St. Joseph’s/Candler Gynecological Oncologist Dr. Christopher Walker explains the different types of GYN cancers, treating and potentially preventing them

No matter how large or small, almost any part of our body is susceptible to cancerous tumors. This includes the various anatomy of the female reproductive system.

Gynecologic oncology is the medical field that focuses on cancers that develop in a woman’s reproductive system. The more common ones are uterine (endometrial), cervical and ovarian, with rarer GYN cancers, such as vulvar and vaginal.

There are nearly 100,000 new cases of gynecological cancers diagnosed each year in that United States, making the need for advanced, personalized care even greater.

At the Nancy N. and J.C. Lewis Cancer & Research Pavilion, we have a dedicated team to treat gynecological cancers led by our gynecological oncologists and surgeons, Dr. Sarah Gill and Dr. Christopher Walker.

How are gynecological cancers diagnosed?

There can be a variety of ways GYN cancers are diagnosed. Most commonly is through your OB/GYN or primary care provider ordering imaging or biopsy, such as screening for cervical cancer, says Dr. Walker.

Unfortunately for some GYN cancers, specifically ovarian, symptoms are often non-specific, such as bloating, reflux or general pain, and the cancer may be discovered after a trip to the emergency room and a CT scan reveals a mass on the ovaries.

Related Article: What you need to know about ovarian cancer 

How are gynecological cancers treated?

The answer is: it varies. Everyone’s cancer is different; therefore, everyone’s treatment is personalized to the patient and cancer.

“No one cancer is the same,” Dr. Walker says. “I explain it to patients like this: Let’s say you have two sisters; while your DNA may have similarities from your parents, each of you have your own unique DNA. Cancer is the same way.”

Let’s look at some examples of how you may be treated if you are diagnosed with a GYN cancer:

• Endometrial cancer: The majority of endometrial cancers are treated with minimally-invasive surgery on the da Vinci Robotic Surgical System, especially when found in early stages. Robotic surgery typically means shorter hospital stays, less pain, less bleeding and less risk of infection for patients. Both Dr. Walker and Dr. Gill are trained on the da Vinci robot.
  
  “We only do minimally-invasive if we think we can safely do the surgery,” Dr. Walker says. “It’s really patient specific to how a patient’s disease looks and their overall health.”
  
  If your healthcare team thinks there’s a greater than 20 percent risk of the cancer returning, they may recommend radiation therapy after surgery, Dr. Walkers adds. This is typically with brachytherapy, or external vaginal radiation, which has greatly improved over the years with less side effects, toxicity and fewer treatments. (Learn more about that in the next Smart Living blog.)
  
  
• Cervical: Surgery is used less often in cervical cancers. Evidence shows surgery is beneficial when the cancer is small, usually four centimeters or less, Dr. Walker says. If the tumor is larger than four centimeters or if the cancer has started to spread, most commonly the patient will be treated via radiation therapy.
  
  At the LCRP, we offer TrueBeam external beam therapy and brachytherapy to help treat cervical cancer. (Learn more about that in the next Smart Living blog.)
  
  
• Ovarian: With ovarian cancer, evidence shows that surgery is successful when you can remove all the cancer, Dr. Walker says. So if the tumor is large or the cancer has spread to the point where surgery will leave some behind, then you will most likely need chemotherapy before surgery to help shrink the cancer.
  
  One unique thing about gynecological oncologists is they are trained both in surgery and medial oncology, meaning they can manage chemotherapy, targeted therapy and immunotherapy treatments for their patients. So if you need chemotherapy and live in the Savannah area, you can continue to see Dr. Walker or Dr. Gill. If you leave outside of the area, for example Statesboro or Jesup, the LCRP has outpatient infusion centers with medical oncologists that Dr. Walker or Dr. Gill collaborate with so you can have treatment closer to home.

“Especially thanks to clinical trials, treatment has come a long way in just the last 15 years or so,” Dr. Walker says. “We’ve seen new targeted agencies and immunotherapies that allow patients to live longer. There are now drugs for ovarian and uterine cancer and even cervical cancer that have led to improved survival in patients.”

Related Article: Clinical Trials Close to Home: Why you should participate 

Can these types of cancers be prevented?

Prevention is also cancer specific. Let’s take a look:

• Endometrial: There’s no sure way to screen for or prevent endometrial cancer. Dr. Walker does encourage women to have the mindset that if they have gone through menopause, they should never have any vaginal bleeding. The most common presentation for endometrial cancer is post-menopausal bleeding, Dr. Walker says, and you should go see your OB/GYN.
  
  
• Cervical: There are two things you should do when it comes to preventing cervical cancer: Get routine pap smear screening and take the HPV vaccine.
  
  “Doing these two things alone, you can almost eliminate your risk of getting cervical cancer,” Dr. Walker says. “It’s not 100 percent, but it’s amazing compared to how things were before.”
  
  
• Ovarian: Unfortunately, there’s also no good way to prevent or screen for ovarian cancer. However, Dr. Walker encourages women with a family history of ovarian, breast or pancreatic cancer to talk to their primary care provider about genetic testing.
  

Related Article: Should I see an oncology genetic counselor? 

“I am big on screening, and anything we can do to decrease the likelihood of getting cancer is always great,” Dr. Walker says. “But when it comes to the treatment we have available for these cancers, 15 years ago it was almost a death sentence. Now we have options, treatments available and clinical trials that are getting better and better every day.”

 

Coming Thursday: Learn more about how radiation therapy is used to treat gynecological cancers.