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​Gynecologic oncology

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

A gynecological oncologist will work closely with the rest of your care team to tailor treatments to your specific needs, reduce side effects, and address concerns such as fertility or sexual function issues.

Treatment of gynecologic cancers typically begins with a variety of tests and examinations, which may include a pelvic exam, ultrasound, imaging tests, and/ or lab tests. These procedures and tests help a gynecologic oncologist determine the type of reproductive cancer and its stage to better develop a targeted treatment plan.

Gynecologic oncologists are trained to treat gynecologic malignancies using a variety of tools and technologies, including targeted therapy, immunotherapy, chemotherapy and radiation therapy. These treatments are designed and delivered with the intention of treating the disease while sparing healthy tissue.

Surgery often is a first line treatment for many gynecologic cancers. The type of surgery may depend on the type of gynecologic cancer, its stage and a patient’s fertility concerns. The types of surgery performed to treat gynecologic cancers are listed below.

Hysterectomy

A hysterectomy is one of the most common surgical procedures used to treat gynecological cancers, such as uterine and ovarian cancer. In some cases, a partial hysterectomy is performed to remove just the upper part of the uterus. A total hysterectomy removes the entire uterus and the cervix. In a radical hysterectomy, the cervix, uterus, both ovaries, the upper part of the vagina and surrounding tissue is removed.

Learn more about hysterectomies

Lymphadenectomy

Lymphadenectomy, also known as lymph node dissection, is a surgical procedure to remove lymph glands so they can be examined and tested for signs of cancer. A lymphadenectomy is designed to determine whether cancer has spread to nearby lymph nodes. A limited, or regional, lymphadenectomy removes some but not all the lymph nodes in the area surrounding the tumor. In a total or radical lymphadenectomy, most or all the lymph nodes in the area are removed. Lymph nodes produce and store blood cells, and act as filters that help fight disease and infection. Lymph nodes are part of the lymphatic system, located throughout the body, including the neck, armpits, abdomen and groin.

Pelvic exenteration

Pelvic exenteration is a procedure to remove the uterus, cervix, vagina, ovaries, bladder, rectum—the organs in the pelvic cavity—and nearby lymph nodes. This surgery requires patients to have procedures that reroute urine and feces out of the body. A pelvic exenteration may be an option for patients with advanced or recurrent cervical, uterine, vulval or vaginal cancers.

Salpingo-oophorectomy

A salpingo-oophorectomy is the surgical removal of the ovaries and fallopian tubes. A unilateral salpingo-oophorectomy is the removal of one ovary and fallopian tube. A bilateral salpingo-oophorectomy (BSO) is the surgical removal of both ovaries and both fallopian tubes. This procedure may be performed as an open surgery or a laparoscopic procedure. A salpingo-oophorectomy may also be performed as a prophylactic procedure to reduce the risk of ovarian and breast cancers.

Learn more about salpingo-oopherectomies

Intraperitoneal chemotherapy

Intraperitoneal chemotherapy delivers chemotherapy drugs directly into the abdominal cavity. It may be a treatment option for patients with ovarian cancer that has spread inside the abdomen. A similar form of this treatment is called hyperthermic intraperitoneal chemotherapy (HIPEC), which circulates heated chemotherapy drugs throughout the abdomen during surgery.

Learn more about intraperitoneal chemotherapy and HIPEC

Vulvectomy

One approach to treat vulvar cancer surgically removes all or part of the vulva, the external area of the female genitalia, including the labia, clitoris and vaginal opening. A partial vulvectomy is a procedure to remove a portion of the vulva and underlying tissues. A radical vulvectomy, which is rare because it is considered extensive, involves removing the entire vulva, including the inner and outer lips and the clitoris. The lymph nodes that drain lymph fluid away from the vulva may also be removed. Surgery may be recommended in combination with other cancer treatments, such as chemotherapy, radiation therapy or hormone therapy.

Beside hysterectomy or salpingo-oophorectomy, other surgeries that may be used to treat ovarian cancer include:

The da Vinci® Surgical System may be an option for some gynecologic cancer patients, offering a minimally invasive alternative to complex surgery that may result in fewer side effects. Despite smaller incisions, this robotic surgical system allows the gynecologic oncologist to remove the uterus, cervix, ovaries and appropriate lymph nodes and perform other surgeries to treat gynecologic cancers.

Fertility-sparing options

If you want to have children, it's important to know that certain gynecologic cancer treatments may interfere with your fertility and prevent or complicate pregnancy. We’ll address your questions and concerns, to help you make more informed decisions about your care. If you decide you want to preserve your fertility, we'll discuss with you a variety of fertility-sparing options as early in the treatment process as possible.

In addition to fertility concerns, our gynecologic oncologists understand the impact of gynecologic cancer and its treatment on other aspects of a woman’s life, including sexuality, physical and emotional well-being, and family dynamics. Throughout your treatment, we may suggest supportive services, like nutrition therapy, naturopathic medicine, pain management, counseling and physical therapy, to help reduce treatment-related side effects, including sexual side effects, and improve your quality of life.

Learn more about women and cancer