UofL Physicians’ gynecologic oncologists provide the most up-to-date, patient-centered and compassionate care to women with cancerous and precancerous conditions of the female reproductive organs. We assure that our patients have expert access to the latest diagnosis and management options for cervical, ovarian, uterine, vaginal and vulvar cancers, as well as treatment of cervical dysplasia and gestational trophoblastic disease.
UofL Physicians-Gynecology Oncology specialists are trained in the latest clinical modalities that are constantly enhanced by our physicians’ basic science and clinical research to treat all facets of the disease, from detection to surgery to chemotherapy or radiation. Our physicians are on the forefront of minimally invasive surgical procedures, including the computer-assisted robot and laparoscope that offer faster recovery times with less pain and lower risks of complication. In addition, our medical team at the James Graham Brown Cancer Center offers carefully chosen and monitored regional and national research trials to ensure patient access to leading-edge therapies.
When gynecologic cancers are detected early, collaborative treatment is most effective. Our physicians focus on superior, individualized care for each patient through the use of multidisciplinary teams of gynecology oncologists, radiation oncologists, pathologists, diagnostic radiologists, pain and palliative care physicians, oncology nurses and social workers.
Our medical team knows that a diagnosis of cancer can be an emotional experience. We pride ourselves in providing advanced care by educating women about the early warning signs of cancer, types of cancer, treatments and their risks or side effects, prognosis, fertility options after cancer, recovery time and life in remission. We offer comprehensive care while guiding our patients through the best treatments available at a convenient, supportive, world-renowned cancer center. We aim to provide care unsurpassed by anyone in our region.
- Abnormal Pap smears (cervical dysplasia)
- Ovarian cysts, masses and fibroids
- Noncancerous and cancerous tumors of the female reproductive tract (ovaries, uterus, cervix, vagina or vulva)
- abnormal vaginal bleeding
- heavy menstrual bleeding
- bleeding after menopause
- unusual vaginal discharge
- pain in the pelvic area
- pain during sexual intercourse
- bleeding after sexual intercourse
(All of these symptoms can also indicate other conditions, such as a vaginal infection.)
- abdominal discomfort
- abdominal distension or bloating
- nausea
- dyspepsia or indigestion
- early satiety or a feeling of fullness
- constipation
(All of these symptoms may also indicate other noncancerous conditions.)
Uterine cancer – symptoms:
- abnormal vaginal bleeding
- difficult or painful urination
- watery or bloody discharge
- pain in the pelvic area
- weight loss
- post-menopausal bleeding
(All of these symptoms may also indicate other noncancerous conditions.)
Vaginal cancer – symptoms:
- abnormal vaginal bleeding
- abnormal vaginal discharge
- pain during intercourse
- continuous pain in the pelvic area
- a lump in the vagina
- painful urination
- constipation
(All of these symptoms may also indicate other noncancerous conditions.)
- persistent itching in the vulva
- a lump or warty growth in the vulva
- an ulcer in the vulva that persists for more than a month
- tenderness, pain or burning in the vulva
If you have symptoms such as these, contact your gynecologist right away. We advise yearly pelvic examinations to screen for precancerous cell growth.
- Minimally invasive advanced laparoscopic and robotic and computer assisted robotic surgeries for removal of the uterus (hysterectomy), ovaries (oophorectomy), uterine fibroids (myomectomy).
- Advanced laparoscopic and computer assisted robotic surgery for invasive and pre-invasive endometrial, cervical, ovarian and vulvar cancers.
- LEEP procedure: an in-office procedure for abnormal Pap smears (cervical dysplasia)
- BRCA testing for hereditary cancer
- Diagnostic procedures, such as pelvic examination, colposcopy (in-office procedure that examines the cervix, vagina, and vulva to evaluate abnormal Pap smears), endocervical curettage (spoon-shaped instrument that obtains a small tissue sample of the mucous membrane leading from the cervix to uterus to check for abnormal cells), biopsy, and cone biopsy
Surgery: several methods may be used, including:
- laser surgery (burns or vaporizes abnormal cells or removes small sections of tissue)
- conization (removal of a cone-shaped section of tissue with surgical knife, laser or LEEP)
- hysterectomy (removal of some or all of the reproductive organs)
- radical hysterectomy with pelvic lymph node removal ( removal of tissue around cervix and lymph nodes for treatment of cervical cancer)
- pelvic exenteration (removal of reproductive organs, lymph, and possibly of bladder, vagina,rectum, and part of the colon)
Chemotherapy uses drugs to kill cancer cells or to stop their growth. These drugs vary in the way they are given. Some are taken by mouth. Others are injected into a vein or muscle or placed directly into the spinal column, an organ or a body cavity. Some chemotherapy drugs can be applied to the vulva in the form of a cream or ointment. Chemotherapy kills cancer cells but it also can damage normal cells. Side effects such as nausea can be treated during chemotherapy. Most side effects reverse after treatment.
Cervical cancers are treated with a combination of:
- surgery
- radiation therapy
- chemotherapy
The best course of treatment for cervical cancer depends upon its stage. Staging defines a cancer’s size and whether it has spread.
Uterine cancers are treated with one or more of the following:
- surgery
- radiation therapy (uses high energy x-rays to kill cancer cells. External radiation is done with a machine outside the body. Internal radiation places radioactive material directly into or near the cancer inside the body. Radiation can be used in less advanced cancers.)
- chemotherapy
- hormone therapy
Vulvar cancer is treated with some form of surgery to remove as much of the tumor as possible. In some cases, it is possible to remove the cancer and the tissue around it while leaving the vulva intact. Other cases require vulvectomy (removal of all or part of the vulva). Plastic surgery techniques can sometimes be used to reconstruct the vulva. Chemoradiation is used for treatment of advanced cancers.
- chemotherapy
- surgery
- radiation therapy
Evaluation of patients with possible gynecologic malignancies:
Ovarian cancer -- screening is not recommended for women who have no family history or personal history of cancer. Testing can lead to false positive tests that could lead to unnecessary surgery. However, genetic counseling and testing should be offered to women who have strong family or personal histories of breast, ovarian, endometrial, colon or urinary tract cancer. If testing for hereditary cancer is positive, these patients may benefit from preventative surgery or medical treatment. If a women is found to have findings suspicious for ovarian cancer work up could include:
- transvaginal ultrasound
- pelvic examination
- pelvic ultrasound
- CT scan
- barium enema X-ray or colonoscopy
- blood test for CA 125 (a substance released into the blood stream by cells)
- biopsy
- Pap test
- pelvic examination
- dilation and curettage
- hysteroscopy
- biopsy
- transvaginal ultrasound
- physical examination and medical history
- Pap test
- Pelvic examination
- Biopsy
- Colposcopy
- pelvic examination
- biopsy
Uterine cancer – patient evaluation:
- Pap test
- pelvic examination
- dilation and curettage
- hysteroscopy
- biopsy
- transvaginal ultrasound
Vaginal cancer –patient evaluation:
- pelvic examination
- biopsy
UofL Physicians-Gynecology Oncology are dedicated to providing the best care available in diagnosing and treating cancers of the female reproductive organs. Our doctors trained at the three of the most prestigious gynecologic oncology programs in the country: the MD Anderson Cancer Center at the University of Texas, the Memorial Sloan-Kettering Cancer Center in New York City and the Mayo Clinic in Rochester, Minn. Each provides comprehensive cancer care, including non-invasive surgeries performed using laparoscopic and the da Vinci robotic surgery systems.
In addition, our physicians teach the robotic surgery method to other physicians. They serve as leaders on advisory committees at the James Graham Brown Cancer Center, University of Louisville Hospital and on statewide Kentucky advisory boards and coalitions, as well as on a national clinical practice committee for the Society of Gynecologic Oncology. Each conducts research in various areas, such as gene therapy as a treatment for cancer, immunologic involvement in gynecologic malignancies, the use of monoclonal antibody therapy for the treatment of ovarian cancer and anxiety and post-traumatic stress disorder in gynecologic malignancies. Clinical trials for new therapies are ongoing, and when appropriate, patients are enrolled in these studies.
Our physicians have received numerous awards and honors, such as “Top Doctor in America” for consecutive years, “America’s Most Compassionate Doctors,” “Patients’ Choice Award,” Louisville Magazine’s “Top Surgeons,” and national faculty awards for excellence in teaching. In 2012, division director Lynn Parker, M.D., earned the Louisville respected honor of Julep Physician of the Year.
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