Diagnosis & Treatment
Gynecologic Cancer
How is Gynecologic Cancer Diagnosed?
DiagnosisGynecological cancer diagnosis can take place in many ways, depending on family history, personal medical history, and the symptoms being experienced. All diagnoses begin with a review of a patient's medical history and a physical exam. During the exam, your doctor will look for signs and symptoms of gynecologic cancer as well as assess your overall health.
A variety of diagnostic tests are used to make a gynecologic cancer diagnosis, and your doctor will decide which tests are needed following the physical examination.
Diagnostic tests may include:
- Blood tests: Tumor markers and other components of blood that may indicate cancer is present can be found through specific blood tests. The results of bloodwork can help doctors determine next steps in the diagnosis process.
- Pap test: Pap tests are generally performed during annual gynecological examinations. These tests are used as a routine screening for cervical cancer. During a pap test, some cells from the surface of the cervix are removed and sent for testing, even if no signs/symptoms of cancer are present or noticeable. Pap tests are an effective way to detect cell abnormalities even before they become cancerous.
- Imaging tests: Commonly used imaging tests include ultrasounds, magnetic resonance imaging studies (MRIs), X-rays, positron emission tomography (PET) scans, or computed tomography (CT) scans. Imaging tests create images of the organs and tissues inside the pelvis and abdomen and are used to visualize any tumor growth.
- Biopsy: Biopsy, removing a small piece of possibly cancerous tissue for analysis in a laboratory, is necessary to confirm a diagnosis of gynecologic cancer. Biopsies may be performed during an office visit, and might require a minimally invasive procedure using an image-guided needle or surgery. A pathologist examines the tissue sample under a microscope to see if cancer cells are present.
Gynecologic cancer screening
Currently, cervical cancer is the only gynecologic cancer that has a recommended screening test. Pap tests are done at regular intervals as part of routine gynecology exams to check for cell abnormalities that either have turned or could turn, into cervical cancer. Because persistent HPV infections are linked to cervical, vaginal and vulvar cancers, an HPV test is also often performed during annual OBGYN examinations.
How is Gynecologic Cancer Treated?
TreatmentGynecological cancer treatment plans will vary depending on many factors, such as the stage of cancer, whether cancer has spread, and whether the patient is still of childbearing age. Surgery is often the best option for advanced cases, with hysterectomy being a very common option for patients with cervical, uterine, and ovarian cancers. Radiation therapy or chemotherapy may also be suggested in these cases to prevent the further spread of the cancer.
Treatment options fall into broad categories as described below:
Surgical
- When surgery is needed to remove a cancerous tumor or organ, a minimally invasive approach is best whenever possible. You may have a laparoscopy, a procedure that uses tiny incisions with a thin, lighted tube and video camera. This can sometimes be performed as an outpatient procedure and generally means smaller incisions, less blood loss, and a shorter recovery time than open abdominal surgery.
- If you have endometrial cancer and you need a hysterectomy, you may be able to have the operation using robotic surgery, a procedure that uses mechanical arms and surgical instruments controlled by the surgeon. This type of procedure is often used to avoid the need for large incisions.
- Gynecology oncology teams also include urogynecology surgeons with advanced training in female pelvic medicine and reconstructive surgery should this need arise.
Medication
- Precision medicine: Personalized treatment strategies for women with gynecologic cancers are often based on the specific genetic abnormalities in their cancers. Gynecologic tumors are monitored for genetic mutations or markers present only in cancer cells allowing to select of therapies that target these markers destroying only cancerous cells.
Nonsurgical
- Chemotherapy. Chemotherapy uses anticancer drugs and drug combinations designed to slow, stop, or shrink cancer. Intraperitoneal chemotherapy is offered for women who may benefit from chemotherapy delivered directly into the abdomen or pelvis.
- Radiation therapy. External beam radiation therapy, in which radiation beams are finely targeted to a tumor, is often used to spare as much nearby healthy tissue as possible while eradicating cancer cells and shrinking tumors. Radiation therapy often takes place is specialized radiation therapy centers.
Additionally, options within these categories may coincide with genetic testing or clinical trials for gynecologic cancers.
- Genetic Counseling: Genetic counseling and testing will include an evaluation of your family history as well as a discussion about the risks for inherited cancers and available screenings and tests. If you have an increased risk of ovarian cancer, for example, because of a family history of the disease, you can consult with a genetic counselor and undergo genetic testing (for example, screening for BRCA1 and BRCA2 mutations or Lynch syndrome). If you have such a mutation, New York-Presbyterian offers you several options to greatly decrease your risk of developing ovarian and fallopian tube cancer.
- Clinical Trials for Gynecologic Cancers: Clinical trials employ new treatment options, testing them to see if they are safe and determining their effectiveness. This option is something that your doctor will discuss with you and something you may wish to take part. New York-Presbyterian belongs to the Gynecologic Oncology Group (GOG), which promotes excellence in the field of gynecologic cancer research. Many of the therapies used to treat gynecologic cancers today were evaluated through GOG clinical trials. We also offer other clinical trials. You may have the opportunity to participate in a clinical trial of a promising new therapy.
Choosing the right treatment for your gynecological cancer may not be easy. Your doctor at New York-Presbyterian is your best resource when making decisions about your care.
Cancer treatment plans at New York-Presbyterian are customized to meet the needs of the whole patient. New York-Presbyterian's multi-disciplinary approach to cancer treatment addresses the whole patient, caring for other conditions that may develop because of cancer or from a pre-existing condition as well as cancer itself. Treatments may be combined with available support programs to help manage cancer's emotional and physical challenges, further optimizing results.
Trust NewYork-Presbyterian for Gynecologic Cancer Treatment
If you suspect that something you are experiencing could be a sign or symptom of gynecologic cancer, or you are simply experiencing something out of the ordinary for you, your first step is to schedule an appointment with the cancer specialists at New York-Presbyterian. From screening to diagnosis, treatment, and follow-up care, New York-Presbyterian provides the full range of services for gynecologic cancers.
A team of gynecologic oncologists, pathologists, radiologists, genetic specialists, oncology nurses, nurse practitioners, psychosocial support specialists, and other experts is assembled to care for each patient. These teams participate in multi-disciplinary clinics and tumor boards where specialists from different modalities come together to customize treatment needs. This makes it possible for treatment teams to coordinate the highest-level treatment and care with colleagues in other specialties, including breast oncologists, specialized surgeons, and gastroenterologists.