Gynecologic Oncology

Gynecologic oncology treatment

This page was reviewed under our medical and editorial policy by

Ruchi Garg, MD, Chair, Gynecologic Oncology, City of Hope Atlanta, Chicago and Phoenix

This page was reviewed on January 22, 2022.

At City of Hope, we know that gynecologic cancers are complex diseases that require expert, specialized care. The treatment we recommend will depend on a number of factors, including the type of gynecologic cancer you’ve been diagnosed with and whether it’s spread, while also taking into account your individual goals, needs and preferences. Your multidisciplinary team of gynecologic cancer experts will answer your questions and recommend treatment options based on your unique diagnosis and needs.

Cancer Treatment Centers of America® (CTCA) is now City of Hope®, joining forces to expand patient access to personalized, comprehensive cancer care.

What is gynecologic oncology?

Gynecologic oncology is a specialized field of medicine focused on cancers of the female reproductive system. Gynecologic oncologists are doctors who complete a four-year obstetrics-and-gynecology residency program after medical school and a three- or four-year fellowship in gynecologic oncology.

Gynecologic oncologists use their training and experience to manage all or most of their patients’ treatment, including diagnosing and staging the disease and performing surgery to remove the cancer.

Learn more about what gynecologic oncologists do

Types of gynecologic cancers

Gynecologic cancers include:

If you are diagnosed with one of these cancer types, it’s important to consult with a gynecologic oncologist to guide your treatment plan. Research suggests women with a gynecologic cancer who are treated by a gynecologic oncologist have better outcomes than those who aren’t.

Comprehensive risk assessment

When appropriate, gynecologic oncologists use advanced genomic testing to help determine which personalized treatment options are available for a particular patient. They may also use genetic testing to help prevent future disease and assess family members’ risk.

The risk assessment may include lifestyle recommendations, including:

  • Managing chronic conditions like hypertension and diabetes
  • Quitting the use of tobacco products
  • Losing weight if necessary

Treatments for gynecologic cancers

Before you begin treatment, our gynecologic oncologists and pathologists will work together to perform a comprehensive diagnostic evaluation, which may include a pelvic exam, ultrasound, lab and/or other imaging and blood tests, to determine the type and stage of the cancer. Our gynecologic oncologists may also use state-of-the-art robotic and minimally invasive surgical technology to locate and remove tumors that have spread in the pelvic and abdominal regions—and conduct sentinel lymph node dissections, which are performed to help prevent complications after surgery.

Surgical treatments

Types of surgeries performed to treat gynecologic cancers include:

  • Debulking: In this procedure, as much cancerous tissue as possible is removed and the remaining cancer treated with therapies such as chemotherapy and/or radiation.
  • Total hysterectomy: This surgery is performed to remove the entire uterus and cervix.
  • Radical hysterectomy: This procedure removes the entire uterus, the tissue on both sides of the cervix and the upper part of the vagina.
  • Unilateral salpingo-oophorectomy: In this surgery, one ovary and one fallopian tube are removed.
  • Bilateral salpingo-oophorectomy: Both ovaries and both fallopian tubes are removed in this procedure. This type of surgery may be performed to reduce the risk for ovarian and breast cancer.
  • Omentectomy: This procedure is performed to remove the omentum, an area of tissue rich in blood vessels covering the intestines and other organs in the abdomen. This is done to debulk or stage the cancer.
  • Lymph node removal: This surgery removes surrounding lymph nodes because they may contain tumor cells. This may also be necessary for staging the cancer.

Prophylactic surgery

Prophylactic, or preventive, surgery is performed to reduce the risk of cancer. The procedure is typically recommended for women who are at a high risk of developing a certain type of cancer. For example, a prophylactic hysterectomy with bilateral salpingo-oophorectomy may be recommended for women diagnosed with Lynch syndrome—an inherited condition that increases the risk of uterine and ovarian cancer—or who have tested positive for a BRCA mutation.

Other treatments

In addition to surgery, your treatment may include chemotherapy, targeted therapy, hormone therapy and immunotherapy, either alone or in combination. For example, after surgery, your gynecologic oncologist may administer chemotherapy, targeted therapy or immunotherapy, if needed.

For some patients with inoperable or surgically complex tumors or those who have a high risk of local recurrence, radiation therapy may be an option. Whenever possible, our radiation oncologists will employ intensity-modulated radiation therapy (IMRT) to spare normal tissue from radiation exposure, which tends to lower the risk of side effects.

Sexual wellness

Cancer patients may experience changes to their sexual desire, function and relationships during their treatment journey. Patients with any type of cancer may experience some level of sexual dysfunction, but those with gynecologic cancers are especially at risk for symptoms and side effects that may affect their sexual health. At City of Hope, our care teams include experts trained in helping patients address physical conditions, such as pelvic floor dysfunction, and psychological challenges that may impair their sexual wellness.

Learn more about our sexual wellness services 

Fertility-sparing options

If you plan to have children, it’s important to know that certain gynecologic cancer treatments may interfere with your fertility and prevent or complicate your ability to get pregnant or carry a baby to term. Our team will help address your questions and concerns so you can decide what’s best for you. If you decide you want to preserve your fertility, we’ll discuss with you a variety of fertility-sparing health care options as early in the treatment process as possible while weighing the risks and benefits for your oncologic care.

Some options for women with early-stage gynecologic cancers include:

  • For cervical cancers, leaving the uterus in place when treating the cancer surgically and removing part or all of the cervix, or, when radiation therapy is delivered as the primary treatment, moving the ovaries out of the way so they’re not exposed to the radiation beams
  • For early uterine cancers, treating the cancer with only hormone therapy and leaving the organs intact, or removing the uterus and leaving the ovaries
  • For certain stages and types of ovarian cancers, removing only one ovary and leaving the other ovary and the uterus intact

Pain management

Pain, a common early symptom of a gynecologic cancer, is often caused when a tumor presses on nerves, bones or organs. Many gynecologic cancer patients also experience pain after treatment, including surgery, chemotherapy and radiation therapy.

At City of Hope, pain management physicians are part of a multidisciplinary team of doctors and clinicians focused on evaluating, treating and managing acute (short-term) or chronic (long-term) pain for every patient who needs it. The pain management team at City of Hope focuses on treating patients with cancer-related pain using both prescription drugs and non-pharmaceutical strategies, so they can focus on healing while maintaining their quality of life.

Learn more about pain management at City of Hope

Supportive care at City of Hope

Cancer and its treatments may dramatically affect patients, both physically and emotionally. Common symptoms and side effects such as fatigue, nausea and vomiting, neuropathy, mouth sores and depression may be treated with supportive care therapies.

As part of our whole-person model of care, the gynecologic oncologists at City of Hope help patients connect with supportive care clinicians to help manage challenges, before, during and after treatment. Supportive care services may include:

Learn more about supportive care at City of Hope

Our Gynecologic Cancer Centers

At City of Hope, cancers of the female reproductive system are such an important focus that our hospitals in Atlanta, Chicago and Phoenix each has a Gynecologic Cancer Center, where multidisciplinary teams of gynecologic cancer experts develop a comprehensive treatment personalized to the patient’s individual needs and goals. This patient-centered approach is driven by our patient-focused care model, encouraging us to treat all our patients with the compassion, dignity and respect they deserve—just as we’d want our own loved ones to be treated.

For patients who qualify, we offer carefully selected clinical trials. Your care team will discuss with you whether you’re a candidate for any of our ongoing clinical trials and, if so, help you enroll.

Learn more about the our clinical trials program and which trials are available

If you’re interested in learning more about gynecologic cancer treatment at City of Hope, or if you want a second opinion about your diagnosis and treatment plan, call us or chat online with a member of our team.

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