What is Gynecologic Cancer?
Gynecologic cancer is any cancer or an uncontrolled growth of abnormal cells in the body that starts in a woman's reproductive organs. Gynecologic cancers begin in different places within a woman's pelvis, which is the area below the stomach and in-between the hip bones. There are five main types of cancer that affect the woman’s reproductive organs: cervical, ovarian, uterine or endometrial, vaginal, and vulvar. A sixth type of gynecologic cancer is the very rare fallopian tube cancer.
The main types of cancer that affect a woman's reproductive organs are:
Cervical Cancer begins in the cervix, which is the lower, narrow end of the uterus, also called the womb. The cervix connects the vagina to the uterus.
Ovarian Cancer begins in the ovaries, which are located on each side of the uterus and produce female hormones and eggs.
Uterine Cancer begins in the uterus, also called the womb, which is the pear-shaped organ in a woman's pelvis where the baby grows when a woman is pregnant. Uterine cancer is also known as endometrial cancer because it forms in the lining (endometrium) of the uterus.
Vaginal Cancer begins in the vagina, which is the hollow, tube-like channel between the bottom of the uterus and the outside of the body.
Each gynecologic cancer is unique with different symptoms, causes, and risk factors that may increase the chance of getting that form of cancer as well as screening and diagnostic procedures, treatments, and prevention strategies.
You may not know that you have gynecologic cancer unless you experience abnormalities in your body. It is important to pay attention to your body and know what is normal for you. For example, if you experience unusual vaginal bleeding, you should talk to your gynecologist right away. Also, you should see a doctor if you have any other warning signs longer that are not normal to you and that last for two weeks. Symptoms do not automatically indicate the presence of cancer, but the only way to know is to see a doctor for a proper diagnosis. Some symptoms may be diagnosed as precancerous conditions that can be treated to prevent cancer.
The purpose of a diagnostic test is to determine the cause of any symptoms that you may be experiencing or to determine whether you are at high risk of cancer. Women's cancers have a higher chance of being cured as screening and diagnosis options improve. Cancer screening tests are most effective when they can detect cancer early, which can lead to more effective treatment. Of all the gynecologic cancers, only cervical cancer has a screening test that can find signs of cancer early, when treatment is generally most effective. This screening test is known as the Pap test or Pap smear. In addition, the human papillomavirus (HPV) test is used to detect HPV infection. HPV is a common sexually transmitted disease that can cause gynecologic cancer. A vaccine is now available to protect against the HPV strains that most often cause cervical, vaginal, and vulvar cancers.
You play an important role in helping detect possible gynecological cancers by reporting to your doctor any changes you experience in your body, such as irregular bleeding or pain. Tests done early may reveal a precancerous condition that your doctor can treat before cancer develops, and if cancer is diagnosed, assuring that you are treated promptly. Doctors use techniques such as colposcopy, loop electrosurgical excision procedure (LEEP), and cryosurgery to diagnosis and treat precancerous conditions, as forms of early detection and prevention. Genetic counseling and screening, available through Mount Sinai’s family risk program for women considered at high risk of cancer, also play a role in helping you get early diagnostic testing.
Gynecologic oncologists are doctors trained in treating cancers of the female reproductive system. Your gynecologic oncologist will work with you to create a treatment plan. For treatment of gynecologic cancers, the options available include minimally invasive surgery, chemotherapy, hormonal therapy, and radiation therapy, or a combination of these procedures. Additionally, our patients get exposure to national clinical trials for the treatment of gynecologic cancers. Current investigations and clinical trials are available for patients with ovarian, uterine, cervical, and endometrial cancers.
Minimally Invasive Surgery
As an early adaptor of robotic surgical systems, today we perform approximately 60 percent of our surgeries using a minimally invasive approach. We are gratified to offer these minimally invasive surgeries, accommodating easier healing with less scarring, and a faster return to your normal activity through shorter hospital stays.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by keeping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity, such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy) Delivering anticancer drugs directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube is called intraperitoneal chemotherapy. Whether you receive regional, systemic, or intraperitoneal chemotherapy depends on the type and stage of your cancer.
Hormone therapy is a cancer treatment that removes hormones which are substances made by glands in your body and circulated into the bloodstream, and stops cancer cells from growing. Some hormones can cause certain cancers to grow.
Radiation therapy refers to the use of high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. With external radiation therapy, a machine outside your body directs radiation at your cancer. With internal radiation therapy, a radioactive substance sealed in needles, seeds, wires, or catheters is placed inside your body in or near your cancer. Whether you receive internal or external radiation depends on the type and stage of your cancer. Some women instead undergo intraperitoneal radiation therapy, in which radioactive liquid is injected directly in their abdomen through a catheter to kill the cancer or keep it from spreading.
Treatments in Development
New cancer treatments in development include:
- Biologic therapy: This treatment uses your immune system to fight cancer. The idea is to use substances made by your body or replicated in a lab to boost, direct, or restore your body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
- Targeted therapy: This treatment uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
Mount Sinai has earned a reputation for successfully treating women who have survived gynecologic cancer with fertility sparing (non-hysterectomy) treatment, while providing support for their individual journey to parenthood. For women who are about to undergo chemotherapy or radiation to treat cancer, preserving eggs opens up the possibility of using their own genetic material to have a child once the disease is treated. We achieve high success rates in both low-tech and high-tech infertility treatments by individualizing protocols, maintaining strict quality control procedures and by emphasizing compassionate and patient-friendly care.