Gynecologic Cancers

Symptoms of gynecologic cancers can be vague or mimic other conditions, making awareness crucial. Regular gynecologic exams can help identify conditions such as cervical cancer through pap smears, as well as concerns like abnormal or postmenopausal bleeding and vulvar lesions that may require further evaluation. While specific signs vary by cancer type, general symptoms that warrant medical attention include:

• Abnormal vaginal bleeding or discharge (especially postmenopausal bleeding) 
• Vaginal discomfort
• Pelvic or abdominal pain or pressure 
• Bloating or changes in appetite
• Changes in bowel or bladder habits (increased urination frequency, constipation)
• Itching or burning of the vulva
• Changes in vulvar skin color or texture (rash, sores, warts)

If you experience persistent signs of gynecologic cancers, consult your doctor or gynecologist promptly. At St. Luke's, diagnosing gynecologic cancers involves a comprehensive approach:

• Pelvic Exams and Imaging Tests: A routine check allows doctors to feel for abnormalities in the uterus, ovaries, cervix, and vagina, while imaging tests such as transvaginal ultrasound, CT scans, or MRI scans can help visualize the reproductive organs and detect tumors or other abnormalities.
• Biopsy and Pathology Review: The definitive diagnostic test, involving the removal of a small tissue sample for microscopic examination. This can be done via colposcopy (for cervix/vagina), hysteroscopy (for uterus), or laparoscopy/surgery (for ovaries).
• Genetic Testing: Can provide referral for risk reducing surgical intervention when appropriate (e.g., BRCA or Lynch syndrome)

Our goal is to provide answers quickly, clearly, and with the support you need to move forward with confidence.

Gynecologic cancers are classified by their origin:

• Uterine Cancer (Endometrial Cancer): Starts in the lining of the uterus (endometrium). Most common gynecologic cancer, often presenting with postmenopausal bleeding.
• Cervical Cancer: Starts in the cervix, the lower part of the uterus. Largely preventable with HPV vaccination and regular Pap/HPV screening.
• Ovarian/Fallopian Tube/Peritoneal Cancers: With many sub-types, can come from the ovary or fallopian tube. Often diagnosed at later stages due to vague symptoms.
• Vaginal Cancer: Rare cancer starting in the vagina.
• Vulvar Cancer: Rare cancer starting on the outer female genitalia (vulva).

Gynecologic cancer staging: Staging (typically Stages I-IV) describes how far the cancer has spread from its origin and can be different based on different origins. It considers tumor size, lymph node involvement, and metastasis to distant organs. Accurate staging is crucial for determining the best treatment plan. Our specialists will carefully explain your specific cancer type and stage.

Multidisciplinary Breast Case Conference
Your case may be discussed in a multidisciplinary conference (also known as a tumor board), where specialists review your diagnosis, imaging, and treatment options together. This collaborative approach supports:

• A unified and coordinated treatment plan
• Thoughtful consideration of complex decisions
• Alignment across your entire care team

You benefit from a group of experts working together to determine the best path forward.

Mee Your Care Team
Your care may involve a range of specialists, including:

• Gynecologic Oncologists: Specially trained to provide both surgical care and chemotherapy management, allowing for a more streamlined, coordinated approach to treatment
• Radiation Oncologists: Provide radiation therapy when appropriate
• Genetic Counseling & Testing Specialists: Support risk assessment and personalized care planning
• Clinical Trials Team: Connect patients to innovative treatment options
• Advanced Practitioners: Provide ongoing care, symptom management, treatment coordination, and patient education
• Pathologists: Examines tissue, biopsy, and surgical specimens to make a diagnosis
• Radiologists: Interprets imaging studies to detect and characterize tumors

Together, this team ensures your care is coordinated, personalized, and aligned with your needs.

St. Luke's offers a full spectrum of advanced treatments that are provided by our specialized gynecologic oncologists. Your treatment plan is designed around your diagnosis, your goals, and your life circumstances.

Treatment may include:

• Gynecologic Oncology Surgery: Procedures vary widely depending on the cancer type and stage, ranging from minimally invasive procedures (laparoscopic or robotic hysterectomy, ovarian cyst removal) to more extensive surgeries (debulking for ovarian cancer).
• Radiation Therapy: Uses high-energy rays to kill cancer cells. Can be delivered externally or internally (brachytherapy). Commonly used for cervical, uterine, vaginal, and vulvar cancers, often in combination with chemotherapy.
• Chemotherapy: Uses drugs to kill cancer cells throughout the body. A key treatment for ovarian cancer and used for other types, especially if advanced or recurrent.   
• Targeted Therapy: Drugs that target specific molecular changes in cancer cells (e.g., PARP inhibitors for some ovarian cancers).
• Immunotherapy: Treatments that harness the immune system to fight cancer, showing promise in certain gynecologic cancers, particularly those with specific genetic markers. 
• Hormonal Therapy in Select Cases: Used for certain types of uterine cancer that are sensitive to hormones.
• Clinical Trials: St. Luke's offers access to cutting-edge clinical trials for gynecologic cancers.

Your care team works closely with you to ensure treatment decisions consider not only effectiveness, but also fertility, long-term health, and quality of life.