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Gynecologic oncology for cervical cancer

gynecologic oncology

Gynecologic oncology for cervical cancer

As a gynecologic cancer patient exploring treatment options at CTCA, you’ll meet with a gynecologic oncologist on your first visit. Your gynecologic oncologist will discuss everything going on with your health and spend as much time as needed addressing your questions and concerns.

After reviewing your medical records and health history, and performing a pelvic exam, your gynecologic oncologist will order the appropriate diagnostic tests to determine the best course of treatment. These may include biopsies and imaging scans, as well as blood tests.

You will meet again with your gynecologic oncologist, generally within two to three days of your first visit, to discuss the test results. At that time, we will discuss the treatment options available to you, as well as the ways in which integrative oncology services can be incorporated into your treatment plan.

Our gynecologic oncology team really tries to think outside the box. We individualize treatment using evidence-based medicine, tailoring a program to each patient. Your treatment plan may include surgery, chemotherapy or therapy with a monoclonal antibody. It all depends on your unique case and preferences.

How often do I get treatment?

Once you’ve begun your cervical cancer treatment, you’ll meet with our gynecologic cancer team approximately every three to four weeks in our Patient Empowered Care® clinic. Each time, you’ll undergo a comprehensive set of blood tests and a physical exam. You’ll also see every member of your treatment team, including your dietitian, naturopathic clinician and care manager.

Fertility concerns for younger women

For women with early cervical cancer, fertility-sparing surgery may be a treatment option. We consider fertility issues for younger women, and we provide support for all women who experience sexual side effects as a result of cervical cancer treatment, through our Survivorship Support program.

If you want to preserve your fertility during cervical cancer treatment, your gynecological oncologist can discuss with you a variety of fertility-sparing procedures and whether they might be right for you.

What is gynecologic oncology?

Gynecologic oncology focuses on the diagnosis and treatment of cancers of the female reproductive organs, including the ovaries, endometrium, uterus, cervix, fallopian tube, peritoneal, vagina and vulva.

A gynecologic oncologist is a medical doctor who receives an additional four years of training after completing a residency in obstetrics and gynecology. During this training, he or she acquires highly specialized expertise to stage, diagnose and treat all types of gynecologic cancer.

In addition to performing specialized surgical procedures, a gynecologic oncologist is trained to provide chemotherapy and comprehensive oncology care to a woman throughout the course of cervical cancer treatment. We specialize in advanced surgical techniques that remove cancer, while sparing healthy tissue.

The Gynecologic Oncology Program at Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center (Midwestern) specializes in treating women with cancer of the reproductive organs, including uterine, ovarian, cervical, vaginal and vulvar cancers.

Dr. Sybilann Williams, an experienced gynecologic oncologist, leads this exceptional program.

Dr. Giuseppe Del Priore answers the top 3 questions women have about treating cervical cancer.

Are there minimally invasive treatment options for cervical cancer?

Most surgical treatments for cervical cancer can be minimally invasive. These techniques include robotic, laparoscopic, hand-assisted laparoscopic surgery or a combination of these. With laparoscopic surgery, a surgeon makes smaller incisions than open surgery and uses several thin instruments, along with an attached camera. A surgeon can place a hand through an incision during hand-assisted laparoscopic surgery. This incision is still smaller than traditional surgery. Robotic surgery is similar to laparoscopic surgery in that it involves smaller incisions than open surgery. The technique calls for a surgeon to perform surgery by controlling robotic arms with a computer. Surgeons at Cancer Treatment Centers of America® (CTCA) perform minimally invasive treatments whenever possible and have been doing so for decades.

Are there alternatives to radical surgery and radiation therapy?

Providing optimal care means coordinating experts in all areas of cancer treatment, including imaging, pathology, psychology, medical, surgical and radiation oncology. CTCA brings all these experts under one roof directly to the patient. This approach helps incorporate the patients’ values into a comprehensive treatment plan and avoid radical, single modality therapies whenever possible. For instance, neoadjuvant chemotherapy, which is given before the primary treatment, can be administered for a short course to “downstage” an advanced cancer. Bringing the cancer down to an earlier stage may allow for a less invasive surgery. Similarly, combining surgery after radiation and chemotherapy might reduce the amount of radiation needed. Multiple treatment methods can be blended in different proportions to minimize toxicity from any one treatment depending on the unique needs of the patient.

Can I still have children after treatment?

Many women worry that a diagnosis of cervical cancer eliminates their chance to have children. Fortunately, early diagnosis and new treatment approaches can preserve fertility in most women with cervical and other gynecologic cancers. A cone biopsy or a trachelectomy can be used to treat women with early cervical cancer and even some with more advanced lesions. Early cervical cancer is defined as stage 0, in which cancer cells are confined to the surface of the cervix, and stage I, in which the cancer is deeper but also still confined to the cervix.

A cone biopsy, often used to diagnose cervical cancer, may be the only treatment needed for women with early stage cancer who want to have children. With this type of biopsy, a cone-shaped piece of tissue is removed from the cervix. Trachelectomy is a surgery that removes the entire cancerous cervix and the upper part of the vagina while retaining the uterine fundus, the top of the uterus that carries a pregnancy. Women have been able to carry to term and deliver healthy babies by Cesarean section after a trachelectomy. Even for women with more advanced stages, use of novel chemotherapy combinations can destroy enough cancerous cells to make a trachelectomy possible.

CTCA surgeons use all these techniques. It’s important to keep in mind that the ovaries often can be saved during cervical cancer treatment. Reproductive technologies often further broaden the options for women who want to get pregnant after treatment.