Gynecologic Cancer

Expert gynecologic oncology care for female reproductive and genital cancers

A male doctor and two female doctors gather on a staircase in a clinic setting to discuss aspects of gynecologic cancer.

Michael Silverman, MD, Jo Marie Janco, MD, and Teresa Longoria, MD, Gynecologic Oncology, Scripps Cancer Center, Scripps Clinic

Expert gynecologic oncology care for female reproductive and genital cancers

When you or a loved one is diagnosed with gynecologic cancer, life undoubtedly changes. You want to be cared for by a team of experienced oncologists who offer effective treatments with innovative technology. And you want to be treated with dignity.


 Find a gynecologic oncologist.

Team-based approach to comprehensive gynecologic cancer care

We work together in a variety of ways to optimize your cancer care, including treatment planning conferences, multidisciplinary clinic visits, and follow evidenced-based treatment. Every patient is evaluated by a team of physicians to determine a multidisciplinary treatment plan, specifically designed for you.  


At Scripps Cancer Center in San Diego, we treat the person, not the illness. We design your gynecologic cancer treatment around you, taking special interest in your values and your goals for the future. You will be cared for by cancer experts who have dedicated their careers to comprehensive and compassionate care for women with gynecologic cancer.

Your multidisciplinary team

Your Scripps gynecologic oncology team includes experts and supportive clinicians and services working together to care for you as a whole person. We want our patients to have a home base in gynecologic oncology for timely, compassionate and thorough scientific/evidence-based care. Our focus is on creating an individualized gynecologic cancer treatment plan that accounts for our patients’ unique needs and goals.


Gynecologic oncologists undergo extensive post-graduate training after receiving their MD/DO and complete four years of OB/GYN residency training, followed by an additional three to four years of gynecologic oncology fellowship training. Gynecologic oncologists are surgical oncologists expertly trained in advanced techniques, including complex open oncologic surgery and minimally invasive surgery such as laparoscopy and robotics. They offer comprehensive individualized cancer treatment discussion and planning, including the discussion of fertility-sparing gynecologic cancer treatment if it is appropriate and work closely with other oncology and women’s health clinicians to provide the best treatment for our patients.


At Scripps, we have close relationships with other oncology specialties and offer a wide array of cancer support services. We also focus our attention on excellent communication and accessibility for our patients and referring clinicians. Learn more about your cancer care team and Scripps' multidisciplinary approach to treatment.

Types of gynecologic cancers

Gynecologic cancer is cancer that affects a woman’s reproductive organs, including the ovaries, uterus, cervix, vagina and vulva. A woman’s risk of developing any of these cancers generally increases with age.


Our oncologists treat gynecologic cancers with personalized treatment plans based on several factors. These include the type of cancer a woman has, the stage of the cancer (how far it may have spread), her medical history and overall health, and whether she plans to become pregnant. Learn more about the various types of gynecologic cancers below.

Also known as uterine cancer, endometrial cancer starts in the endometrium, which is the tissue lining the inner cavity of the uterus. It most often occurs in women who have gone through menopause, but may occur before menopause as well.

 

Endometrial cancer symptoms may include vaginal bleeding after menopause (any bleeding after menopause is abnormal), irregular or heavy vaginal bleeding before menopause, unusual vaginal discharge, pain in the pelvis or a mass in the pelvic area. Surgery such as hysterectomy is usually the first treatment for endometrial cancer, and may be combined with radiation and/or chemotherapy if cancer has spread, or other risk factors for cancer recurrence are identified.


Learn more about endometrial cancer.

Uterine sarcoma is a rare form of gynecologic cancer that starts in the muscle and tissue of the uterus. The most appropriate uterine sarcoma treatment options depend on several factors, including the type and stage of the cancer. Types of treatment include surgery (such as hysterectomy), chemotherapy, radiation therapy and hormone therapy.


Learn more about uterine sarcoma. 

Ovarian cancer begins in a woman’s ovaries or Fallopian tubes (ovarian cancer and Fallopian tube cancer are treated similarly). Most women do not have symptoms in the early stages. Many ovarian cancer symptoms — such as abdominal discomfort, bloating and indigestion — may be caused by non-cancerous conditions like a virus. While there is no ovarian cancer screening exam, women with a family history of the disease or a significant family history of cancer in general (particularly breast cancer) may consider being tested for a genetic inherited mutation that can significantly increase their risk.

 

Ovarian cancer treatment usually involves surgical removal of the ovaries and uterus. If the cancer has spread, nearby organs may be removed as well. Chemotherapy is often incorporated into treatment as well, but depends on the subtype and stage of ovarian cancer, and other individual factors. 


Learn more about ovarian cancer.

Cervical cancer begins in the cells of the cervix, which is the lower part of the uterus. It usually develops slowly, beginning with pre-cancerous changes in cells (dysplasia). The majority of cervical cancers are caused by human papillomavirus (HPV), and receiving the HPV vaccine can significantly reduce the risk of developing, and prevent, cervical pre-cancer/dysplasia and cancer. Detecting and treating cervical pre-cancer/dysplasia, can also prevent cervical cancer.

 

The best treatment of cervical cancer is prevention. A preventive screening test, which is called a Pap test (at times in combination with a test for detection of high-risk HPV activity) can detect abnormal cell changes in the early stages of the disease or before cancer develops. 


Cervical pre-cancer/dysplasia treatment usually involves removing or destroying abnormal tissue. Symptoms of cervical cancer include abnormal vaginal bleeding, abnormal vaginal discharge and pelvic pain. Cervical cancer may be treated with surgery, radiation therapy, and/or chemotherapy, depending on the stage (how far it has spread). 


Learn more about cervical cancer.

Vulvar cancer develops in the outer part of a woman’s genitals, called the vulva. Like vaginal cancer, it is rare and usually develops slowly over several years. Vulvar cancer often begins with pre-cancerous changes in cells (dysplasia), and when found early, is often successfully treated.

 

Vulvar cancer symptoms include pink, red or white bumps on the vulvar skin, a sore on the vulva that does not heal, changes in the vulvar skin, unusual vaginal bleeding or discharge, pain while urinating, a lump or rough/raised patch of vulvar skin or an area of persistent itching. Often, these changes are found during a yearly pelvic exam. 


Vulvar pre-cancer/dysplasia treatment may involve topical therapy for early pre-cancerous changes, or surgical procedures (excision, laser ablation) to eliminate abnormal cells. Early-stage vulvar cancer is typically treated with surgical removal/excision. If cancer has spread, additional surgery, radiation therapy, and/or chemotherapy may be part of the treatment plan.


Learn more about vulvar cancer.

Vaginal cancer begins in the cells of the vagina. It is a rare type of cancer that usually grows slowly, and often begins with abnormal changes in cells (dysplasia). Vaginal cancer symptoms may include unusual vaginal bleeding or discharge, painful intercourse or a lump or mass in the vagina. Concerning symptoms should be evaluated with a pelvic examination and biopsies as indicated. Regular pelvic exams can detect changes in the tissue that are concerning. 


Preventive screening tests, such as a Pap test (sometimes in combination with a test for detection of high-risk human papillomavirus/HPV activity) can detect vaginal dysplasia and may be indicated even after hysterectomy with removal of the cervix, for certain women who are at higher risk. Treatment of vaginal cancer may include surgery, radiation, and/or chemotherapy.


Learn more about vaginal cancer.

Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus instead of, or after a pregnancy. Trophoblast cells normally form part of the placenta. Treatment of gestational trophoblastic disease may involve chemotherapy or surgery.

Advanced cancer treatment options 

Our comprehensive approach combines our multidisciplinary teams with tools to diagnose and treat cancer — including many leading-edge therapies — to focus on your individual needs. 


  • Precise surgical capabilities, including minimally invasive laparoscopic and robot-assisted laparoscopic procedures that can mean fewer incisions and faster recovery.
  • Chemotherapy and drug infusion centers that provide the latest therapies to reduce side effects, such as nausea and hair loss, in comfortable, soothing environments.
  • Wide range of advanced internal and external radiation therapy methods to target tumors while protecting surrounding healthy tissues. 
  • Nutrition support – registered dieticians and nutritional consultants with specific expertise in working with patients with cancer. 
  • Integrative therapies especially for cancer patients, including yoga and meditation, at Scripps Center for Integrative Medicine.

Your custom cancer treatment plan

Your Scripps cancer care team will develop a customized cancer treatment plan outlining the treatments and therapies we recommend for your care. Before you begin treatment, you and your physician will review your plan together and discuss any questions or concerns you may have.


Your gynecologic cancer treatment plan generally includes:


  • Family and medical history
  • A summary of your cancer diagnosis and staging information
  • Diagnostic testing completed (e.g., imaging, biopsy, lab tests)
  • Plans for surgery, radiation, chemotherapy and/or other treatments
  • Potential side effects of treatments
  • Contact information for your cancer care team members


Along with helping you understand your course of treatment and encouraging discussion between you and your physician, your plan helps your team coordinate your care. You also can share your treatment plan with other providers who may be involved in your medical care.

Cancer treatment locations

Scripps diagnoses and treats cancer at numerous locations throughout San Diego County. From Chula Vista and La Jolla to Encinitas and beyond, our extensive network of Southern California cancer care centers includes:


  • Five hospital campuses 
  • Outpatient clinics
  • Specialty cancer treatment centers


Visit cancer care locations for details of each cancer hospital, clinic and specialty center.

Support groups, services and resources

Scripps offers a comprehensive lineup of support groups, support services and resources to help you along every step of your cancer journey.

In support of our patients, survivors, their family members, and the community, we host cancer support groups as well as a range of free workshops and health and wellness events on a number of topics, such as:


  • Nutrition
  • Yoga
  • Meditation


Check the current list of support offerings or contact your oncology social worker or cancer care coordinator.

We are here for you — not only as your oncologists, but as a robust multidisciplinary team of experts who understands that your cancer journey is about much more than your medical treatment. Specifically, Scripps Cancer Center offers a variety of patient support services to ensure your physical, psychological and emotional well-being as well as resources for dealing with the logistical and financial aspects of cancer care. Our services and resources include:


  • Oncology nurses and nurse navigators with extensive clinical expertise in cancer care to help guide you and your caregivers to make informed decisions and ensure your optimal care.
  • Palliative care to provide an extra layer of supportive care to manage pain and relieve symptoms, offer emotional and spiritual support, and improve your quality of life. 
  • Oncology social workers specially trained to provide counseling, connect you with community and medical resources, assist with transportation and housing and coordinate care after discharge.
  • Our registered dietitian nutritionists offer individualized nutrition support for patients whose efforts to optimize their nutrition may be affected by cancer symptoms or treatment side effects.
  • Referrals and professional care from experts in psychology, psychiatry and emotional health, including individual and family counseling to help with the emotional challenges of cancer.
  • Physical rehabilitation and occupational therapy services, including wound care, voice therapy and swallowing therapy, lymphedema therapy, balance and vestibular rehabilitation, yoga and more.
  • Scripps Center for Integrative Medicine for patients interested in mind-body healing through acupuncture, biofeedback, herbal nutrition, massage therapy, integrative cancer care and more.
  • Nondenominational spiritual care offered by our chaplains to help coordinate spiritual care with your own clergy, rabbi or spiritual advisor.
  • Visiting patient services if you reside beyond San Diego and want help arranging appointments or learning more about short-term lodging.


For the full spectrum of offerings, please visit our cancer patient support services section.

Patient education is an integral part of understanding and coping with your cancer diagnosis and treatment. To stay informed, we encourage our patients, along with their caregivers and family members, to:


  • Bookmark the Scripps glossary of cancer terms for easy referencing.
  • Consult your oncology team for educational materials and a list of trusted online sources beyond the Scripps site. 


Navigating cancer might seem overwhelming — especially with so much information online. To ensure you receive the most accurate details, always look to your multidisciplinary team of cancer care experts first.