Types of Gynecologic Cancer
These are the types of gynecologic cancer, including the part of a woman’s reproductive organs where they begin:
- Cervical. The cervix is the lower, narrow section of the uterus, or womb.
- Ovarian. Women have two ovaries, which is where your eggs are produced. The ovaries, similar in shape and size to an almond, are situated at either side of the uterus.
- Fallopian Tube. Connecting the ovaries and uterus, these are rarely touched by cancer.
- Uterine. The uterus, or womb, is where a baby grows during pregnancy. It’s a muscular organ, shaped like an inverted pear, and situated between the bladder and rectum.
- Vaginal. The vagina is a muscular canal lined with nerves and mucus membranes that extends from the uterus to outside the body. Babies pass through the vagina during childbirth.
- Vulvar. The vulva is a woman’s external genitals surrounding the opening of the vagina.
Other Gynecologic Conditions
Besides gynecologic cancers, our team also treats:
- Gestational Trophoblastic Disease (GTD): These tumors, mostly noncancerous, form inside the uterus from tissue that develops when the sperm and egg join after conception. They do not spread to other parts of the body.
- Premalignant Conditions: These are mostly of the cervix, vagina and vulva. These conditions are most often identified by an abnormal pap smear.
- Genetic Mutations: Some women carry genetic mutations that increase their risk for developing gynecologic cancers.
Symptoms of Gynecologic Cancer
There are different clues that a gynecologic cancer is developing, often based on its location.
Sometimes, routine exams by your primary care provider or gynecologist reveal masses or abnormalities on the cervix, ovaries, uterus, vagina and vulva. A Pap test can identify cancerous or precancerous cells on the cervix.
Uterine cancer often presents with bleeding after menopause or irregular bleeding before the menopause.
Ovarian or fallopian tube cancers can produce symptoms such as abdominal pain, bloating, loss of appetite or a sense of feeling full after eating only small amounts.
If you have symptoms like these for two weeks or longer or they are severe, talk to your primary care provider or gynecologist.
Diagnosing Gynecologic Cancer
The type and location of a gynecologic cancer will determine the diagnostic tools our specialists choose for diagnosis.
Here are some of the available tests:
- Imaging Tests: We use CT scans, MRIs, positron emission tomography (PET) and ultrasound technology.
- Transvaginal Ultrasound: Using a special probe placed into the vagina, the specialist is able to create internal images.
- Endoscopy: A long, flexible tube called an endoscope is inserted into the body to produce images with an attached camera and light.
- Colposcopy: This technology uses a magnifying lens and attached light to give the specialist a view of the cervix and vagina.
- Biopsy: Sometimes we must remove small samples of tissue for examination under a microscope.
Treating Gynecologic Cancer
We talk to you about your specific of gynecologic cancer before determining the best way to shrink or remove it. Your oncologist involves other experts as needed, especially if the cancer has spread. This could include experts in colorectal surgery, urology and plastic surgeons.
Here are some options:
- Chemotherapy
- Hormone Therapy
- Immunotherapy
- Radiation. Our radiation oncologists are experienced in using external beam radiation therapy to manage gynecologic cancers. Specialized approaches may include intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT).
- IMRT enables our physicians to customize the intensity of each radiation beam to conform to specific tumor shapes and sizes. This reduces the dose of radiation to healthy tissues and may lessen the risk of side effects.
- IGRT allows our physicians to maximize the accuracy of the radiation using high-quality X-ray or CT scan images.
- Brachytherapy (Intracavitary radiation) allows our physicians to place radiation directly next to the tumor to maximize the treatment dose while reducing the effects on the surrounding tissues and organs.
- Surgery. Our surgical team is skilled in the most advanced interventions and collaborates with surgical subspecialists on more aggressive cases of gynecologic cancer.
Surgery can be performed either through an incision or using minimally-invasive techniques like laparoscopy or robotic-assisted laparoscopy. This approach reduces bleeding and helps patients return to normal activities faster. Most uterine cancers and some early stage ovarian and cervical cancers are treated with robotic surgery.
Our team includes the most experienced robotic surgeons in the region.
Available surgical procedures for gynecologic cancer include:
- Debulking: This is the removal of all or most of the tumor, usually followed by chemotherapy.
- Total Hysterectomy: Surgeons remove the uterus and cervix.
- Radical Hysterectomy: Besides removing the uterus and cervix, surgeons take out part of the vagina and connective tissue surrounding the cervix (parametrium).
- Salpingo-oophorectomy: This is the removal of the ovaries and fallopian tubes. A unilateral salpingo-oophorectomy is when one ovary and one fallopian tube are removed. In a bilateral salpingo-oophorectomy, both ovaries and fallopian tubes are removed.
- Lymph Node Removal: Surgeons often need to remove some or all lymph nodes affected by the cancer.
- Fertility-preserving: Women interested in bearing children may opt to have surgery that preserves the uterus and ovarian tissue.
Advanced Technology
Cancer Institute surgeons use the latest techniques for gynecological cancer surgery, including sentinel lymph node dissection for cervical, endometrial and vulvar cancers.
For many gynecologic cancers, minimally-invasive surgery – either robotic or laparoscopic – offers advantages like a faster recovery, less pain and bleeding, and the ability to start other treatments or return to your daily life faster.
- Laparoscopic Surgery: Surgeons place thin instruments through small incisions, and operate while guided by a camera. This technique results in less scarring, shorter hospital stays and a quicker recovery than open surgery.
- Robot-assisted Surgery: Our da Vinci Surgical System is part of a new wave of laparoscopic surgery that combines precise robotics, a 3D view and greater flexibility than traditional laparoscopy. It allows our surgeons to reach cancers in the tightest spaces and perform more complicated procedures.
- Sentinel Lymph Nodes Surgery: This approach allows staging of certain cancers (uterine, cervical or vulvar) by removing fewer lymph nodes. The risk of side effects is decreased as compared to the traditional approach.
Clinical Trials
Cancer Institute gynecologic oncology patients have access to the latest clinical trials and cancer research from across the nation. Our membership in the Memorial Sloan Kettering Cancer Alliance brings clinical research options, as does our status as a research site for the National Cancer Institute and our participation in the national Gynecology Oncology Group of the NIHNRG Oncology Group, a nonprofit research organization.
Support Along the Journey
Gynecologic cancers affect a woman’s health and well-being, We have developed programs to provide support that help during treatment and help women get back to their lives and activities as soon as possible. This includes integrative therapies, support groups, exercise programs and partnerships with community groups to offer the Look Good / Feel Better wellness program and others.