October 3, 2016 | by Alison Shore
Know your body.
This is straightforward, but sage advice from gynecologic oncology surgeon Ernest Han, M.D., Ph.D., assistant professor in the Division of Gynecologic Oncology at City of Hope, whose work focuses on cancers of the reproductive organs. "While these cancers — including ovarian, uterine, cervical, vaginal and vulvar — are much less common than lung, breast or colon cancers in women, every woman should be aware of the signs, symptoms and risk factors for developing one of these cancers.
Here Han shares how he and City of Hope are on a mission to ease patients’ anxieties, find better diagnostic and treatment methods, and empower women with the knowledge they need to maintain their gynecologic health.
How is City of Hope looking at ways to improve the treatment of these cancers?
“We’re trying to develop fluorescence imaging technologies to identify ovarian cancer cells during surgery, which would be more sensitive than the naked eye,” Han said. “This could potentially help improve the surgical removal of this deadly disease. We are using this type of technology already for other gynecologic cancers, such as cervical and uterine. Currently, we are exploring the use of sentinel lymph node detection by fluorescence imaging — whether it will be a standard of care, I don’t know, but it seems to be catching on across the country.”
What are the barriers to early detection of ovarian cancer?
“The key missing factor is a great screening tool,” he said. “We’ve tried to use pelvic ultrasound; looked for biomarkers such as CA-125 or used a combination of the two. These approaches have produced too many false positives, resulting in unnecessary surgeries and false negatives, which miss the cancer altogether. The problem is where the cancer is. In ovarian, it’s internal and deep, so we can’t perform a biopsy and sample the ovaries, which we can do in cervical. We’re still trying to find a noninvasive way to screen.”
Are you using or studying any promising gynecologic cancer treatments at City of Hope?
“We’re trying to focus on less invasive surgical procedures, such as robotic-assisted surgery or laparoscopy, at least for uterine and cervical cancers,” Han explained.
“For ovarian cancer, major abdominal surgery is still required. Our medical oncologists are optimistic about regional therapies, in particular, getting chemotherapy right to where the tumor was in the abdomen and pelvis. We are studying heated chemotherapies administered into the abdomen during surgery, as well as other new drug delivery systems such as nanoparticles and viruses.”
What can women do to help prevent and detect gynecologic cancer?
“The best thing women can do is monitor for symptoms,” Han said. “Be aware of your body. Pelvic pain and abnormal vaginal bleeding or discharge, particularly for longer than a few weeks, can be warning signs for cancers and should be evaluated by your health care provider.” Vaginal bleeding after making the transition into menopause should always be checked, he added.
Han encourages women to know their family histories. With ovarian cancer, 10 to 15 percent of cases are hereditary. Genetic testing may be an option, but women should consult with their health care provider first.
“If you do get a cancer diagnosis, see a gynecologic oncologist — it’s important for women to understand that these are OB-GYN specialists who went through specialized training to treat women’s cancers below the belt,” he said.
Han also reinforced the importance of getting children and young adults between the ages of 9 and 26 vaccinated for the human papillomavirus (HPV).
“Unfortunately, we haven’t done a great job of getting the message out about the vaccine,” he said. "We are very fortunate to have such an effective HPV vaccination. It's incredible to be able to say 'wouldn't you like to take a cancer vaccine to prevent this type of cancer?'"
Learn more about City of Hope's gynecological cancers program. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.