The gynecologic oncology program at M. D. Anderson – Orlando provides services for women who have been diagnosed with cancer of the reproductive organs and for those who experience other difficult gynecologic problems, such as masses that are suspicious for cancer or persistently abnormal pap smears. Board certified gynecologists and gynecologic oncologists on our staff provide patients with rapid and accurate evaluation, diagnosis, and treatment recommendations. Additionally, our physicians have the necessary expertise to perform radical surgery procedures or chemotherapy sometimes required in the treatment of patients with gynecologic malignancies.
Gynecologic cancers are found in the female reproductive tract and include ovarian, cervical, uterine, vaginal, vulvar, or tubal cancer.
Dr. Alan Gordon discusses Gynecologic Cancer
What is ovarian cancer?
Currently, ovarian cancer is the second most common malignancy of the female reproductive tract in the United States. About 90 percent of ovarian cancers are epithelial ovarian carcinomas. In this type of cancer, a malignant tumor originates in the lining from outside of the ovary. The risk of epithelial ovarian cancer increases with age, especially after 50. About 10 percent of patients have a strong family history of ovarian or breast cancer.
Germ cell tumors account for approximately 5 percent of all ovarian cancers and originate from egg-producing cells found within the ovary. This type of ovarian cancer can occur in women up to the time of menopause but about 80 percent are diagnosed in women under the age of 30.
Stromal tumors develop in the connective tissue that holds the ovary together and produces the female hormones estrogen and progesterone. These tumors account for about 5 percent of all ovarian cancers. These can occur in women of any age. Stromal tumors are relatively rare and usually less aggressive than other ovarian tumors.
What is cervical cancer?
The overall incidence of cervical cancer has declined since the mid-1940s with the introduction of the Pap smear and now 13,000 new cases are anticipated in the United States annually. It is believed that up to 95 percent of cervical cancer cases are linked to the human papilloma virus (HPV), a sexually transmitted infection, although most women infected with HPV will not develop cervical cancer. The use of a new vaccine against HPV should further reduce the number of new cases.
What is cervical dysplasia?
Cervical dysplasia is a precancerous change of the cervix that can lead to cervical cancer if not treated. Early treatment can allow for preservation of fertility (reproductive function).
What is uterine cancer?
A rare type of cancer of the uterus, uterine sarcoma forms in the connective tissue of the uterus. Uterine sarcomas are usually treated with surgery. Radiation and/or chemotherapy may sometimes be used after surgery. Staging is used to determine how advanced the cancer is and to measure progress of the disease. The type of treatment is chosen based on the cancer's stage, with advanced cancers requiring therapies that are more aggressive.
What is uterine sarcoma?
A rare type of cancer of the uterus, uterine sarcoma forms in the muscle of the uterus. Uterine sarcomas are usually treated with surgery. Radiation and/or chemotherapy may sometimes be used after surgery. Staging is used to determine how advanced the cancer is and to measure progress of the disease. The type of treatment is chosen based on the cancer's stage, with advanced cancers requiring therapies that are more aggressive.
What treatment is available at M. D. Anderson - Orlando?
Ovarian Cancer
Surgery is essential in the treatment for ovarian cancer. Initially, surgery is used to confirm the diagnosis and stage of ovarian cancer. If necessary, extensive removal of the tumor can be performed to minimize the amount of tumor before chemotherapy.
Chemotherapy is usually required for most ovarian cancer patients following surgery to stop the remaining cancerous cells from dividing and reproducing. Most chemotherapy can be given on an outpatient basis although some regimens require hospitalization and are given over a period of several days.
Intraperitoneal chemotherapy involves inserting a catheter into the abdominal cavity to deliver chemotherapy medications directly to the tumor in the abdomen, rather than through the bloodstream. This can be used in some cases with ovarian cancer.
Cervical Cancer and Cervical Dysplasia
Treatments for cervical dysplasia include:
- Cryosurgery uses an instrument to freeze and destroy pre-cancerous tissue.
- Laser surgery uses a laser beam as a knife to remove the cancer, or to kill the cancerous cells.
- Loop electrosurgical excision procedure (LEEP) uses an electric current passed through a thin wire loop, which then is used as a knife to remove pre-cancerous tissue.
- Cone biopsy uses a scalpel to remove a wedge of the tissue from the cervix while preserving the uterus for childbearing.
- Hysterectomy is the removal of the uterus and cervix. If the uterus is removed through the vagina, the procedure is called a vaginal hysterectomy. If the uterus is taken out through an incision in the abdomen, the procedure is called a total abdominal hysterectomy.
Treatments for cervical cancer include:
- Radical hysterectomy involves the removal of the cervix, uterus, fallopian tubes, ovaries, and part of the vagina. Lymph nodes are also removed from the lower abdomen.
- Pelvic exenteration may beconsidered if cancer has recurred in the pelvis. In this operation, the lower colon, rectum, or bladder may be removed along with the cervix, uterus, and vagina.
- Radiation therapy is the use of X-rays or other type of radiation to kill cancer cells and shrink tumors. Radiation therapy may be either external, using a machine from outside the body, or internal. Internal radiation therapy uses radioisotopes (substances that produce radiation) that are inserted directly into the area where the cancer cells are located.
Chemotherapy for cervical cancer is given simultaneously with radiation for a better outcome. Multiple trials have shown that the approach improves results.
Uterine Cancer
Surgery is the most common treatment for endometrial cancer. Depending on the extent of the cancer, one of the following may be performed:
- Hysterectomy and bilateral salpingo-oophorectomy involves removal of the uterus, fallopian tubes, and ovaries. Pelvic lymph nodes also usually removed. This can be done through an incision in the abdomen or with a laparoscope using robotics.
- Radical hysterectomy is the removal of the cervix, uterus, fallopian tubes, ovaries, and part of the vagina. Pelvic lymph nodes are also removed.
Chemotherapy for endometrial cancer is used for recurrent or widespread disease.
Radiation therapy may be either internal or external and may be used alone or in addition to surgery, chemotherapy or both.
Hormone therapy is used to block certain hormones such as estrogen and progesterone that may affect the way some cancers grow. This may be done using medications to block the hormones or by surgically removing the organs that make hormones.
Our Team of Experts
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