The Gynecologic Oncology Program at Smilow Cancer Hospital focuses on the care for women with gynecologic cancers. Supported by a team of medical oncologists, radiation oncologists, surgeons, oncology nurses and researchers, our cancer patients can face their disease from a position of strength.
Each gynecologic cancer is unique, with different signs and symptoms, different risk factors and different prevention strategies. All women are at risk for different types of gynecologic cancer, and risk increases with age. A woman who is experiencing abdominal or pelvic pain should see her doctor. Symptoms may be caused by something other than gynecologic cancer, but an evaluation by a physician is the only way to know for sure.
Women diagnosed with vulvar, vaginal, cervical, uterine, fallopian tube, or ovarian cancers are provided with exceptional care. The team treats soft tissue tumors of the pelvis, gestational trophoblastic disease, as well as women with precancerous changes that have been identified in the vulva, vagina, and cervix, including dysplasia and carcinoma in situ, or premalignant changes of the endometrium, including adenomatous hyperplasia.
The Gynecologic Oncology Program offers a wide spectrum of advanced strategies for the diagnosis and treatment of gynecologic cancers including colposcopy evaluation, conformal radiotherapy, and novel, targeted chemotherapies. The program is comprised of the Departments of Obstetrics, Gynecology & Reproductive Sciences, Radiation Oncology, Radiology and Biomedical Imaging, Genetics, Pathology, Pharmacy, and Social Work. A dedicated patient coordinator facilitates patient appointments and communication, coordinates services, and supports each patient and their family.
At Smilow Cancer Hospital, gynecologic oncology services unite a multidisciplinary team of clinicians. Our physicians are board-certified in obstetrics and gynecology and in the subspecialty of gynecologic oncology, which brings together surgery, chemotherapy and radiation oncology.
The expertise of the Gynecologic Oncology Program covers all of the components critical to managing the care of women with gynecological cancers: comprehensive evaluation and diagnosis, leading-edge treatment options, thorough follow-up, and psychosocial support. Women are welcome whether they are newly diagnosed or have already received extensive treatment.
The multidisciplinary focus extends to the tumor board, held weekly under the direction of the Gynecologic Cancers Program working in concert with radiation oncology and pathology. The slide for all gynecologic cancer patients are reviewed at the tumor board. All therapeutic decisions are made by a panel of experts in the field of gynecologic malignancy diagnosis and management.
The Gynecologic Pathology team is a fundamental component in the prevention, diagnosis, and treatment of diseases of the female genital organs at Smilow Cancer Hospital. Our gynecological pathologists have extensive diagnostic experience and a passion for patient care. Team members actively participate in the real-time decision making process for patient management, including daily operative consultations, weekly tumor board conferences, and many on-going clinical trial programs.
Our Gynecologic Cancers Program offers urologic, gastrointestinal and gynecologic surgery for the management of previously untreated gynecologic cancers, These operations include radical hysterectomies for cervical cancer, cytoreductive surgery for ovarian cancer, radical vulvectomies for vulvar cancer and total abdominal hysterectomies, bilateral salpingo-oophorectomies, and lymphadenectomies for the staging and treatment of endometrial cancers. Gynecologic surgery for unusual tumors occurring in the female pelvis, such as benign and malignant soft tissue tumors, are routinely managed by the Gynecologic Cancer Program.
Minimally invasive robotic surgery is also available for some women in need of gynecologic surgery.
Conventional laparoscopic and robotic surgery is available to women in need of surgery for uterine cancer, for removal of the uterus, tubes, and ovaries. The surgeries are also offered to women with invasive cervical cancer who require a radical hysterectomy.
When possible, preservation of fertility in women with gynecologic cancers is always a priority. We have routinely preserved fertility in women with rare germ cell ovarian cancers. In addition, we perform radical trachelectomies in women with early stage cervical cancer who desire fertility preservation. For women with early stage, low-grade endometrial cancers, hormonal therapy is prescribed.
The Gynecologic Cancers Program at Smilow Cancer Hospital provides surgical management of complications resulting from gynecologic cancers or for progressive disease that include small and large bowel resections, colostomies, fistula repairs, and repair of pelvic support for the management of patients with gynecologic malignancies.
We also provide surgical management of disease that previously was not susceptible to effective surgery or whose recurrence now makes it appropriate to operate. Gynecologic surgery can include radical resection of recurrent ovarian cancer, radical hysterectomies and pelvic exenterations for recurrent cervical cancer, radical resections of pelvic and abdominal disease for recurrent endometrial cancer and surgical resection of vulvar lesions following surgery or surgery, radiation, and chemotherapy for the management of vulvar cancer.
Clinicians with the Gynecologic Cancers Program are routinely asked to provide surgical management for gynecologic cancer patients with benign gynecologic conditions, particularly those that had previously been treated surgically unsuccessfully. Such conditions include endometriosis, extensive uterine fibroids (leiomyomas), recurrent ovarian cysts, pelvic pain, and pelvis organ prolapse. Prophylactic surgery, including hysterectomy, bilateral salpingo-oophorectomy, or bilateral salpingectomy with ovarian conservation, is also available to women looking to prevent ovarian cancer occurrence.
We have a full spectrum of chemotherapeutic agents useful in the management of ovarian cancer, fallopian tube cancer, uterine cancer, mesenchyme tumors of the uterus, cervical cancer, vaginal cancer, and vulvar cancer. These chemotherapeutic agents may be used either for primary treatment or treatment of recurrent disease.
Neoadjuvant chemotherapy, or chemotherapy prescribed before surgical treatment, is often used for women with advanced ovarian cancer to reduce the size and impact of the cancer and its metastases. This minimizes complications during surgery and improves recovery following the operation. Intraperitoneal chemotherapy, where chemotherapy is injected directly into the abdomen through a catheter, is also an option for ovarian cancer treatment.
The Gynecologic Cancers Program offers chemotherapy both for previously untreated gynecologic malignancies as well as for the management of recurrent gynecologic malignancies that may have initially failed to respond to chemotherapy or other treatment modalities.
Our radiation oncology services use both brachytherapy and external beam radiation therapy for the management of a spectrum of gynecologic cancers including cervical cancer, vaginal cancer, and vulvar cancer. Patients treated at Smilow have access to the latest, most precise technologies, including image-guided intensity modulated radiation therapy and high-dose-rate brachytherapy.
We have a full-service colposcopy program for the evaluation of women with abnormal Pap smear results and to help diagnose premalignant and malignant reproductive diseases. We offer laser, LEEP, and cold knife conizations for cervical cancer and have applied these techniques for vulvar and vaginal cancer in selected patients.
Yale Cancer Center provides information on screening prevention and treatment of the following cancers: cervical, childhood cervical and vaginal, childhood ovarian, urethral, vaginal and vulvar. More information is also provided on gestational trophoblastic disease and ovarian germ cell tumors.
In 2012, Mary Di Gioia, a grandmother of four was working as a social worker when she began experiencing abdominal pain. “I ignored it for a while,” said Ms. Di Gioia, who has since retired. But when the discomfort persisted, she went for an ultrasound and was eventually diagnosed with endometrial cancer.
