Gynecologic Cancer Program
Women with gynecologic cancers must deal with the psychological impact of a cancer that affects their very definition of femininity while they worry about survival. At Froedtert & The Medical College of Wisconsin, a team of specialists helps women cope with the psychological effects of having a gynecologic cancer, while designing a treatment program to give them the best chance of a positive outcome.
Specialty CareThe physicians in the Gynecologic Cancer Program at Froedtert & The Medical College of Wisconsin are nationally recognized experts who work together for the benefit of their patients. While women are assigned a gynecologist oncologist who will oversee their case, all treatment decisions are made as a team, after considering the input of multiple experts. The Gynecologic Oncology tumor board, a multidisciplinary group that includes radiation oncologists, gynecologic oncologists, pathologists, radiologists and specialists in obstetrics and gynecology, meets regularly to review individual patient cases. Having all of this expertise in one room allows physicians to create coordinated treatment plans based on the input of experts from each discipline involved with treatment. This is critical when treating a complex disease such as cancer; an uncoordinated approach may complicate treatment or may not uncover treatment options that could be of benefit.
A Broad Range of Treatment OptionsIn the Gynecologic Cancer Program, women have access to the most current treatments. Surgical alternatives include open, laparoscopic and robotic-assisted procedures. Chemotherapy is administered intravenously and, when appropriate, using intraperitoneal chemotherapy, a technique that has been proven to increase ovarian cancer survival. Radiation therapy is tailored to the specific cancer and may include external or internal radiation. Froedtert & The Medical College of Wisconsin set the standard in cancer treatment, frequently bringing new therapies to residents of Wisconsin.
Clinical TrialsClinical trials offer additional treatment options for women who meet specific eligibility criteria. If you have been newly diagnosed with cancer, or if you have not responded to standard treatmaents, ask your doctor about participating in a clinical trial. By participating in a cancer clinical trial, you become a partner in discovery and work one-on-one with the research team. You also have a vital and active role in your care. You should know that you will receive the customary, high standard of medical care whether or not you choose to participate in a clinical trial. Take plenty of time to review all the information you receive about a clinical trial so you fully understand it. The decision to participate is yours to make. Learn more about current clinical trials for gynecologic cancers.
SurgerySurgery is a mainstay of cancer treatment. Most patients with gynecologic cancer will undergo some kind of surgery; for many patients, surgical treatment may be all that’s required.
At Froedtert & The Medical College of Wisconsin, gynecologic oncologists recommend surgical alternatives based on the patient’s type of cancer and its stage, as well as a woman’s health history and overall health status. Whenever possible, our physicians recommend (and perform) minimally-invasive surgeries to increase patient comfort and decrease healing time. Hysterectomy, the treatment of choice for endometrial cancer, can be performed laparoscopically with or without the aid of the da Vinci® Surgical System. This physician-controlled robotic technology improves the visual field and increases range of motion, enabling physicians to manipulate surgical tools in ways that would be impossible for the unaided human hand. Our physicians are accustomed to being on the leading edge: Medical College of Wisconsin gynecologic oncologists were the first in the area to perform laparoscopic cancer staging and the first to perform laparoscopic radical hysterectomies.
ChemotherapyNot all gynecologic cancer patients will require chemotherapy. But for those who do, Froedtert & The Medical College of Wisconsin presents a broad range of treatment options, including standard intravenous chemotherapy, intravenous and intraperitoneal chemotherapy, and novel combinations of drugs offered as part of national clinical trials.
Froedtert & The Medical College of Wisconsin were the first in the region to offer intraperitoneal chemotherapy for patients with ovarian cancer – just a month after the national Gynecologic Oncology Group published a report showing increased survival rates for ovarian cancer patients treated with a combination of intravenous and intraperitoneal chemotherapy (chemotherapy instilled directly into the abdomen). Today, approximately 80 percent of our ovarian cancer patients qualify for – and receive – intraperitoneal chemotherapy. Nationwide, only about 50 percent of women who qualify for intraperitoneal chemotherapy receive the potentially life-saving treatment.
RadiationAs an academic medical center, Froedtert & The Medical College of Wisconsin treats thousands of patients every year. Because our radiation oncologists have such extensive experience, they are able to offer a wide variety of innovative radiation therapies.
Froedtert & The Medical College of Wisconsin were the first in the region to use high dose rate brachytherapy, a kind of internal radiation, to treat gynecologic cancers. With high dose rate brachytherapy, a number of tiny catheters (tubes) are placed into and around the tumor, and a high dose of radiation is delivered through the catheters to the tumor. The entire treatment takes hours instead of days. Image guidance is used to target the tumor and avoid adjacent normal tissues.
Froedtert & The Medical College were also the first healthcare facility in the nation to be named a “Tomotherapy Center of Excellence,” and are expanding the use of image-guided radiation to improve patient outcomes while minimizing side effects. Imaging scans allow the radiation oncologist to deliver high doses of radiation precisely to the tumor location. (The tumor location can change slightly from day to day.) Our advanced technology enables us to target the tumor, while avoiding healthy tissue.
Cancers TreatedOur Gynecologic Cancer Program specializes in the treatment of cervical, endometrial, ovarian, vaginal and vulvar cancers. We also see women with rare, pregnancy-related cancers, including gestational trophoblastic disease.
Cervical cancer Our specialists treat pre-cancerous cervical and invasive cervical cancer. We are participating in a National Institutes of Health-funded study to evaluate genetic predisposition to the development of cervical cancer. Visit our clinical trials section to learn more.
Endometrial cancerThe key symptom of endometrial cancer is unexplained vaginal bleeding. If you have any unexpected vaginal bleeding, particularly after menopause, contact your healthcare provider at once.
Ovarian cancerBecause there are not yet any effective screening methods for this disease, and because it often causes no symptoms or ill defined symptoms, ovarian cancer is frequently advanced by the time it’s diagnosed. That makes prompt treatment an absolute necessity.
Early symptoms may include:
- Persistent abdominal bloating
- Feel full only a few bites into a meal
- Nausea or vomiting
- Changes in bowel habits, especially constipation
- Abdominal pain or pressure
- Sharp pelvic pain
- Distended abdomen
Vaginal and vulvar cancersEarly symptoms of vaginal and vulvar cancers may include pain, discomfort during intercourse, or a palpable lump.
Gestational trophoblastic disease (GTD)GTD is a general term for a rare group of cancers that occur in women of childbearing age. Instead of growing on or in an internal organ, tumors related to GTD develop from cells that would normally grow into the placenta during a pregnancy. GTD is highly treatable.
PreventionThe specialists in the Gynecologic Cancer Program at Froedtert & The Medical College of Wisconsin also help women identify and act on risk factors for gynecologic cancer. Certain genetic mutations, particularly mutations of the BRCA 1 and BRCA 2 genes (commonly known as “breast cancer genes”) can increase a woman’s risk of ovarian cancer. If a woman has a family history of breast or ovarian cancer, she should bring it to the attention of her physician, who may recommend additional screening or prophylactic removal of the ovaries to prevent cancer. Endometrial cancer may be related to colorectal cancer, so a family history of gastrointestinal cancers requires further investigation as well.
Women with a family history of uterine and colon cancer may wish to meet with a genetic counselor to be screened for Lynch Syndrome. Sometimes, testing can be done in Pathology with a tissue sample to see if a woman is at increased risk.
The Cancer Genetics Screening Program at Froedtert & The Medical College of Wisconsin serves individuals who may be at increased risk of cancer due to a personal history or family history of cancer. Certified genetic counselors assess risk and provide information about genetic testing, cancer genetics, early detection, improved cancer management and possible risk reduction. Learn more about the Cancer Genetics Screening Program.
Women should also take advantage of screening programs designed to catch gynecologic cancers at an early stage. The PAP test, a screening test for cervical cancer, is perhaps the most effective cancer screening test in history. While there are no proven screening techniques for ovarian cancer, pelvic ultrasound and CA-125 blood tests can be used to screen high-risk women.
Second Opinion ProgramMake sure you have all the information you need before making a treatment decision. The specialists at the Gynecologic Cancer Program at Froedtert & The Medical College of Wisconsin offer second opinion appointments within 24 hours of your call. When you schedule an appointment, the Gynecologic Cancer Program team will review your case carefully, including lab results and pathology reports. A physical examination is also made before treatment recommendations are formed. To schedule a second opinion appointment, call the Gynecologic Cancer Second Opinion Program at 414-805-0505 or 866-680-0505.
Rehabilitation After Cancer TreatmentGynecologic cancers can cause lingering side effects, such as lymphedema, even after the cancer is under control. Rehabilitation is an important part of comprehensive care. The Rehabilitation Program focuses on improving quality of life and functional independence in mobility, safety and activities of daily living after cancer treatment. The team is led by physicians with specialized training in physical medicine and rehabilitation, as well as by experienced physical and occupational therapists. Rehabilitation includes inpatient and outpatient services, depending on the functional needs of the individual.
The functional recovery process continues in an outpatient setting in the Froedtert & The Medical College Clinical Cancer Center. Physical medicine and rehabilitation physicians, along with physical and occupational therapists, create individualized rehabilitation plans that address specific patient needs.
The Cancer-Brain ConnectionAt Froedtert & The Medical College of Wisconsin, we understand that cancer affects the mind as well as the body. While many patients expect to feel some sadness or depression, they are often surprised to experience mental slowness or difficulty with memory following cancer diagnosis and treatment. Our Neuro-Oncology Cognitive Clinic can help patients and their families deal with mental and emotional challenges, including the very real cognitive changes that can occur as a result of chemotherapy.
Preserving FertilityGynecologic cancers attack a woman’s reproductive organs – but that doesn’t mean you’ll never be a parent. Froedtert & The Medical College of Wisconsin offer fertility preservation options, including egg freezing. We use a highly specialized technique called “vitrification,” which freezes eggs quickly, preserving their viability. Learn more about fertility preservation, offered through our Reproductive Medicine Center.
Support ServicesOur patients also have access to the Jeffrey C. Siegel Quality of Life Center (located within the Clinical Cancer Center) for emotional, nutritional and spiritual support, as well as financial counseling. We are proud to have psych-oncology nurse specialists on staff. These are advanced degree nurses who counsel patients and families and can also prescribe medication. Other resources include a rehabilitation gym and the Small Stones Wellness Center, located at the Clinical Cancer Center. Genetic counselors are available if family history indicates a genetic link to gynecologic cancer. We also offer cancer support groups, including a support group just for women with gynecologic cancers. Each group session offers a speaker and new topic, as well as a chance to mingle with women facing a similar diagnosis.
Learn more about support available at the Quality of Life Center.
Palliative CareWhen a cure is no longer an option, the Gynecologic Cancer Program team works closely with the specialists within the Palliative Care Program to provide comfort and support to patients and their families. The Froedtert & The Medical College of Wisconsin Palliative Care Program was established in 1993 and remains the only program of its kind in the state of Wisconsin. It is known locally and nationally as a leading resource for improving end-of-life care.
Last Review Date: June 26, 2013
Online Editor(s): Andy Monigal