How We Treat Gynecologic Cancers

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

Learn more about cancer surgery.

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.

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 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.

Learn more about radiation therapy.

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

Learn more about chemotherapy and infusion therapy options.

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.

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.

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.