Gynecologic Oncology Program

Surgery is often the first and most critical step in treating gynecologic cancers, and our team is uniquely equipped to provide the highest level of surgical care across the full spectrum of gynecologic malignancies. For patients facing a new diagnosis, our gynecologic oncology surgeons are experienced at providing radical hysterectomies for cervical cancer, cytoreductive surgery for ovarian cancer, radical vulvectomies for vulvar cancer and total abdominal hysterectomies, bilateral salpingo-oophorectomies, and lymphadenectomies for the staging and treatment of endometrial cancers. Conventional laparoscopic and robotic surgery is available to patients in need of surgery for uterine cancer, as well as for removal of the uterus, tubes, and ovaries.

We also recognize that for some patients, the most powerful step they can take is a preventive one. For those with a known genetic risk or strong family history of ovarian cancer, we offer a range of prophylactic surgical options, including hysterectomy, bilateral salpingo-oophorectomy, or bilateral salpingectomy with ovarian conservation for those who wish to preserve their ovaries. Our team works closely with genetic counselors and medical oncologists to ensure that every patient considering preventive surgery has the information and support they need to make the right decision for their health and their future.

For many of our patients, the possibility of having children remains deeply important even in the face of a cancer diagnosis. Fertility preservation is always a priority for our team, and we are committed to exploring every available option before recommending treatment that would affect a patient's reproductive future. We perform radical trachelectomies for patients with early-stage cervical cancer who desire fertility preservation. For patients with early-stage, low-grade endometrial cancers, hormonal therapy is prescribed.

We routinely provide surgical management for patients with benign gynecologic conditions, particularly those that have previously had unsuccessful or complicated gynecologic surgery. Such conditions include endometriosis, extensive uterine fibroids (leiomyomas), recurrent ovarian cysts, pelvic pain, and pelvic organ prolapse.

Surgical expertise is available for patients to address complications resulting from gynecologic cancers, or for progressive disease. Procedures include small and large bowel resections, colostomies, fistula repairs, and repair of pelvic support for patients with gynecologic cancers.

When a gynecologic cancer diagnosis requires medical treatment, our team is prepared to offer the most advanced, evidence-based therapies available today. The Gynecologic Oncology Program provides a comprehensive range of targeted, chemotherapeutic, and systemic treatment options for patients facing ovarian cancer, fallopian tube cancer, uterine cancer, mesenchymal tumors of the uterus, cervical cancer, vaginal cancer, and vulvar cancer.

For patients with advanced cancer, neoadjuvant chemotherapy (chemotherapy prescribed before surgical treatment), is often used to reduce the size and impact of the cancer and its metastases, thereby minimizing complications during surgery and support a smoother, faster recovery. Intraperitoneal chemotherapy, where chemotherapy is injected directly into the abdomen through a catheter, is also an option for ovarian cancer treatment.

In addition, clinical trials offering the latest treatment combinations and new therapies are available for our patients. Clinical trials for both previously untreated gynecologic cancers, as well as for recurrent cancers that may have initially failed to respond to chemotherapy—or other treatment modalities—are options.

New trials are available using PARP inhibitors, targeted therapies, and immunotherapies for the treatment of gynecological cancers and recurrent cancers.

Radiation oncologists with gynecologic expertise collaborate with our team to provide both brachytherapy and external beam radiation therapy for the management of cervical, vaginal, vulvar, and ovarian, and other gynecologic cancers. Our patients have access to the latest, most precise technologies, including image-guided intensity-modulated radiation therapy, and high-dose-rate brachytherapy.

The Yale Department of Radiology and Biomedical Imaging works closely with our team to provide state-of-the-art CT, MRI, and ultrasound exams to better assess gynecologic disease. Radiologists routinely consult with the physicians in the Gynecologic Oncology Program and review all available imaging to ensure proper diagnoses and optimal treatment plans can be made.

The Gynecologic Pathology team is a fundamental component in the prevention, diagnosis, and treatment of diseases at Smilow Cancer Hospital. In addition to tissue diagnosis, team members participate in the real-time decision-making process for patients, including daily operative consultations, weekly tumor board conferences, and on-going clinical trial programs. Our experienced gynecologic pathologists are pioneers in the clinical validation and applications of molecular genotyping in the diagnosis of Gestational trophoblastic disease (GTD) and offer diagnostic services to pathologists throughout the United States and abroad.

Hyperthermic Intraperitoneal Chemotherapy is a technique that delivers high doses of heated chemotherapy directly to abdominal organs to kill cancer cells that may remain after surgical removal of visible tumors. Our physicians are national leaders in the delivery of HIPEC, with a deep understanding of the types of cancer it can be used to treat, the nuances of the therapy, and its effectiveness. Clinical trials using HIPEC are also available

For the evaluation of women with abnormal Pap smear results, and for patients with possible recurrences of premalignant or malignant disease in the lower reproductive tract, we provide a full colposcopy program. We also offer laser, LEEP, and cold knife conizations for cervical cancer, as well as for certain vulvar and vaginal cancers.

We believe that exceptional care goes far beyond medical treatment. From the moment you contact us, our intake specialists, clinical secretaries, and schedulers work to ensure you are fully prepared for your first visit and that your appointments are coordinated to fit your life. Throughout your treatment, our physicians, nurses, advanced practice providers, and nurse coordinators make sure you feel informed and supported.

Our supportive care team connects patients and their families to a wide network of essential services including social work, pastoral support, dietary and nutritional counseling, physical therapy, integrative medicine, pain management, and psychosocial support.

We also offer a one of a kind Sexuality, Intimacy & Menopause Program that combines both medical and psychological interventions, and is designed to help patients who experience sexual dysfunction after cancer.