Pelvic cancer is a collective term for any malignancy that originates in the organs and tissues within the pelvis, the basin-shaped structure at the base of the spine. This region houses the bladder, rectum, and the reproductive organs. A diagnosis of “pelvic cancer” is a location-based description that encompasses many distinct types of cancer affecting different organ systems within this confined space.
Specific Cancers Found in the Pelvic Region
Cancers categorized as pelvic cancer vary significantly between biological sexes due to different reproductive anatomies. For individuals with female reproductive organs, the most recognized types are grouped as gynecologic cancers. These include cervical cancer, which originates in the lower part of the uterus, and uterine or endometrial cancer, which develops in the lining of the uterus. Other gynecologic malignancies are ovarian cancer, vaginal cancer, and vulvar cancer. For individuals with male reproductive organs, the most common pelvic cancer is prostate cancer, which develops in the small gland located below the bladder. Testicular cancer is also sometimes included in discussions of pelvic region malignancies.
Beyond sex-specific organs, the pelvis contains structures common to all individuals that can develop primary cancers. Bladder cancer begins in the lining of the bladder. Rectal and anal cancers are also considered pelvic malignancies, as the terminal parts of the large intestine are situated within this bony structure.
Additionally, primary cancers of the bone and soft tissue can occur in the pelvis. These tumors, known as sarcomas, include chondrosarcoma (cancer of the cartilage) and osteosarcoma (cancer of the bone), which affect the large pelvic bones. The diverse origins of these malignancies require specific identification of the originating tissue for proper classification and treatment.
Common Warning Signs and Symptoms
The physical manifestations of pelvic cancers are often vague in early stages, which can lead to delayed diagnosis. Symptoms typically arise when a tumor grows large enough to press on nearby organs, nerves, or blood vessels, leading to changes in normal bodily functions.
Abnormal bleeding or discharge is a frequent sign, especially in gynecologic cancers. This can present as post-menopausal bleeding, bleeding between menstrual periods, or bleeding after sexual intercourse.
Changes in urinary and bowel habits are also common indicators. These can include a persistent, urgent, or frequent need to urinate, sometimes accompanied by pain or blood in the urine. Similarly, pressure on the bowel can cause new-onset constipation, diarrhea, or blood in the stool.
Persistent pelvic pain or pressure is a generalized symptom that can signal a problem with any organ in the region. Individuals with ovarian or uterine cancer may experience chronic abdominal bloating, a feeling of fullness after eating a small amount, or increased abdominal size. Pelvic pain may also manifest as discomfort during sexual intercourse. Any new sore, lump, or persistent itching in the vulvar or anal area should be medically evaluated. Paying attention to persistent changes that are not normal for one’s body is the most effective approach for seeking timely medical attention.
How Pelvic Cancers Are Diagnosed
The diagnostic process begins with a comprehensive medical history and a physical examination, including a pelvic and rectal exam to feel for abnormal masses or tenderness. Initial laboratory tests involve blood work to check for general health indicators and specific tumor markers, such as CA-125, which can be elevated in ovarian cancer.
Imaging studies visualize the internal structures of the pelvis and determine the size and extent of any abnormal growth. Transvaginal or transrectal ultrasound uses sound waves to create detailed images. More advanced imaging involves a CT scan, which provides cross-sectional X-ray images, or an MRI, which uses magnetic fields and radio waves to create high-resolution soft tissue images.
A definitive diagnosis requires a biopsy, where a small tissue sample is removed for examination by a pathologist. This is often performed using an imaging-guided needle or during a minimally invasive surgical procedure called a laparoscopy. The biopsy determines the type and aggressiveness of the cancer cells.
Once cancer is confirmed, additional imaging, such as a PET scan, may assess if the disease has spread to lymph nodes or distant organs. The results from the physical exam, imaging, and biopsy are used to assign a clinical stage to the cancer, which defines the extent of the disease and guides the treatment plan.
Key Risk Factors and Prevention Strategies
Risk factors for pelvic cancers include non-modifiable elements like increasing age and a family history of specific cancers, such as those related to the BRCA1 and BRCA2 gene mutations. Genetic syndromes, including Lynch syndrome, also raise the likelihood of developing uterine and ovarian cancers.
Lifestyle factors represent the most actionable areas for prevention. These modifiable risks include:
- Smoking, which is a known risk enhancer for several pelvic malignancies, including cervical and bladder cancer.
- Chronic inflammation, obesity, and a sedentary lifestyle, which are strongly associated with increased risk for uterine and some other pelvic cancers.
- Persistent infection with high-risk types of the Human Papillomavirus (HPV), which is the primary cause of nearly all cervical and most vaginal, vulvar, and anal cancers.
Actionable prevention strategies focus on reducing exposure to these risks and engaging in proactive screening. The HPV vaccine is a highly effective preventative measure, recommended for individuals before they are exposed to the virus. Regular screening with the Pap test and HPV test allows for the detection of precancerous changes in the cervix, enabling treatment before cancer develops. Maintaining a healthy body weight through diet and exercise is also recommended to mitigate the risk associated with obesity.