If you have questions regarding our services, please read some of our frequently asked questions below. If you have any other concerns that aren’t listed here, please don’t hesitate to contact us.
A gynecologic oncologist is a doctor who specifically manages the treatment of cancers of the ovary, uterus, cervix, vagina, vulva and other female genital tract malignancies. After medical school, gynecologic oncologists complete a 4-year residency in Obstetrics and Gynecology. Following this, a 3 to 4 year fellowship in Gynecologic Oncology is completed. During this time, special surgical skills are obtained in radical pelvic, gastrointestinal, and urologic surgery. This fellowship also provides training in administration of chemotherapy. The gynecologic oncologist must take a written and oral examination in Obstetrics and Gynecology to become a board certified OB/GYN. After this, a second written and oral examination must be taken in Gynecologic Oncology to become a board certified Gynecologic Oncologist.
The specific cause of cancer is unknown.
A papanicolaou smear (Pap Smear) is a screening tool used to detect pre-cancerous changes of the cervix. It is not useful in screening for ovarian or uterine cancers. If pre-cancerous changes are noted on pap smears, it can often be treated before it turns into invasive cancer.
If the Pap smear is abnormal, your doctor may use an instrument to magnify the cervix called a colposcope. This is done in the office and is usually painless. It allows the examiner to identify abnormal areas of the cervix, vagina or vulva. There may be slight burning when acetic acid (vinegar solution) is applied to accentuate abnormal cells. If there are abnormal appearing areas, a biopsy may be taken. This will cause some mild cramping.
The stage of a malignancy describes the location of the cancer and what organs it may have spread to. Gynecologic cancers have 4 stages. Stage I and II usually represent early disease while Stage III and IV correlate with advanced disease. Grade is a description of what the cancer cells look like under a microscope. Gynecologic cancers usually have 3 grades.
A CA-125 blood test measures secretions from some cancers, especially ovarian cancer. It is not a good screening tool because it can be elevated in some benign conditions. It is primarily used in patients with ovarian cancer to monitor the disease.
Ovarian cancer can spread by shedding malignant cells from the ovary throughout the abdominal cavity. The cells can implant on the lining of the abdominal cavity (peritoneum) and can also grow on the surface of the liver, diaphragm, omentum, bladder, or intestines. Cancer cells can also spread through the blood stream or lymphatic system.
You are at increased risk of developing ovarian cancer if a close relative, such as a mother or sister has the disease. A genetic test called BRCA 1 and 2 may be recommended if you have a strong family history of breast and/or ovarian cancer. Removal of the ovaries will be discussed if this test is positive. There is no screening test for ovarian cancer. Exams, vaginal ultrasound and CA 125 tests may be recommended once or twice a year in high risk women.
Radiation Therapy FAQs
Radiation therapy is a treatment using high energy rays (x-rays) to kill cancer cells. The radiation may come from the outside of the body (external radiation) or from radioactive materials placed directly in or near the tumor (internal radiation from implants). A doctor who specializes in this type of radiation treatment is called a Radiation Oncologist. External radiation is usually given 5 days a week for 5-6 weeks. A low dose of chemotherapy is often given with radiation to sensitize the cancer cell to the radiation. This makes the radiation more effective.
Complications and side effects associated with radiation include fatigue, diarrhea, nausea and vomiting. The skin may become red, dry, tender, and itchy. There may be a darkening of the skin in the treated area. This area should be protected from sunlight. Bleeding from the bladder or rectum, vaginal scarring, intestinal obstruction or leaks (fistulas) from the urinary or intestinal tracts may also develop. Radiation to the vaginal areas can also cause vaginal dryness and scarring which may cause difficulty with intercourse.
Please let your doctor know if these problems occur as some of these may be corrected with the proper treatment.
Chemotherapy is the use of drugs to treat various types of cancer.
Benign, or non-cancerous cells, grow and die in a controlled way. Cancer cells are abnormal and continue to divide forming more cells without order or control. Chemotherapy or anti-cancer drugs destroy cancer cells by killing rapidly dividing cells. Unfortunately, chemotherapy effects both cancer and healthy cells.
Depending on the type of cancer and the drugs used, chemotherapy may be given in the following ways:
Intravenous - Chemotherapy given through a thin needle or catheter inserted into a vein in the hand, lower arm or through a port.
Oral - Some chemotherapy drugs are given in a pill or capsule form.
Intraperitoneal - delivers chemotherapy directly into the abdominal cavity. This requires placement of a catheter and port beneath the skin entering the abdominal cavity. The chemotherapy is given via a needle into this port which then enters the abdominal cavity.
The side effects of cancer treatment vary depending on the type of treatment and the individual receiving the drugs. It is difficult to limit the effects of therapy so that only cancer cells are destroyed, therefore, healthy cells and tissues can be damaged and cause unpleasant side effects.
Nausea and vomiting may occur with some chemotherapy. Prior to chemotherapy, anti-nausea medications are given intravenously. You will also be given prescriptions for medications which may be taken after treatment if nausea and vomiting persist. Please call the oncology nurse if the nausea or vomiting is not controlled with the prescribed medication.
Hair loss (alopecia) is a common side effect of some chemotherapy drugs used to treat gynecologic cancers. Hair loss can occur on all parts of the body, not just the head. You may lose facial, underarm, leg, pubic hair, along with eyelashes and eyebrows. Hair usually starts to fall out 2-3 weeks after the first treatment. Hair loss is temporary and does grow back after chemotherapy is completed. Hair may grow back in a different color and possibly texture. Your oncology nurse can help you to deal with your hair loss and provide information about wigs, turbans, scarfs, etc.
Fatigue and anemia sometimes result from bone marrow suppression secondary to chemotherapy. The bone marrow’s ability to make red blood cells is decreased with chemotherapy. Red blood cells carry oxygen throughout your body. When there are too few red blood cells, you may experience anemia. This may make you feel weak and tired. Your blood will be checked often. If your red blood cell count is low, medication or a blood transfusion may be needed.
Infection may occur during chemotherapy because of a lower white blood cell count. White blood cells are important to help fight infections. Chemotherapy decreases the bone marrow’s ability to produce white blood cells. Your blood count will be checked often to monitor these cells. If the count is low, medication may be needed to increase the count or oral antibiotics may be prescribed to prevent or treat infection.
Bleeding may occur during chemotherapy secondary to lower platelet counts (cells that help blood clot). If you cut yourself, apply pressure and notify your doctor if the bleeding continues.
Diarrhea or constipation may occur with some chemotherapy drugs. Medications and/or changes in the diet may be needed to help correct this problem. The nurses can be helpful if these problems continue to recur.
Neuropathy or nerve pain (numbness, tingling, or burning) in the hands and feet is a side effect associated with many chemotherapy drugs. These symptoms may go away after treatment is completed but this may take up to one year. Sometimes this can be permanent. Medications may help with symptoms. Please talk with the nurse or physician if this is a problem.
Joint aches and muscle pain may be experienced during and after treatment with some chemotherapy drugs. These symptoms usually occur 2-4 days after treatment and may last for another 2-3 days. Medication can be prescribed to lessen the pain.
It is important to eat a healthy diet while on chemotherapy. This can sometimes be difficult due to changes in appetite, taste, nausea, vomiting, or mouth sores. It is recommended that you try to eat a diet high in protein and carbohydrates and drink plenty of water or fluids (at least 6-8 large glasses per day). It may also be helpful to eat 5 or 6 small meals daily rather than 3 regular sized meals. If eating becomes difficult, nutrition supplements may be helpful.
*It is extremely important to communicate any of the previously listed side effects or any other problems to the oncology nurse or doctor. The oncology nurses are available to help in many ways.
Every patient receiving chemotherapy is different. Some are able to do normal activities and others are not. It is very important to do only what you feel you can do and not to over extend yourself or work to exhaustion.
Progress during treatment will be monitored closely by your doctor and oncology nurse. You will be monitored with frequent blood work and physical exams. X-rays and scans may be done at the discretion of the doctor.