Gynecologic cancer affects the female reproductive organs – including the cervix, Fallopian tubes, ovaries, uterus, vagina and vulva.
How is gynecologic cancer diagnosed?
Your physician may conduct one or more of the following procedures to search for a cancer or to find out where a cancer is coming from and where it is:
Dilatation and curettage (D&C) – a surgical procedure to remove samples of tissue from the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue for biopsy. This procedure is usually done under general or regional anesthesia, but often it is possible to conveniently take a smaller endometrial sample in the office without anesthesia.
Biopsy – a tissue sample is removed and then viewed under a microscope by a pathologist to check for signs of cancer.
Ultrasound exam – a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
Barium enema – a series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series. A barium enema can be uncomfortable and tiring, but typically takes only 30-45 minutes to complete.
CT scan (CAT scan) – a procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure isalso called computed tomography, computerized tomography, or computerized axial tomography.
MRI scan – Magnetic Resonance Imaging utilizes large magnets to produce very detailed images of your internal organs. The procedure usually necessitates lying flat and being able to keep relatively still. Sometimes gadolinium is injected into a vein to make the images clearer.
PET scan – Positron Emission Scanning is a study of the whole body which involves the injection of a small amount of tracer which is concentrated in areas of the body with high metabolic activity which might indicate the site of cancer. These ‘hotspots’ can be identified on the computer image. When a CT scan is performed in addition, the study can show with a high degree of accuracy exactly where the hotspot is situated. The very first combined PET/CT scan in the region was perfomed at the Brown Cancer Center.
Gynecologic cancer treatment options
If you have cancer, your treatment plan will depend on the location of the tumor, the stage of the cancer, your age, and other factors such as your general health. Whatever treatment plan your physician specifies will be carefully discussed with you, and you will have the resources of the Brown Cancer Center’s state-of-the-art technology and most advanced methods of treatment available. Treatment options may include one or a combination of the following:
Patients in good health are often offered surgery as treatment for gynecologic cancer. This surgery may include removing the cancer cells, tumor and/or infected tissue. If the cancer has progressed, some or all of the affected organ may be removed. In many cases, it is possible to perform minimally-invasive surgery with a laparoscope or with the da Vinci Si Surgical System. This enables you to recover from surgery much quicker with fewer complications, and in many cases leave the hospital within one to two days from surgery.
Radiation therapy, which is also called radiotherapy, uses high-energy rays to kill cancer cells. Before you undergo radiation, a radiation oncologist and physicist plan the precise delivery of the radiation to minimize radiation to your vital organs and maximize the radiation to the affected area.
Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer.
Chemotherapy uses drugs to destroy cancer cells. The drugs enter the bloodstream and travel throughout the body. Chemotherapy may be recommended to kill any remaining cancer cells following surgery, or to control cancer growth and relieve symptoms. Most chemotherapy drugs are given intravenously or by catheter.
Intraperitoneal (IP) Chemotherapy
During intraperitoneal chemotherapy, the chemotherapy is delivered directly into the abdominal or peritoneal cavity. As a result of clinical trials conducted at the Brown Cancer Center and elsewhere, the National Cancer Institute suggests that IP chemotherapy should be offered to all women with advanced ovarian cancer following optimal initial surgery.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is done in conjunction with the surgical removal of cancerous tumors and cells. Chemotherapy is heated and circulated directly into the peritoneal cavity.
Brown Cancer Center surgical oncologists and gynecologic oncologists are among the nation’s few highly trained physicians that specialize in this leading edge treatment plan. Please speak to your gynecologic oncologist about participating in possible clinical trials of this treatment.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Hormonal therapy keeps cancer cells from getting the hormones they need to grow. Like chemotherapy, hormonal therapy can affect the cancer cells throughout the body. In general, with hormonal therapy, you will not suffer hair loss or many of the other side-effects associated with chemotherapy.
Clinical Trials and Research
In addition to using the most advanced methods of diagnosis and treatment, the Brown Cancer Center is constantly examining new approaches to cancer treatment. Brown Cancer Center physicians participate in and initiate a wide range of ongoing clinical trials and research, giving you access to new therapies that may not yet be available in other parts of the world.
If you have general questions about your condition, the Brown Cancer Center, or free services available to you and your loved ones, please contact the M. Krista Loyd Resource Center at 502.562.4158 or 866.530.5516.