Gynecologic Oncology

A cancer operation in this field is not simply a larger version of routine gynecologic surgery. Staging, assessment of lymph nodes and the decision about how much tissue must be removed all change the outcome of treatment, and they are made during the operation as well as before it. That is why the subspecialty exists.

Conditions Covered

• endometrial cancer, which begins in the lining of the uterus and most often announces itself through abnormal bleeding.
• cervical cancer, which develops in the neck of the womb and is closely linked to persistent HPV infection.
• ovarian cancer, which tends to produce vague symptoms and has no approved population screening test.
• Cancers of the vulva, vagina and the peritoneum, which are less common but managed within the same subspecialty.

Benign conditions that still require subspecialty surgery are also managed here, including myoma (fibroid) surgery, deep endometriosis and ovarian cysts whose imaging features are not clear cut.

How the Surgical Method Is Chosen

Open, laparoscopic and robotic surgery are tools rather than competing brands. The choice follows the extent of the disease, the patient’s general condition and what she expects from treatment. Details of the minimally invasive options are on the laparoscopic and robotic surgery page.

How an Assessment Usually Proceeds

A first appointment begins with the history and examination, followed by ultrasound in most cases. Where the findings require it, further imaging such as MRI, a biopsy, or blood tests are arranged. The purpose at this stage is to establish what is actually there before any decision about treatment is discussed.

If you have been assessed elsewhere, bring the reports with you. Comparing a current scan with an earlier one frequently answers more than either scan does alone, and it can spare you a repeat investigation.

When a Subspecialist Should Be Involved

• A mass with suspicious features on ultrasound or MRI
• Any bleeding after menopause
• A biopsy or smear result that suggests precancerous or cancerous change
• A known family history of ovarian, uterine or bowel cancer
• A diagnosis already made elsewhere, where a further opinion is wanted before surgery

Treatment in this field is rarely the work of one person. Pathology, radiology, medical oncology and radiation oncology all feed into the plan, and the pathology report in particular often changes what is recommended after surgery. Patients are told what the report showed and what follows from it.

Common questions are answered on the frequently asked questions page. To arrange an assessment, see the contact page. This page is general information and does not replace an examination. Decisions about your own treatment can only be made after assessment.