Treatment for gynecologic cancers depends on several factors, including the type of cancer, its extent (stage), its location and your overall health. It is important to talk with several cancer specialists, including a radiation oncologist, surgeon and medical oncologist, before deciding on the best treatment for you, your cancer and your lifestyle. Sometimes, your cancer may be treated by using only one type of treatment. In other cases, your cancer may be best treated using a combination of surgery, radiation therapy and chemotherapy.
Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to treat cancer safely and effectively. Radiation oncologists use radiation therapy to try to cure cancer, control cancer growth or relieve symptoms, such as pain.
Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them. Healthy cells are also affected by radiation, but they can repair themselves in a way that cancer cells cannot.
There are two types of radiation therapy. External beam radiation therapy directs radiation beams at the cancer from outside your body. Internal radiation therapy, or brachytherapy, is delivered with radioactive sources that are temporarily placed into the vagina, uterus and/or surrounding tissues to kill the cancer cells.
Surgery is an important part of treatment for many tumors of the female reproductive system. A gynecologic oncologist is a doctor who specializes in surgically removing and treating gynecologic cancers.
For uterine and cervical cancers, surgery usually involves the removal of the uterus and cervix, called a hysterectomy. The surgeon may also remove lymph nodes and check for any cancer cells within the fluid within the abdomen. For less common tumors like vulvar cancer, surgery is more likely to involve removing part or all of the vulva and sampling lymph nodes.
Surgery and radiation can be combined to help lower the risk of recurrence of cancer after surgery, but this strategy varies based upon the disease and stage (how much the tumor seems to have spread).
In cases where radiation is the main treatment, it is often still important to keep your surgeon involved in follow-up after radiation to monitor for signs of recurrence.
Anti-cancer drugs known as chemotherapy have been proven to improve cancer cure rates in certain gynecologic cancer patients. These medications are used in a variety of different cancers and tend to be used for stage III and IV gynecologic cancers. The dose and schedule for treatment varies, and chemotherapy can be done either alone or with radiation therapy. Because chemotherapy recommendations vary significantly depending on disease and stage, it is important to discuss this with a medical oncologist or gynecologic oncologist (surgeon). Both can prescribe chemotherapy for gynecologic cancers. Talk with your surgeon about whether you need a separate appointment with a medical oncologist for evaluation or treatment.