Gynecological Cancers

As a dedicated team of gynecologic oncology experts, we focus on compassionate, patient-centered, leading-edge care to save the lives of women.

A diagnosis of a gynecologic cancer is life-altering. The Gynecologic Oncology Program at City of Hope offers a unique approach for women diagnosed with all types of gynecologic cancer (cervical, ovarian, endometrial/uterine). Our expert team of physicians and laboratory researchers provides an integrated approach to treatment. These professionals work together to turn innovative scientific discoveries into more effective treatments for gynecologic cancers so we can improve our patients’ lives today.  At City of Hope, we focus on the patient as a whole, treating both the physical and emotional changes that a gynecologic cancer diagnosis can bring, while also addressing the needs of partners and families.

City of Hope’s Comprehensive Cancer Center is a member of the National Comprehensive Cancer Network, and our doctors are instrumental in creating evidence-based guidelines and are dedicated to providing the best cancer care available. City of Hope is one of the top programs in the nation for gynecologic cancer care as ranked by U.S.News & World Report. Our multidisciplinary team of dedicated surgeons, medical and radiation oncologists, nurses, genetic counselors, and social workers provides compassionate, individualized care as well as access to state-of-the-art technologies and treatments.

We tailor treatment according to the individual patient’s cancer characteristics.
 
  • We recognize that gynecologic cancer is different for every patient, and that each woman needs her own personalized treatment plan. We tailor our treatments to the patient according to age, genetics, psychosocial and spiritual needs.

 

  • Doctors in our world-renowned Clinical Cancer Genetics Program provide comprehensive consultations in cancer screening and prevention by assessing the cancer risk for individuals and families. They provide recommendations to prevent as well as detect gynecologic cancers at their earliest and most curable stage. This includes identifying patients at high risk for ovarian cancer who may be treated by curative oopherectomy by our surgeons.

 

  • We use state of-the-art imaging for accurate and rapid diagnosis and surgical planning to maximize the benefit of irradiation for gynecologic cancers, while minimizing unnecessary exposure.

 

  • We offer the latest modalities of tumor-debunking surgeries, minimally invasive robotic surgery, oncoplastic surgery, and reconstructive surgery to provide optimal cancer surgery and the best cosmetic outcomes.
 
  • We offer leading-edge fertility-sparing options for young women who want to preserve their fertility after treatment.
 
  • We are one of an elite number of gynecologic cancers programs in the country to routinely use intraperitoneal (IP) chemotherapy and/or heated intraperitoneal chemotherapy (HIPEC) to treat ovarian cancer, which can greatly improve the outcomes for women with advanced disease.
 
  • Through our drug-development program, we are constantly developing and evaluating new drugs, including immunotherapeutics and natural compounds, to better treat early-stage cancers and advanced metastatic disease.
 
  •  We assess the needs of cancer patients and family members using biopsychosocial screening that addresses the biological, psychological and social factors that all play a significant role in the lives of women diagnosed with cancer.
 
  • All gynecologic cancer patients can participate in our Survivorship Program. At City of Hope, care does not end after completion of treatment. Our doctors and researchers are working to develop resources to help improve the quality of life for survivors, and all patients are able to participate in ongoing long-term research related to life after cancer.
 
Combining the power of collaboration with a dedication to compassion, we seek to save the lives of women. The Gynecologic Oncology Program at City of Hope treats all types of gynecologic cancers.
 
About Gynecologic Cancers
 
Gynecologic cancer is any cancer that begins in a woman's reproductive organs. There are five main types of gynecologic cancers defined by where they originate: cervical, ovarian, uterine, vaginal, and vulvar.

This type of cancer begins in the cervix, which is the lower, narrow end of the uterus (also called the womb). The incidence of cervical cancer has decreased sharply as Pap screenings have become more prevalent, and more than 75 percent of women can have good outcomes after current treatments.
 

This type of cancer begins in the ovaries, which are on either side of the uterus. Ovarian cancer is the eighth most common cancer among women with an estimated 22,280 new cases of ovarian cancer diagnosed in the U.S. in 2012. Ovarian cancer accounts for three percent of all new cancers in women.
There are many different types of ovarian cancer, which can be grouped into three categories:
 
  • Epithelial ovarian cancer: This is the most common type of ovarian cancer. It begins in the cells on the surface of the ovary or in the fallopian tubes.
 
  • Germ cell ovarian cancer: This is an uncommon type of ovarian cancer. It begins in egg-producing cells of the ovaries. This type of cancer is more common for young women (ages 10-29).
 
  • Sex cord-stromal ovarian cancer: This is a rare form of ovarian cancer that develops in the connective tissue cells that hold the ovaries together and make female hormones.

This type of cancer begins in the uterus, the pear-shaped organ in a woman's pelvis where the fetus grows when a woman is pregnant. Cancer of the uterus is the most common cancer of the female reproductive organs in the United States, with an estimated 47,000 new cases in 2013. Nearly 80 percent of these women will have good outcomes after treatment.

  • Vaginal cancer: This type of cancer begins in the vagina, the channel between the bottom of the uterus and the outside of the body.
     
  • Vulvar cancer: This type of cancer begins in the vulva, the outer part of the female genital organs. When vulvar cancer is detected early, it is highly curable.
     
Gynecologic Cancer Risk Factors
 
The risk of gynecologic cancers varies depending on the cancer type, with uterine and ovarian cancer more common than other types. The exact causes of gynecologic cancers are not known, but understanding the risk factors may help you take preventative measures to reduce the likelihood of developing a disease.

General
 
  • Age: Most cases of gynecological cancer are found in women who are middle-aged or older. Two-thirds of women diagnosed with ovarian cancer are 55 or older.
 
  • Childbearing status: Women who have never had a pregnancy are at increased risk of ovarian cancer. Scientists believe that the high number of lifetime ovulations in women who don’t have children is what increases risk. However, taking oral contraceptives at some point during your life, which reduces your number of lifetime ovulations, may decrease risk of ovarian cancer. Breast-feeding can also reduce the risk.

Lifestyle
 
 
  • Obesity: Being overweight increases your risk of uterine and ovarian cancers.
 
  • Smoking: Smoking may weaken the cells of the cervix, vulva and vagina, increasing the likelihood that abnormal cells will advance to cervical cancer, vulvar cancer, or vaginal cancer.

Genetics
 
 
  • Family history of gynecologic cancer or other cancers: If your mother, sister or daughter has been diagnosed with a gynecologic cancer, you are at increased risk. Your risk is also increased if you have a family history of other cancers, including breast cancer, colon cancer and rectal cancer.
 
  • Inherited gene mutations: Women with mutations in certain genes or whose families have genetic syndromes that increase risk of several types of cancer are at increased risk for gynecologic cancers. Mutations in the genes BRCA1 and BRCA2 increase the risk of ovarian cancer. A syndrome known as hereditary non-polyposis colorectal cancer (Lynch syndrome) increases the risk of ovarian cancer and uterine cancer.

Previous treatments or conditions
 
 
  • Radiation therapy: Women who have had radiation to the pelvic area are at a higher risk of developing a gynecologic cancer.
 
  • Hormone therapy: Menopause hormone therapy using both estrogen and progesterone is associated with an increased risk. Exposure in the womb to diethylstilbestrol (DES). This synthetic estrogen was prescribed to pregnant women until 1971 to relieve complications of pregnancy. It is now known that offspring of women who took this drug are at increased risk of cervical cancer and vaginal cancer.
 
  • Diabetes: Women with diabetes have a higher risk of developing uterine cancer. HIV or another condition that weakens the immune system: These conditions increase the risk of cervical, vulvar and vaginal cancers.

     
  • HPV infection: Infection with the human papillomavirus (HPV) can increase the risk of cervical, vaginal and vulvar cancers. HPV often does not cause any symptoms and infects at least half of all sexually active people at some point in their lives. Not every woman who gets HPV will develop gynecological cancer.
     
  • History of abnormal Pap smears: Women who have had abnormal Pap smears (pre-cancerous conditions) have increased risk of gynecologic cancers.
     
  • Tamoxifen: Taking this drug, often used to prevent breast cancer in women at high risk for that disease, slightly increases risk of uterine cancer.