Our Program

The Gynecologic Oncology team at USC treats some of the most complex cases in the Los Angeles area. Our multidisciplinary approach means that our medical, surgical and radiation cancer specialists work together to bring their combined skills and expertise to your plan of care. Our physicians, as faculty of a medical school, stay up-to-date with research that allows them to make the most difficult of diagnoses. Because we see a high volume of patients, your team possesses a broad level of expertise in treating rare gynecologic cancers that gives us the edge on new and innovative therapies.

Our specialists have an exceptional level of expertise in treating vulvar cancer, vaginal cancer, cervical cancer, ovarian and fallopian tube cancer and peritoneal cancer, as well as rare cancers such as neuroendrocrine cervical cancer, intergestational trophoblastic disease and uterine sarcomas.

In addition, the Lynne Cohen Preventive Care Clinic for Women’s Cancers is available to support patients who are at high risk of developing a gynecologic cancer. Gynecologic specialists work with breast specialists and geneticists in a unified clinic to focus on early detection and prevention for our patients.

Our Approach

Our commitment is to care not just for the patient, but to make you feel cared for. We seamlessly weave together a multidisciplinary team of medical, surgical and radiation specialists that treats you from diagnosis to imaging and finally to treatment and after-care and support. Your team is always available to answer your questions, facilitate difficult decisions and customize an individual treatment plan for your specific condition and situation. You are unique, and we will treat you that way.

We are national leading experts pioneering breakthroughs in fertility-sparing therapies for cervical cancer. We are one of a few centers that offer radical vaginal trachelectomy, a surgical procedure for the treatment of cervical cancer that preserves fertility. We have expertise in the use of minimally invasive robotic surgery using the da Vinci® robotic surgical system, chemotherapy and radiation oncology treatment.

Your team participates in weekly patient care conferences in which we review your individual treatment plan and situation. Each specialist brings the most current knowledge in his/her field and, working together, can coordinate your care to ensure an optimal outcome. This centralized treatment approach means your entire course of therapy can occur at USC Norris.

Conditions

As part of an academic medical center, the gynecological cancer program at the USC Norris Comprehensive Cancer Center at Keck Medicine of USC treats some of the most complex cases in the Los Angeles area. The multidisciplinary team is highly skilled and their expertise ensures patients are cared for every step of the way from diagnosis to treatment.

Tumors can be either benign or malignant, and can have the risk of metastasizing (spreading throughout the body). Each type of cancer is unique, with different symptoms, signs and risk factors. Conditions that are treated at the gynecological cancer program include:

Cervical cancer is cancer of the cervix (the opening of the uterus). Two types of cervical cancer make up most of the cancers seen: Squamous cell carcinoma which make up about 80 to 90 percent of all cervical cancers and adenocarcinoma, which make up 10 to 20 percent of all cervical cancers.

Rare cervical cancers include more rare tumors like small cell and large cell cervical cancers, and a subset of those, neuroendocrine cervical cancer (which originate from hormone-producing or nerve cells). About 100 out of 11,000 cervical cancers diagnosed each year are rare cancers.

Clear cell cancer is a relatively rare (2 to 3 percent of ovarian cancers) tumor that appears first in the epithelium of the ovary. Clear cell carcinoma can appear in women who have had endometriosis.

Fallopian tube cancer is similar to ovarian cancer, but it originates in the tubes that carry an egg from the ovary to the uterus.

Germ cell tumors are cancers that begin in the egg-producing cells within the ovary. These make up less than 2 percent of all ovarian cancers, and are usually benign. However, cancerous forms can be life-threatening.

Gestational Trophoblastic Disease are rare tumors that appear in the uterus. These tumors differ from uterine and cervical cancers because they originate from cells that normally would turn into the placenta during pregnancy. Most, but not all, of these tumors are benign.

Gynecologic sarcoma is a rare type of cancer that appears in the woman’s reproductive tract.

Ovarian cancer originates in the cells making up a woman’s ovary, accounts for 3 percent of all women’s cancers, but it causes more deaths than any other cancer of the female reproductive system. It is, however, treatable if detected early.

Peritoneal cancer is a rare cancer that looks like ovarian cancer, but has originated in the walls of the pelvis and abdomen, in a layer of cells called the peritoneum. This cancer spreads very much like malignant ovarian cancer, and can occur in women who have had their ovaries removed.

Stromal tumors are cancers that originate from structural cells that hold the ovary together and produce estrogen and progesterone — about 1 percent of ovarian cancers are stromal tumors.

Uterine cancer is cancer that originates in any part of the uterus. This is the most common gynecologic cancer in the United States. Learn more about uterine cancers, including endometrial cancer, by visiting our online health library.

Vaginal cancer is a relatively rare cancer of the vagina. The four types of vaginal cancer are named after tissue in which they initially develop. The types are squamous cell cancer (the most common), adenocarcinoma, clear cell adenocarcinoma and melanoma.

Vulvar cancer includes tumors that appear in the labia, clitoris and openings to the vagina and urethra. Three types of vulvar cancers, named after the layer of skin in which they first develop, are squamous cell cancer (the most common), melanoma and adenocarcinoma.

Treatments and Services

The gynecological cancer specialists at the USC Norris Comprehensive Cancer Center at Keck Medicine of USC in Los Angeles take an individualized, patient-centered approach to care. This means our patients not only receive the latest in medical technology, medicines and minimally invasive procedures, but also the attention and whole-person support needed to combat cancer.

Unlike many medical centers, the gynecological cancer program provides services at every treatment step, from diagnosis through surgical procedures and chemotherapy, if necessary. This also means that the physicians are experts at treating precancerous changes as well.

Cancer genetics is key in diagnosing and treating certain cancers. Some cancers are inherited or result from a genetic mutation that spurs the growth of many types of cancers throughout the body. Counselors and physicians from the Cancer Genetics Program at the USC Norris Comprehensive Cancer Center can help determine if a patient has an inherited cancer, or is at risk of such a cancer.

Chemotherapy is a treatment approach that uses cancer-killing drugs that are injected into a vein, instilled into the abdominal (or peritoneal) cavity, or taken by mouth. Chemotherapy may be used with radiation (chemoradiation) or with targeted therapy (biologic drug) to treat persistent, recurrent, or late-stage cancer. It may be used as palliative therapy for advanced (metastatic) cancer.

Fertility sparing approaches are something women of childbearing age should discuss with their cancer care team. Some treatments used for cervical cancer can make a woman infertile. USC is one of the few medical centers in the United States that performs a fertility sparing surgical approach for cervical cancer, called a Radical Vaginal Trachelectomy. Patients should address any concerns and questions they may have about how various cancer treatments could affect their fertility. They may also wish to have a consultation with a fertility specialist. Sometimes treatments for cancer (surgery, chemotherapy, radiation therapy) may affect, diminish, or eliminate fertility. The women’s cancer team works closely with their fertility specialists to find the best options for each patient.

Lynne Cohen Clinic is a preventive medicine clinic specifically in place for women who are at increased risk for breast and gynecological cancers based on either genetic mutation or family history. The clinic is very unique because breast, gynecologic, imaging, and genetic specialists in one location see patients. The focus is early detection/prevention for women who are at elevated risk with individualized screening programs for each patient based on their history and wishes

Minimally invasive surgery is conducted through one or more small incisions using small tubes, tiny video cameras and surgical instruments and may allow for a faster recovery time and a shorter hospital stay. Some minimally invasive surgeries may be performed on an outpatient basis.

Open approaches are surgical methods involve making a larger incision on the abdomen above the pubic bone. This is a more traditional procedure, but it is the most effective for certain conditions.

Pathology expertise, or physicians who look at the tumor microscopically to determine aspects about the disease, help the medical team make an accurate diagnosis and select the most effective and successful course of treatment. The gynecological cancer program includes experts in cancer pathology, who can avoid common misidentification of certain cancerous cells. When cancer is precisely identified, it ensures the most optimal course of treatment can be designed for each patient.

Radiosurgery describes the CyberKnife(R) and Gamma Knife(R), which are not surgical techniques, but focus a radiation beam directly to the tumor. These techniques can precisely destroy a tumor with minimal or no damage to surrounding healthy tissues for specific tumors.

Robotic surgery is a type of minimally invasive surgery, which gives surgeons greater dexterity, precision and ability to perform the procedure. With robotic surgery, the surgeon is not touching the patient, but is using a remote-controlled device by the surgeon that can very precisely remove disease or damaged tissue, and can reach areas not accessible using traditional surgical techniques. Robotic surgery includes the Da Vinci surgical system.

Patient Information

The gynecological cancer program at the USC Norris Comprehensive Cancer Center at Keck Medicine of USC uses a whole-patient approach, in which a team of nurses, physicians, surgeons, radiologists and other specialists will help determine the best course of treatment, as well as address other issues such as family impact, stress, and proper nutrition and lifestyle. You also play a key role in your treatment, helping the team with your preferences on deciding on the best course of action for you. Our team is always available to answer your questions, facilitate difficult decisions and customize an individual treatment plan for your specific condition and situation. You are unique, and we will treat you that way.

Diagnostic procedures will depend greatly upon what your symptoms are and what disease is expected. These can range from blood tests, fluid samples from the peritoneal and other tissues, a PAP smear (for cervical cancer), and other tests.

Similarly, your treatment options will vary according to what your diagnostic and pathology tests have discovered, and according to what you and your treatment team have agreed on as a course of action.

Some treatments, including some surgical procedures, can be done in one day or on an outpatient basis. Still others may require a hospital stay. Certain conditions may not require any treatment.

Resources

There are a number of sources of valuable information on gynecological cancers. Some are specific to a certain condition, while others are more general. These include:

American Society for Clinical Oncology
cancer.net

American Cancer Society
cancer.org

Foundation for Women’s Cancer
foundationforwomenscancer.org/about-gynecologic-cancers

National Cancer Institute
cancer.gov

USC sponsors support groups for patients with certain disorders. You should talk with your team members about whether joining such a group could be beneficial for your care.

Patients have the option of taking part in clinical trials being conducted at Keck Medical Center of USC. While clinical trial participation does not ensure that an effective treatment will be received, participation does help provide invaluable information for future treatments, and possibly a cure in the future. The women’s cancer team also participates in national and regional cooperative group clinical trials to bring the latest options to their patients.

Our Physicians

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Practicing Locations

Keck Medicine of USC - Pasadena
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Medicine of USC - Pasadena
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Children's Hospital Los Angeles
Keck Medicine of USC - Pasadena
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Medicine of USC - Pasadena
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Hospital of USC
LAC+USC Medical Center
USC Norris Comprehensive Cancer Center and Hospital
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Practicing Locations

Keck Medicine of USC - Pasadena
USC Norris Comprehensive Cancer Center and Hospital