medical professional societies.

In addition to vaccines, Wallace recommends condom use and the avoidance of tobacco to help prevent cervical cancer. She also said obesity is one of the major risk factors for endometrial cancer, so staying at or getting to a healthy weight with diet and exercise can help prevent the most common types of uterine cancers.

Wallace added that any concerning finding or symptom should be brought up to your provider. If someone is diagnosed with a gynecologic cancer, it is recommended to seek care and undergo treatment by a specialist in gynecologic oncology. Studies have shown that women who are treated by gynecologic oncologists have improved outcomes, including improved survival.

“It’s time to stop tiptoeing around the subject of gynecologic cancer,” Wallace said. “My hope is that women feel empowered to learn more and to take an active role in monitoring all aspects of their health.”

About 1.7 million new cancer cases are diagnosed each year in the U.S. Here at Novant Health, our focus is on one — yours.

Photo - Dr. Amy Wallace is a board-certified gynecologic oncologist with Novant Health Oncology Specialists in Thomasville and Winston-Salem.