The Gynecologic Oncology Program at Smilow Cancer Hospital brings together a team of clinicians whose focus is to care for women with gynecologic cancer in the dedicated Women’s Center on the first floor of the hospital. Physicians are board certified in obstetrics and gynecology and in the subspecialty of gynecologic oncology, which unites surgery, chemotherapy and radiation therapy into the oncologic management of patients.
The specific diseases treated by the Gynecologic Oncology Service are:
- Precancerous changes of the vulva, vagina and cervix, including dysplasia and carcinomas-in-situ
- Premalignant changes of the endometrium including adenomatous hyperplasias
- Vulvar cancer
- Vaginal cancer
- Cervical cancer
- Uterine cancer
- Fallopian tube cancer
- Ovarian cancer and
- Gestational trophoblastic disease
- Soft tissue tumors of the pelvis
Surgery for previously untreated gynecologic cancer
The Gynecologic Oncology Program offers gynecologic, gastrointestinal, and urologic 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. Minimally invasive robotic surgery is also available for some women in need of gynecologic surgery. In addition, the Gynecologic Oncology Program routinely manages surgery for unusual tumors occurring in the female pelvis, such as benign and malignant soft tissue tumors.
Surgery for the complications of gynecologic malignancies
The Gynecologic Oncology Program offers 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.
Surgery for recurrent gynecologic cancer
The Gynecologic Oncology Program offers surgical management of disease that previously was not a candidate for effective surgery or whose recurrence now makes it appropriate to operate. Such operations would 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.
Difficult gynecologic surgery for benign gynecologic disease
The Gynecologic Oncology Program routinely is asked to provide surgical management for 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.
Chemotherapy management of gynecologic cancers
The Gynecologic Oncology Program offers 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. Clinical trials offering the latest treatment options and new therapies are available for our patients through Yale Cancer Center. The Gynecologic Oncology 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.
Radiation therapy for gynecologic malignancies
Radiation oncologists collaborate with the gynecologic oncologists at Smilow to provide both brachytherapy and external beam radiation therapy for the management of a spectrum of gynecologic cancers including cervical, vaginal, and vulvar cancer.
Colposcopy for the diagnosis of premalignant and malignant disease in the pelvic reproductive tract
We offer a full service colposcopy program for the evaluation of women with abnormal Pap smear results and for patients with possible recurrences of premalignant or malignant disease in the lower reproductive tract using the colposcopic evaluation approach. We also offer laser, LEEP, and cold knife conizations for cervical cancer and have applied these techniques for vulvar and vaginal cancer in selected patients.
A tumor board is held weekly under the direction of the Gynecologic Oncology Program working in concert with the Department of Therapeutic Radiology and the Department of Pathology. All patients treated have their slides reviewed in a prospective fashion at the tumor board. All therapeutic decisions are made by a multidisciplinary panel of experts in the field of gynecologic malignancy diagnosis and management.