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Treatment

Gynecologic cancers are those that involve the organs of the female reproductive system, including the uterus, cervix, and ovaries, fallopian tubes, vagina and vulva. RAS Radiation Oncology Centers (ROC) offer state of the art radiation treatments for gynecologic cancers.  RAS radiation oncologists work closely with gynecologic surgeons and medical oncologists to form a multidisciplinary healthcare team offering comprehensive, integrated gynecologic cancer treatment and management.
 
When external beam radiation therapy is indicated, a treatment planning CT scan is used to carefully map out each patient’s anatomy. This process enables concentration of the highest possible doses of radiation at the tumor site from multiple different angles, while sparing adjacent normal tissue as much as possible. Women with more complex tumors may benefit from intensity-modulated radiation therapy (IMRT), an advanced high-precision radiation therapy that improves upon traditional three-dimensional (3-D) conformal radiation therapy by separately modulating the intensity of each radiation beams. IMRT enables sculpting of high-intensity radiation doses to tightly conform to the geometrical shape tumors with complex curvatures and concave areas.
 
A course of external beam radiation therapy usually involves daily sessions, Monday through Friday, for 5 to 7 weeks. Treatments take less than 15 minutes per day and generally are well tolerated.
 
For many of the gynecological cancers, brachytherapy, sometimes referred to as implants or internal radiation, is used either alone or together with external beam radiation therapy. At RAS Radiation Oncology Centers (ROC), high dose rate brachytherapy is used so that the procedure can be performed on an outpatient basis for the patients’ convenience and without radiation exposure to  their loved ones.
 
What to Expect
Possible side effects and complications vary, depending upon the procedure being performed.
 
Uterus
Uterine cancer is a malignancy of the uterus. It can take several forms. The most common is endometrial cancer which arises from cells lining the uterus.  Postmenopausal bleeding occurs often and patients seek prompt medical attention. Because of this, endometrial cancer is usually diagnosed early and has a high cure rate.
 
Less common are uterine sarcomas, which form in muscle or other tissues of the uterus.  Some examples are carcinosarcoma (which has both glandular and muscle cancerous components ),  leiomyosarcoma (which develops in smooth muscle cells) and endometrial stromal sarcoma (which grows in connective tissue cells). Although uterine sarcomas also affect mostly postmenopausal women, they are often more aggressive than endometrial cancers and has a worse prognosis.
 
Cervix
Cervical cancer is a malignancy that forms in the cervix, which is the lower, narrow part of the uterus that is visible in the upper vagina. In very early stages, cervical cancer often does not exhibit any symptoms that you can feel, but fortunately cancerous cells can be detected with regular Pap smears and treated successfully. Most cervical cancers are caused by HPV (which is a sexually transmitted virus). Vaccination of children and young adults before exposure to the virus can be effective in preventing cervical cancer.
 
Ovary
Ovarian cancer can take either of two forms: ovarian epithelial carcinomas, which develop in the cells on the surface of the ovaries, or malignant germ cell tumors, which develop in the egg cells. Women with strong family history of ovarian and breast cancer should talk to their doctor about their risks and be considered for genetic testing since there is no effective screening for ovarian cancers.
 
Fallopian Tubes
Fallopian tube cancers are rare. They behave similar as ovarian epithelial carcinoma as they arise from the cells that line the Fallopian tubes and are treated similarly as ovarian epithelial cancers.
 
Vagina
Vaginal cancer appears as either squamous cell carcinoma (which develops in the cells lining the vagina) or adenocarcinoma (which begins in glandular cells embedded in the lining of the vagina). Because radical curative surgery usually results in the loss of sexual and/or critical organ function, invasive vaginal cancer is treated primarily with radiation therapy.
 
Vulva
Vulvar cancers can afflict the external female genital organs — the clitoris, vaginal lips or the opening to the vagina. They are usually squamous cell carcinomas. Early stages are treated surgically but combined modality treatment is often recommended for late stages or centrally located tumors.


Side Effects and Complications
Possible side effects and complications vary, depending upon the procedure being performed.