We use a combination of imaging, lab work and procedures to diagnose your specific type and stage of gynecologic cancer, including:

• Colposcopy with biopsy: Closely examines your cervix and removes small tissue samples for further testing.
• Human papillomavirus (HPV) testing: Detects high-risk strains of the virus, which is often linked to cervical cancer.
• Pap test: Screens for abnormal or precancerous cervical cells.
• Pelvic exam: Assesses your cervix and nearby tissues.
• Cystoscopy or proctoscopy: Checks bladder or rectum for signs of cancer if symptoms suggest spread.
• Examination under anesthesia: Sometimes used for precise staging.
• Molecular testing: Identifies biomarkers that guide therapy for advanced cases.
• Magnetic resonance imaging (MRI) of the pelvis: Shows whether the cancer has spread. 
• Pathology review: Confirms the diagnosis by examining biopsy samples.
• Hysteroscopy: A small camera attached to a thin tube is inserted through your vagina to examine your uterus.
• Biopsy: Similar to a pap smear and involves taking a tissue sample from the lining of your uterus.
• Dilation and curettage (D&C): A procedure performed under anesthesia that involves removing tissue from your uterus.
• Blood tests: Look for high levels of cancer “markers” in your blood.
• Magnetic resonance imaging (MRI): Uses radio waves and strong magnets to create detailed images of your pelvis.
• Computed tomography (CT) scan: Uses X-rays to create 3D pictures of your pelvis. 
• Positron emission tomography (PET) scan: Can detect tumor activity in your body.

Once we confirm your diagnosis, we build a treatment plan based on your specific cancer type, stage and goals.

Treating gynecological cancer or a precancerous growth may require removing the uterus (hysterectomy). We may also recommend removing the ovaries and fallopian tubes (salpingo-oophorectomy).

Our gynecologic oncologists can perform many of these surgeries with minimally invasive techniques. They often use robotic-assisted surgery, which involves a platform with highly precise robotic arms and instruments controlled by a surgeon.

Because robotic surgeries involve smaller incisions, you can usually expect a much faster recovery compared to traditional surgery. Most of our patients go home the same day and recover in a few weeks.

Traditional, open surgery may be the best approach for certain gynecological cancers, such as ovarian cancer. Options may include:

• Removing one or both ovaries and fallopian tubes (salpingo-oophorectomy)
• Removing the uterus (hysterectomy)
• Removing the tissue that lines the inside of the abdomen called the omentum (omentectomy)
• Cytoreductive surgery, sometimes following chemotherapy, to remove as much cancer as possible

During surgery, we will aim to remove all your tumor tissue if possible. You may stay in the hospital overnight, and your recovery may take up to eight weeks.

During a hysterectomy, our surgeons can also perform sentinel lymph node mapping and biopsy. This procedure can determine whether cancer has spread to nearby lymph nodes.

During this procedure, our team injects a solution or dye near the cancer. The solution or dye marks or stains the sentinel nodes where the cancer is most likely to have spread. Then, the surgeon removes just those select lymph nodes.

Our team can use our advanced robotic surgery system to remove these lymph nodes using very small incisions.

If cancer is found early enough, surgery with sentinel lymph node mapping and biopsy may be the only treatments needed.

If your gynecological cancer is more advanced, we may recommend radiation therapy. Our radiation oncologists offer options such as:

• External-beam radiation therapy: An external machine delivers radiation to your body. 
• Brachytherapy: A device is used to inset radiation into your vagina.
• Chemoradiation: Combines radiation with low-dose chemotherapy.

Chemotherapy is another option for more advanced gynecological cancer. Sometimes, it is combined with radiation therapy. Because we’re part of an academic health system, you may benefit from new chemotherapy drugs before they are widely available.

Another option for advanced gynecological cancer is hormone-blocking medication that slows tumor growth. These medications work on tumors that grow in response to hormones like estrogen and progesterone. Examples of hormone therapies include:

• Progestins
• Tamoxifen
• Fulvestrant
• Aromatase inhibitors
• CDK 4/6 inhibitors

Hormone therapy can cause hot flashes and more serious side effects, but we can help manage and prevent these concerns.

Targeted therapies work differently than chemotherapy, which can also damage healthy cells. Instead, these drugs target specific features of cancer cells, effectively directing medicine to tumors.

Biologics called antibody-drug conjugates (ADCs) are an option for certain gynecological cancer, such as endometrial and ovarian cancer. One drug called Enhertu binds to a protein on cancer cells and delivers chemotherapy right to the tumor.

Other types of biologic drugs target cancer cells in different ways. For example, drugs called PARP inhibitors may help if your ovarian cancer is caused by a BRCA gene mutation. Our medical oncologists have extensive experience working with all types of targeted therapies for specific types of ovarian cancer.

Immunotherapy drugs called immune checkpoint inhibitors may treat some gynecological cancers. These drugs make your body’s immune system more effective at destroying cancer. Options for treating gynecological cancer include PD-1 inhibitors and PDL-1 inhibitors.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is an advanced treatment for gynecological cancers that have spread to the thin lining inside the abdomen, called the peritoneum. During this treatment, a chemotherapy solution is heated and circulated throughout the abdomen to destroy microscopic cancer cells.

The chemotherapy used during HIPEC is heated to approximately 106-109°F, which is why the treatment is sometimes called a “hot chemo bath.” The elevated temperature helps the medication penetrate tissues more effectively and may increase its efficacy.

Unlike traditional chemotherapy that travels through the bloodstream and affects the entire body, HIPEC delivers treatment directly to the affected area. This targeted approach allows doctors to use higher concentrations of chemotherapy at the tumor site while reducing many of the widespread side-effects commonly associated with systemic chemotherapy.

If preserving your fertility is a priority, we talk through options early. Depending on your diagnosis and timing, this may include:

• Fertility-sparing surgery
• Egg or ovarian tissue preservation
• Coordination with reproductive endocrinology to help time treatment around your fertility goals

We also offer:

• Long-term cancer surveillance and follow-up care
• Screening and treatment for preinvasive cervical conditions
• Treatment for noncancerous gynecologic conditions
• Treatment for invasive and noninvasive vulvar disease
• Screening through the Show Me Healthy Women program (free cervical and breast screening for eligible patients)

Your care doesn’t end after treatment. Our gynecologic oncology survivorship clinic helps you stay healthy and manage long-term effects.

We provide:

• A personalized treatment summary for your primary care provider
• Education and follow-up planning
• Nutrition and exercise guidance
• Referrals to local and national survivorship resources
• Support for managing side effects