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Pain, Stigma, and Other Gynecologic Cancer Issues

Friday, March 20, 2020

Just as some women feel after undergoing a mastectomy for breast cancer, women undergoing treatment for gynecologic cancers can feel de-feminized, too, explained Don S. Dizon, MD, FACP, FASCO, head, women's cancers, Lifespan Cancer Institute; director, medical oncology, Rhode Island Hospital; associate professor of medicine, The Warren Alpert Medical School of Brown University.


It is striking how women who have had their ovaries and/or their uterus removed due to a gynecologic cancer have the same issues with body image. The de-feminization of a woman after surgery for a gynecologic cancer can be quite significant, and I would almost say it can be stigmatizing. I think that's something that I do confront, and sometimes it's something that needs to be worked out.

Issues regarding pain are more significant after radiation to the pelvis, for example. Women who have had radiation, their vaginas can close. This is a process called agglutination where the mucosa within the vagina gets so raw that as it heals, it scars. If women aren't careful or educated about that, one of the most depressing things I've seen is a woman where it has completely closed because it's agglutinated. One can surgically open up the vaginal vault, if there is such an agglutination. But it doesn't act like a normal, healthy vagina.

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