Gynecologic cancers include cancer of the uterus, ovaries, cervix, vagina, vulva and Fallopian tubes.
Approximately 110,000 women will be diagnosed with a gynecologic cancer this year.
The most common gynecologic cancer is uterine cancer and it is on the rise, with more than 60,000 cases expected this year.
Widespread screening with the Papanicolaou (“pap”) test has allowed doctors to find pre-cancerous changes in the cervix and vagina, which has helped to prevent the development of some invasive cancers.
Treatment Options for Gynecologic Cancers
Treatment of gynecologic cancers depends on several factors, including the type of cancer, extent of disease (stage), location and your overall health. It is important to talk with several cancer specialists before deciding on the best treatment for you.
A gynecologic oncologist is a doctor who specializes in surgically removing gynecologic cancers.
A radiation oncologist is a doctor trained to treat cancer with radiation therapy.
A medical oncologist is a doctor who specializes in treating cancer with drugs (chemotherapy).
Sometimes, your cancer may be treated by using only one type of treatment. In other cases, your cancer may be best cured using a combination of surgery, radiation therapy and chemotherapy.
External Beam Radiation Therapy
External beam radiation therapy involves a series of daily treatments delivering radiation to your tumor. In most gynecologic cancers, radiation treatments consist of treatment for the primary tumor +/- regional lymph nodes. 3-dimensional conformal radiotherapy (3D-CRT) combines multiple radiation treatment fields for precise delivery of radiation to the pelvis. Each of the radiation beams is designed to accurately focus on the patient’s tumor while at the same time minimizing radiation to nearby organs such as the bladder, rectum or hips. Intensity modulated radiation therapy (IMRT) is an advanced version of 3D-CRT that modifies the intensity of the radiation within each beam and may be used to improve sparring of your non-cancerous tissues.
Radiation treatments usually last less than 5 minutes but your appointment time is 15-30 minutes each day, Monday through Friday, for five to 7 weeks. This may be performed in combination with brachytherapy (internal radiation), chemotherapy/hormone therapy, or both.
Potential short-term side effects include skin irritation, fatigue, increased frequency or discomfort with urination, vaginal irritation, and cramping and/or diarrhea. Some patients have minor or no side effects, and typically symptoms resolve within a few weeks after completing treatments. If you have any symptoms during treatment, talk to your doctor, as he or she may be able to provide medications or other treatments that may help.
Brachytherapy (Internal Radiation)
Brachytherapy (also called internal or intracavitary radiotherapy) involves placing radioactive sources in or next to the cancer. This is usually done at the same time or after external beam radiation therapy. Brachytherapy is very important in the treatment of vaginal, cervical and uterine cancers.
There are two main types of brachytherapy:
Low-dose rate brachytherapy is delivered over the course of 48 to 72 hours. You will be admitted to the hospital to receive this treatment. This type of treatment is less frequently used, now only in specific situations.
High-dose rate brachytherapy is administered over the course of several minutes, but the entire procedure takes a few hours and typically requires general anesthesia. After recovery from anesthesia, you will be able to go home, later the same day.
Depending on the type of cancer you have, you may need to have several sessions of internal radiation as part of your treatment.