Treatment Approaches
City of Hope is at the forefront of gynecologic cancer treatment. For women needing medical intervention, we take a comprehensive and aggressive approach to treatment offering state-of-the-art surgical, medical, and radiation therapies, including many that are not yet available to the general public. Our Supportive Care and long-term follow-up programs help women and their families manage the process of treatment and recovery.

City of Hope uses a multidisciplinary approach to treat gynecologic cancers. Our surgeons, medical and radiation oncologists, and laboratory researchers collaborate closely throughout treatment to ensure gynecologic cancer patients receive the best care possible.
 
 
 
Surgery

City of Hope offers the latest advances in the surgical management provided by specialty trained gynecologic oncology surgeons. The scope of surgery is determined by the type, size, and location of the cancer.

For women with gynecologic cancers, in particular ovarian cancer, our goal is to locate and remove as much of the tumor tissue as possible. This type of procedure, known as “debulking” surgery, helps us to understand the extent of the cancer in the ovaries and elsewhere in the abdomen, and allows us to remove all of the visible cancer.  Ultraradical debulking, a surgery in which as much cancer as possible is removed, followed with chemotherapy gives patients the best chance of a cure. We are experts in this procedure.
 
When appropriate for patients, our specialists utilize minimally invasive surgery with advanced technologies such as laparoscopy and the da Vinci S Surgical System with robotic capabilities that allow for greater precision. We are one of a select number of gynecologic oncology programs in the country to routinely offer this surgery.  These surgeries feature small incisions, potentially less blood loss, less pain, shorter hospital stay and recovery time, fewer complications, and a quicker return to normal activities.
 
Our team of world-class specialists offers the latest modalities for gynecological organ preservation, and we offer leading-edge fertility-sparing options for young women who want to preserve their fertility after treatment.
 
For women at high risk of developing gynecologic cancer, we offer a preventative surgery called salpingo-oophorectomy, which involves the surgical removal of the ovaries and fallopian tubes. This procedure can reduce the chance of ovarian and related cancers by as much as 80% in women at high risk.
 
Medical Oncology
 
Medicines that slow or stop the growth of cancer cells are often included in a patient’s treatment plan. These drugs travel through the bloodstream and are able to kill any small cancer cells that have leaked into the blood and may take root in other parts of the body. We offer the best treatments available and are constantly investigating promising new treatments, including novel chemotherapies, endocrine therapies, and immunotherapies to help save the lives of our patients.

Patients with small tumors or early-stage gynecologic cancers may receive chemotherapy alone, or before or after surgery. Neoadjuvant chemotherapy is given before surgery to help shrink the tumor. Adjuvant chemotherapy is administered after debulking surgery in order to “mop up” any remaining disease.  Patients may also be given hormonal therapies.

Patients with large primary tumors may be considered for neoadjuvant treatment. Patients with more advanced disease may also be candidates for new strategies developed to slow the spread of cancer. These may include combinations of standard drugs, investigational and targeted therapies or other options.
 
Intraperitoneal (IP) chemotherapy
We are one of only a select number of gynecologic oncology programs in the country to routinely use intraperitoneal (IP) chemotherapy and heated intraperitoneal chemotherapy (HIPEC) to treat ovarian cancer. IP chemotherapy and HIPEC deliver drugs directly into the abdomen during or after surgery. This type of chemotherapy can greatly improve the outcomes for women with advanced disease.
 
Radiation Therapy
 
Radiation therapy is often used in treating gynecologic cancers. It may be used as a stand-alone treatment for early-stage cancer, or in combination with surgery and other treatments in more advanced cases, to help reduce the chance of cancer recurrence. We also offer new investigational treatments for appropriately selected patients.
 
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. We use two types of radiation therapy used to treat gynecologic cancers:
 
  • External beam radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed into or near the cancer.
     
The way the radiation therapy is given depends on the type and stage of the cancer being treated.
 
Intensity modulated radiation therapy (IMRT)
IMRT targets tumors with pencil-thin “beamlets” of radiation. By sculpting the radiation to precisely match the tumor’s contours, a higher dose can be delivered to the cancer while avoiding unnecessary exposure of healthy tissues. Treatment with IMRT may also minimize certain side effects.
 
Click on the links to learn more about treatments for cervical cancer,   endometrial/uterine cancer or ovarian cancer .