Gynecologic Oncology

What Conditions do Gynecologic Oncologists Treat?

Gynecologic oncologists typically provide treatment for cancers affecting the female reproductive system, such as ovarian, uterine (endometrial), cervical, vaginal, and vulvar cancers. Let's understand each cancer-

• Ovarian cancer: This cancer begins in the ovaries and destroys the surrounding healthy tissues.
• Uterine (endometrial) cancer: Uterine cancer is a cancer that forms in the lining of the uterus (endometrium). It is a common cancer that develops in the female reproductive system.
• Cervical cancer: This cancer originates in the cervix (the lower part of the uterus that connects to the vagina). HPV infection (a group of 200 related viruses) plays a role in causing cervical cancer.
• Vulvar cancer: This cancer originates in the tissues of the vulva. The vulva includes all the external sex organs, which include the opening of the vagina, mons pubis, opening of the urethra, perineum, etc.
• Vaginal cancer: Vaginal cancer develops in the vagina, the muscular tube that connects the uterus to the external genitals.

What Tests or Diagnostic Procedures are Done Under Gynecologic Oncology?

Some of the common tests and procedures conducted under gynecologic oncology include:

1. Pelvic Examination: Pelvic examination involves assessing the external genitalia, cervix, uterus, vagina, ovaries, and rectum to detect any abnormalities, such as lumps or masses.
2. Pap smear: This test is conducted to diagnose cervical cancer. It involves scrubbing the cells in the cervix region to search for any abnormalities.
3. Imaging Studies: It includes tests like:

• Ultrasound: This test uses sound waves to form images of the pelvic organs. Pelvic organs are the organs present in the lower part of the abdomen. In females, these organs include cervix, vagina, ovaries, uterus, etc. The images created using sound waves help detect medical issues like cysts or tumors.
• Computed Tomography (CT) Scan: This scan helps produce clear and precise cross-sectional images of the pelvic organs. CT scan assists the healthcare provider in knowing the extent of the cancer and if it has extended to nearby body structures.
• Positron Emission Tomography (PET) Scan: PET scans are also used to assess whether cancer has expanded to other parts of the body.

4. Colposcopy: Like pelvic examination, colposcopy tests also examine the cervix. However, in this test the doctor uses an instrument called a colposcope that helps the doctor see the surface of the cervix clearly. If any irregularities are discovered, a biopsy (removal of a small piece of tissue) is done.

What are the Various Treatment Options Under Gynecologic Oncology?

Gynecologic oncologists use various treatment options to manage gynecologic cancers. The option chosen depends on several factors such as the type of cancer, its stage, the patient's overall condition, etc. Some main treatment options in gynecologic oncology include the following:

Chemotherapy: In chemotherapy treatment, the doctor provides drugs (medications) to destroy cancer cells and restrict their growth. Depending on the type and stage of gynecologic cancer, chemotherapy may be taken by mouth or given as an injection.

Radiation Therapy: Radiation therapy uses high radiation to kill cancer cells in the female reproductive system. These high doses of radiation help destroy cancer cells or hamper their growth. Radiation therapy is mainly used to treat vaginal and cervical cancer.

Targeted Therapy: Targeted therapy uses certain drugs to impede/obstruct the growth and expansion of cancer cells in the female reproductive system. This therapy targets specific pathways (molecules) that are responsible for the development of cancer. The therapy provides a less toxic treatment compared to traditional chemotherapy.

Immunotherapy: This therapy uses the body's immune system to identify and destroy cancer cells in the body. Immunotherapy helps kill cancer cells, leaving healthy cells unharmed.

Hormonal Therapy: In hormone therapy, the natural hormones present in the body can lead to cancer growth. Therefore, depending on the type of gynecologic cancer, your doctor may utilize hormonal therapy to obstruct the hormones that cause cancer to grow. It may be used to give patients synthetic hormones to cease the production of natural hormones that lead to cancer development.

Surgery: Some standard surgical procedures for gynecologic cancer include:

• Staging surgery: In this surgery, tissue samples are removed from various parts of the pelvic region to determine the type, stage, and how far the cancer has advanced.
• Hysterectomy: Hysterectomy is a procedure to remove the uterus. This treatment is mainly used for treating cervical and endometrial (uterine) cancer. The uterus is removed because it is the primary site of cancer in the uterine as well as cervical cancer. Hysterectomy can be partial or total. In a partial hysterectomy, the doctor pulls the uterus but leaves the cervix intact. However, in a total hysterectomy the entire uterus, including the cervix is removed from the body. In the case of gynecologic cancer, typically total hysterectomy is performed.
• Salpingo-oophorectomy: In this surgery, one or both ovaries and fallopian tubes are removed.
• Debulking surgery: This treatment of cancer involves removing as much tumor as possible from the body. This procedure is typically conducted before chemotherapy so that there is less tumor to treat.