Diagnosis & Treatment
Screening & Diagnosis
If tests are needed to assess the results of a positive Pap smear or diagnose the cause of gynecologic symptoms, we offer:
- Physical examination
- Imaging exams such as ultrasound (sonogram), CT, MRI, and PET/CT scanning
- Biopsy to remove a sample of tissue to analyze for cancer cells
How We Treat Gynecologic Cancers
If you have been diagnosed with a gynecologic cancer, your treatment may include surgery, medical treatments, radiation therapy, or a combination of those approaches, depending on the type, stage, and biology of your cancer.
Minimally invasive gynecologic surgery. Our gynecologic oncologists take a minimally invasive approach to surgery whenever possible. You may have laparoscopy or robotically-assisted surgery, which can often be performed as an outpatient procedure and is associated with smaller incisions, less blood loss, and a shorter recovery time than open abdominal surgery.
Whether surgery is minimally invasive or performed through an open skin incision (“laparotomy”), our surgeons are exceptionally skilled at performing gynecologic cancer surgery, including these specific procedures:
- Laser surgery for precancers of the cervix, vagina, or vulva
- Surgical removal of affected tissue for cervical pre-cancers (“LEEP” and conization procedures)
- Hysteroscopy to look inside the uterus, take biopsies, and at times remove a polyp or mass for diagnosis
- Risk-reducing surgery to remove the fallopian tubes and ovaries and/or uterus to reduce cancer risk, depending on family history, genetic predisposition, and age/fertility goals
- Vulvectomy to remove part or all of the vulva for pre-cancers or cancerous lesions
- Hysterectomy (removal of the uterus and cervix) and sometimes the ovaries and fallopian tubes (salpingo-oophorectomy), depending on the diagnosis
- Radical trachelectomy — removal of the cervix and the upper part of the vagina, leaving the body of the uterus in place for future pregnancy
- Lymph node assessment, including “sentinel” lymph node mapping — assessment of the local lymph nodes in the pelvis for cancer spread to help “stage” the cancer and guide treatment recommendations
- "Debulking" surgery for ovarian, fallopian tube, and primary peritoneal cancers — extensive removal of tissue in the abdomen that contains ovarian cancer cells
- Fertility-preserving surgery. If you wish to become pregnant after your treatment is over, we have expertise in fertility-sparing surgery whenever feasible that can preserve the ability to have children without compromising your outcome. We can collaborate with infertility specialists to review your fertility preservation options. Embryo freezing and egg freezing are sometimes available before you begin your cancer treatment, and in vitro fertilization afterward.
Chemotherapy and immunotherapy. Most individuals with ovarian cancer and others with a gynecologic cancer that has spread need chemotherapy to kill any cancer cells remaining in the body. Patients with certain types of advanced cervical cancer, endometrial cancer, or ovarian cancer may receive immunotherapy, which boosts the ability of the immune system to detect and kill cancer cells. Intravenous treatments are provided in our modern and comfortable Infusion Center, where you are monitored by our experienced oncology nurses. Some vulvar precancers (such as vulvar intraepithelial neoplasia) are treated with topical chemotherapy, which you can apply yourself at home as a cream or lotion.
Targeted therapies. Precision medicine — tailoring treatment to the biology of your tumor — enables us to offer targeted therapies for some gynecologic cancers, such as PARP inhibitors for some advanced ovarian cancer.
Hormonal therapy. Some patients with uterine cancer receive hormonal therapy to inhibit tumor growth. Your doctors will let you know if this is an option for you.
Radiation therapy. Our goal is to destroy cancer cells while sparing as much healthy tissue as possible, using techniques such as external beam radiation therapy. In very few cases, individuals with uterine sarcomas receive radiation therapy before surgery to shrink the tumor.