Gynecologic cancer care

The most common gynecologic cancers are cervical, endometrial and ovarian cancer. Because their symptoms and methods of detection can differ, you need expert caregivers who thoroughly understand each disease.

The specialized physicians and staff at HonorHealth Cancer Care will carefully consider your symptoms, conduct tests to make a diagnosis and create a plan tailored to you to treat your cancer.

The network offers many kinds of treatments for gynecologic cancer. A navigator will guide you and your family, answering questions and offering assistance at every stage of your cancer journey.

Cervical cancer

Almost all cases of cervical cancer are caused by the human papillomavirus. The two primary types of cervical cancer are squamous cell carcinomas and adenocarcinomas. Signs and symptoms can include vaginal bleeding and pelvic pain.

More than 4,000 American women die each year from cervical cancer. However, it's largely preventable, thanks to the HPV vaccine and screening exams such as your annual Pap test. As with any cancer, detecting and treating it at an early stage give you the best chances of beating it.

If tests came back identifying pre-cancerous cells, your doctor will treat it in one of these ways: cryosurgery (freezing the cells), laser surgery, a biopsy or hysterectomy. If the cells are cancerous, your doctor will refer you to an HonorHealth gynecologic cancer specialist.

Cervical cancer treatment generally includes one or more of the following:

• Surgery: Conization to remove a cone-shaped piece of tissue from the cervix and cervical canal; a hysterectomy to remove the uterus and cervix, and sometimes the ovaries and fallopian tubes; and/or other surgeries to remove affected tissues nearby. HonorHealth surgeons are experts in the use of single-incision robotic and minimally invasive surgery.
• Chemotherapy: Drugs that kill cancer cells or stop them from dividing.
• Radiation therapy: Radiation may be applied via external or internal beam through radioactive seeds (brachytherapy) depending on the type and stage of your cancer. HonorHealth doctors are innovators in this field, having invented many of the standards used internationally.
• Targeted therapy: This option attacks specific cancer cells without harming normal cells.
• Clinical trials: You may have the option of participating in a clinical trial through the HonorHealth Research Institute. Please discuss this option with your care team.

If you have a family history of cervical cancer, talk to your HonorHealth care team for more information.

Endometrial cancer

Nearly all uterine cancers are endometrial — found in the lining of the uterus. Obesity, high blood pressure and diabetes may increase your risk of this cancer. Approximately 60,000 women, mostly over age 60, are diagnosed annually with the disease. Signs and symptoms include unusual vaginal discharge or pelvic pain.

Common endometrial cancer types are:

• Adenocarcinoma, the most common form
• Carcinosarcoma
• Squamous cell carcinoma
• Undifferentiated/mixed carcinoma
• Small cell carcinoma
• Transitional carcinoma

Rare forms of endometrial cancer are:

• Clear cell carcinoma
• Mucinous carcinoma
• Papillary serous carcinoma

The best way to catch endometrial cancer early is by having a regular schedule of pelvic exams with your HonorHealth gynecologist. If your physician detects something suspicious, subsequent tests may be ordered and may include an ultrasound and endometrial biopsy to extract cells from the endometrium.

If your gynecologist finds cells indicating cancer, seek a referral to an HonorHealth Cancer Care gynecologic cancer specialist. If you have a family history of endometrial cancer, talk to your doctor to help manage your risks.

If you're diagnosed with endometrial cancer, the gynecologic cancer experts with HonorHealth Cancer Care will develop a personalized treatment plan for you that may include one or more of these options:

• Surgery: Hysterectomy in some form, depending on the stage of the cancer, is the most common treatment.
• Chemotherapy: Several drugs, often administered in combination, can be administered orally or intravenously, depending on your treatment plan.
• Radiation: Timing of external beam or internal (brachytherapy) radiation depends on your tumor and its stage.
• Hormone therapy: Uses drugs to block the production of cancer cells fueled by hormones.
• Clinical trials: Ask your HonorHealth team of experts about a clinical trial with potential groundbreaking new treatments for the disease.

Ovarian cancer

Most common in women over age 63, this type of cancer can develop over months or years. A family history of the disease means you're at increased risk of developing it. Because there's a correlation between genes and breast, colorectal and ovarian cancer, genetic testing may be helpful.

There's no single test for ovarian cancer, so it's important to know the symptoms:

• Bloating
• Pain in the pelvis or abdomen
• Feeling full when eating
• Upset stomach
• Constipation
• Feeling the urge or needing to urinate frequently
• Fatigue
• Menstrual changes
• Painful intercourse
• Back pain
• Swelling
• Abnormal weight loss

To diagnose ovarian cancer, your doctor will perform a pelvic exam and order blood and imaging tests. A biopsy, or tissue sample, may be needed.

Epithelial ovarian tumors are the most common type of ovarian cancer. Other forms include germ cell tumors, stromal tumors and cysts. Ovarian cancer begins within the ovaries or fallopian tubes and gradually spreads to nearby organs such as the bladder.

Treatment options include:

• Surgery: Performed by a gynecologic oncologist, surgery is the main treatment for most types of ovarian cancer.
• Chemotherapy: It usually involves two or more drugs.
• Hormone therapy:This treatment uses hormones or hormone-blocking drugs. Rarely used with epithelial ovarian cancer, it's more commonly used with ovarian stromal tumors.
• Targeted therapy: It involves drugs or other substances to attack the inner workings of cancer cells. Targeted therapy changes the way a cancer cell grows and divides, fixes itself or interacts with other cells.
• Clinical trials: Be sure to discuss clinical trials with your HonorHealth team of experts to see if a trial might benefit you.