The specific cancer type is generally named after the organ where it originates. Each year, approximately 80,000 women are diagnosed with one of these types with a majority classified as either ovarian or uterine.
Ovarian cancer is believed to arise in the tissue of the fallopian tube and then disseminates to the ovaries and peritoneal cavity. Typically, there are no early symptoms of this type of cancer. For this reason, it has usually spread by the time of diagnosis. It is estimated that more than 22,000 women were diagnosed in 2016. There are several subtypes including epithelial and stromal cell; with epithelial being the most common subtype.
Cervical cancer affects the cervix – the passage between the uterus and the vagina. With the use of the PAP smear as an early screening tool, abnormal tissue development can often be found at an early stage. The human papilloma virus (HPV) is linked to the development of cervical cancer and a vaccine has been introduced as a weapon to prevent this disease.
Fallopian Tubes are the ducts through which eggs travel from the ovaries to the uterus each month. The majority of these cancers are papillary serous adenocarcinoma. Less common types are sarcomas (leiomyosarcomas), or transitional cell carcinomas.
Peritoneal cancer affects the inner lining of the abdominal cavity and is less common. It is closely related to the epithelial type of ovarian cancer, but a woman can develop this even if her ovaries have been removed.
Uterine cancer usually develops in the lining of the uterus (known as the endometrium) and if it continues to grow, it moves into the muscle. The uterus (or womb) is the pelvic organ where the fetus normally develops. The most common type of uterine cancer is endometrial and usually doesn’t occur until menopause. A more rare type forms in the connective tissue, which supports the uterus and is called uterine sarcoma.
Vaginal cancer forms in the tissue of the vagina or birth canal, which leads from the cervix to the outside of the body. It is not a common form of gynecological cancer. There are two primary types: Squamous cell is typically found in older women and adenocarcinoma, which occurs in females under the age of 30. Squamous originates in the vaginal lining and is also linked to HPV exposure. Much more rare forms are melanoma and sarcoma.
Vulvar cancer affects a female’s external genitalia or vulva, which includes the opening to the vagina, the clitoris and the labia. This area is mostly epithelial, so the majority of cancers are skin-related: Squamous cell is the most common; melanoma, basal cell and adenocarcinoma are more rare.
Currently, oncologists base their treatment strategies upon the stage of disease. Early stage may be managed with surgery alone. For more advanced stages, physicians generally use standard chemotherapy protocols.
For cervical cancer patients it is usually cisplatin often combined with radiation.
Ovarian cancer patients usually receive the combination of Carboplatin plus Taxol (paclitaxel). However, many other drugs are active in this disease, including: Cytoxan (cyclophosphamide), Doxil (liposomal doxorubicin), Doxorubicin (Adriamycin), Gemcitabine, Taxotere (docetaxel), and Topotecan. Common drug combinations include Carboplatin & Taxol, Carboplatin & Taxotere, Carboplatin & Doxil, Carboplatin & Gemcitabine and others.
Uterine cancer patients typically receive carboplatin plus Taxol, or Cytoxan plus Adriamycin, either alone or in combination with radiation.
Nagourney Cancer Institute uses each patient's tumor to determine the right drug or drugs to prescribe for a woman with a gynecologic cancer. Our clinical staff works with each patient to provide an individualized and comprehensive treatment plan.
The graph below is derived from an analysis published in Gynecologic Oncology. It represents a prospective correlation between drug sensitivity to the combination of cisplatin plus gemcitabine in ovarian cancer patients with a mixture of platinum-sensitive and platinum-resistant disease.
The results reveal a statistically significant correlation between drug sensitivity and time to progression. In addition, this publication revealed a statistically significant correlation between drug sensitivity and clinical response.
This drug combination, developed by us at Rational Therapeutics (now Nagourney Cancer Institute) in the mid-1990s, received FDA approval in July 2006 predicated in part upon this landmark study and the subsequent GOG clinical trial written by Dr. Nagourney (Gyn Oncol, 2006).
Other gynecologic cancer patients helped by our staff at Nagourney Cancer Institute, let us help you find the right treatment. We invite you to check out their stories.
I had an extremely aggressive form of advanced ovarian cancer and my life expectancy was measured in weeks to months. Today, I am cancer free. When all other physicians wrote me off for dead, Dr. Robert Nagourney gave me life.
— Elizabeth Panke
This time the tests revealed that Marjorie had Stage IV ovarian cancer. And as is typical with this diagnosis, she was given about one year to live. But instead of listening to her own doctor, she listened to the advice of Ronald Bitter, MD, Neena’s doctor, who referred her to Robert Nagourney, MD, and Rational Therapeutics (now Nagourney Cancer Institute).
— Marjorie Gromme