Gynecologic Cancer

Gynecologic cancer is one of the more common forms of cancer. In fact, more than 90,000 women are diagnosed with it each year. These cancers are highly treatable, especially when caught early. You can trust us for education, early detection and screening, genetic risk factor assessment and next steps after a diagnosis.

When you’re diagnosed with a gynecologic cancer, every day counts. We help you review and understand your options quickly. Our compassionate care team provides in-depth expertise, and your nurse navigator will be with you every step of the way so you can begin treatment within days after cancer is detected.

Gynecologic cancer detection and diagnosis

Gynecologic cancer is any cancer that starts in the female reproductive organs. This can include cervical cancer, endometrial cancer, ovarian cancer, uterine cancer, vaginal cancer or vulvar cancer. When you notice a change in your body at home, or when something is detected during an annual exam, we’ll work quickly to get a diagnosis. You’ll usually be referred to our advanced imaging services and may need a biopsy. A pathologist, a doctor who specializes in diagnosing disease, will look at your cell samples to identify the presence of cancer and determine its type and whether it’s noninvasive or invasive.

Innovative technologies offered at SCL Health

We target gynecologic cancer with some of the most advanced treatments and technology available. Our accredited cancer programs may offer:

• Minimally invasive surgery – A surgical technique requiring smaller incisions so you can heal faster. Used to remove cancerous tumors in the uterus, ovaries or cervix.
• Minimally invasive robotic-assisted surgery – A robotic surgical system designed to facilitate complex surgery using a minimally invasive approach. This system enables surgeons to make smaller, more precise movements with tiny instruments inside your body, which can help you heal more quickly. Robotic-assisted surgery is used for partial or total hysterectomies and removal of the ovaries.
• Radiation oncology concentrated dosing – A radiation therapy administered during surgery to the area where the cancer was removed. This treatment does as little damage as possible to normal tissue.
• Intraperitoneal chemotherapy – This chemotherapy treatment is most effective for ovarian cancer and is delivered directly into the abdomen during surgery through a lining in the stomach.

You will need to call your local hospital to learn which of these options are available in your area.

How We Treat Gynecologic Cancers

You are unique, which means your treatment plan will be designed specifically around your needs. Every week, a team of specialists meets to discuss gynecologic cancer cases and collaborate on the best treatment for each patient. You benefit from the combined expertise of specialists in radiology, surgery, pathology, pharmacology, oncology and therapists in fields like physical therapy and psychology.

Your recommended treatment will be based on best practices that have worked for other patients, specific aspects of your cancer/tumor, the results of all your tests, the type of cancer you have, the stage of your cancer and your personal preferences.

Gynecologic cancer is typically treated through a combination of treatments, such as radiation therapy, infusion, chemotherapy or other specialized therapies. Surgery is often done to remove the tumor or affected organs.

Cancer Surgery

Surgery is the most common way to treat most gynecologic cancers, although your doctor may recommend a different treatment option first.

Cervical cancer surgery

There are a number of surgical options for cervical cancer. Cryotherapy uses very cold temperatures to freeze and kill cancer cells while laser surgery can be used to burn off abnormal cells found in the cervix. A hysterectomy, either simple (removing the uterus and cervix) or radical (removing the uterus, tissues next to the uterus and the upper part of the vagina next to the cervix) is a treatment course as well. The ovaries and fallopian tubes are not removed as part of cervical cancer surgery.

Endometrial cancer surgery

Surgery is often the main treatment for endometrial cancer, involving removal of the uterus and possibly the cervix. Often the removal of one, or both, fallopian tubes and ovaries is needed as well as removal of lymph nodes. In some cases, pelvic washings are done in which the abdominal cavity is flooded with saline, and if the cancer has spread, your surgeon will do a debulking procedure to remove as much cancer as possible.

Ovarian cancer surgery

Surgery is the best treatment for most ovarian cancers. Goals of ovarian cancer surgery are to see how the cancer has spread and to remove as much of the cancer/tumor as possible. For women who want to preserve the option of having children, early detection and treatment may make it possible to avoid removal of both ovaries and the uterus.

It’s recommended that your surgery be performed by a gynecologic oncologist, a specialist in the treatment and surgical removal of ovarian cancer, especially if you’ve been diagnosed with epithelial ovarian cancer (cancer found in the cells that cover the surface of the ovary).

Uterine cancer surgery

Surgery is the main treatment for uterine sarcoma. In a simple hysterectomy, the whole uterus and the cervix are removed, and the surrounding tissue is left intact. In a radical hysterectomy, the uterus, tissues next to the uterus and the upper part of the vagina next to the cervix are removed. The ovaries and fallopian tubes are often removed as part of uterine cancer surgery. Your doctor may also do surgery to see if the cancer has spread to the lymph nodes in your pelvis, which may require other types of treatment after surgery.

Vaginal cancer surgery

Surgery is not usually the recommended treatment option for vaginal cancer. Vaginal surgery may be recommended when cancer is detected early, but most typically it’s done when radiation therapy is unsuccessful in treating all the cancer.

Vulvar cancer surgery

Surgical options vary for women diagnosed with vulvar cancer. This type of surgery can significantly impact a woman’s sexuality and quality of life. The earlier vulvar cancer is detected and treated, the less invasive surgery will need to be. The goal is to leave as much healthy tissue as possible, but when cancer is more advanced, extensive procedures, like a vulvectomy, may be necessary.

After a vulvectomy, surgery may be used to reconstruct your genitalia using your own skin and underlying fatty tissue.

Cryotherapy

Also known as cryosurgery or cryoablation, cryotherapy is used to treat early-stage cervical cancer. Cryotherapy uses very cold temperatures to freeze and kill abnormal cells and can often be done as an outpatient procedure in your doctor’s clinic.

Radiation therapy

Radiation therapy uses either external high-energy X-rays or radioactive particles internally, in or near the cancer, to kill the cancer cells. This treatment can be used to shrink a tumor before surgery or to kill cancer cells that may remain in the pelvic, abdominal or groin region after surgery. Radiation therapy is often used for cervical cancer, endometrial cancer, uterine cancer and vulvar cancer and is the most common treatment for vaginal cancer. Radiation therapy is rarely used as the main treatment for ovarian cancer, although it is useful in treating any areas where the cancer has spread.

Chemotherapy and infusion

This treatment uses powerful medicines to kill cancer cells all through the body. It may be used to shrink a tumor before surgery or to kill any cancer cells that remain after local treatments. Chemotherapy may also treat tumors that have grown in other places in the body. Gynecologic cancer that has spread is usually treated with chemotherapy, sometimes in combination with hormone therapy or radiation therapy. Chemotherapy is often used for:

• Cervical cancer (often with radiation therapy)
• Endometrial and ovarian cancers (often as a combination of chemotherapy and other cancer-fighting drugs; used rarely as the main treatment for ovarian cancer)
• Uterine cancer (as the main therapy or in combination with surgery and radiation)
• Vaginal cancer (as the main treatment if the cancer has spread)
• Vulvar cancer

Targeted therapy

Targeted therapy uses drugs that are different from standard chemotherapy medicines. These drugs target the parts of cancer cells that make them unlike normal cells and do so without affecting most normal, healthy cells. They may work when chemotherapy medicines don’t and often have less severe side effects. Targeted therapy is used to treat cervical cancer and ovarian cancer.

Hormone therapy

This treatment stops the growth of cancer cells that rely on certain hormones. Hormone therapy is done through medicines, such as progestins or tamoxifen, or through removal of the ovaries, which make hormones. Hormone therapy may be used after surgery to decrease the chance of ovarian, endometrial or uterine cancer coming back or a new cancer growing. It can also be used to treat cancer that has spread. It’s sometimes used with chemotherapy.

Pre-cancer treatments

Sometimes, abnormal cells are detected that are considered precancerous (meaning they have the ability to turn into cancer). For precancerous vaginal or vulvar cells, chemotherapy may be administered either through application of an ointment or injection of the drugs. Laser surgery is a second option for treatment of vaginal pre-cancer. During this procedure, a beam of high energy is used to burn off any abnormal tissue found. Laser surgery is very effective and works well for larger lesions.

For precancerous cervical cells, effective treatment options include laser surgery, cryosurgery (using extreme cold to destroy abnormal cells), loop electrosurgical excision procedure (LEEP, which uses an electric current passed through a loop of thin wire to remove abnormal cervical tissue) and cone biopsy (removal of a cone-shaped piece of tissue during a procedure called a colposcopy).

These treatments are not used for invasive cancer, or cancer that has spread from the lobule where it began. Any cancer with the potential to spread requires more aggressive cancer treatments.

Care and Support

Your care team

Our gynecologic care teams know that great care is the result of seamless communication between you, your family and your existing healthcare providers. When you have this kind of collaboration, you can expect a more efficient, effective and tailored approach to meeting your individual needs.

Cancer nurse navigators

One of your key team members is your nurse navigator, who serves as a patient educator and care guide focused on improving your cancer treatment experience. Your nurse navigator will assist you at every stage, help you understand your diagnosis and treatment options and coordinate care between your physician, surgeon and other support teams.

Life beyond cancer

With earlier detection, more patients are surviving gynecologic cancers than ever before. Our survivorship program gives you access to specialists who partner with you for your post-treatment. This program focuses on nutritional goals, healthy living and emotional well-being. We’ll also help you set up regular medical checkups with your primary doctor to prevent, detect and manage any complications related to your cancer or cancer treatment. Because you may be at higher risk for second cancers, screening and surveillance are essential to your long-term health.

Survivorship care

Talk with your doctor about developing a survivorship care plan. This document will summarize the cancer treatment you received and outline the medical guidance you’ll need as you transition to living beyond cancer.

Lymphedema treatment

Lymphedema occurs when lymphatic fluid accumulates in tissue and causes painful swelling, most often in the arms or legs. Lymphedema can occur in gynecologic cancer patients who’ve had all or some of their groin and abdominal lymph nodes removed.

Our trained specialists can provide relief from pain and swelling and help you prevent and manage lymphedema.