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Q&A Topic: What Should I Know About Gynecologic Cancers?

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Gizelka David-West, MD gynecologic cancer

Ask a Gynecologic Oncologist
Gizelka David-West, MD
Northwell Health Cancer Institute
Northern Westchester Hospital, Phelps Hospital

Q. What is important for women to know about gynecology and cancer?
A. When many people think of gynecology, they think of pap smears, but there is much more to it than that. Gynecologic cancers can develop in a few different reproductive organs: the uterus, cervix, ovaries, fallopian tubes, vagina, and vulva. It’s important for women to know that even after having children or experiencing menopause, they should continue their annual visits and be aware of screening guidelines: pelvic exams annually after age 18, cytology-based pap smears every 3 years after age 21, or co-testing with cytology and human papillomavirus (HPV) tests every 5 years between the ages of 30 to 65.

Q. Early detection is key to preventing many types of cancer. How does this apply specifically to gynecologic cancers?
A. The best screening method we have is the combination HPV test and pap test for cervical cancer that is proven to prevent disease. Uterine cancer screening is a clinical evaluation and assessment of the clinical history of patients with abnormal uterine bleeding patterns. There is also much research being done in early detection methods for ovarian cancer.

Q. Should women have different gynecologic concerns at different ages in their life?
A. Age plays a role in gynecologic cancers, but the role varies with each cancer type. Cervical cancer is prevalent in younger women in their 40s, uterine cancer in ages 50 and up, and ovarian cancer from ages 50 to 60. While guidelines state that women can stop cervical screening at age 65, it is important for women over 65 to know that they should continue screening, especially if they’re sexually active or have a history of HPV infection.

Q. How does your use of robotics benefit patients undergoing gynecologic cancer surgery?
A. The da Vinci surgical system is a robotic, minimally invasive tool that allows for greater precision and increased dexterity for me as the surgeon. Because of this, patients typically experience less pain, recover quicker, and may have lower risk of blood loss and infection. While it is preferred over open surgery, the benefit depends on the type of cancer being treated. We primarily use it for endometrial cancer.

Q. What about the future of gynecologic oncology excites you?
A. The incorporation of maintenance therapy for our patients with advanced stage disease has dramatically changed the treatment landscape. In ovarian cancer, we are seeing an improvement in survival thanks to available maintenance therapies, such as VEGF and PARP inhibitors. And, earlier this year, the SIENDO study showed promising results which may address the increasing mortality rate we are seeing in uterine cancer and provide more options for patients to prevent recurrence of disease. Additionally, in cervical cancer, there have been great advancements in immunotherapy which gives us an opportunity to improve survival.

Q. What is special about the oncology team at Northwell Health?
A. Northwell puts so much effort and emphasis on the multi-disciplinary approach to cancer treatment. Oncologists and radiologists get together to review every case to ensure patients are receiving the most up-to-date, leading-edge treatment options available. When you’re told you have cancer, not only do you need cancer treatment, you also need psychosocial and wellness support, as well as any necessary physical therapy support. Northwell offers all of this for our cancer patients. In addition, our patient navigators and care managers are great and really help patients through this complex and difficult time in their lives.

Northwell Health Cancer Institute
Northern Westchester Hospital, Phelps Hospital
nwh.northwell.edu/david-west | (914) 666-1775

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