Gynecologic Information
Gynecologic cancers on this page include cervical, uterine/endometrial, and ovarian cancers. The modules below organize key information on symptoms, screening, staging, and treatment planning.
Disease Information
Use the sections below to review diagnosis, staging, and treatment information for each condition in one place.
Cervical Cancer
What is cervical cancer?
Cervical cancer begins in the cervix, the lower, narrow part of the uterus that connects to the vagina. Most cervical cancers develop slowly over time, often starting as precancerous cell changes that can be detected through routine screening. When found early, cervical cancer is one of the most successfully treatable and preventable cancers.
Thanks to advancements in testing, early diagnosis, and preventative measures like the HPV vaccine, outcomes for cervical cancer have greatly improved in recent years.
What are the risk factors for cervical cancer?
- Infection: Nearly all cervical cancer is caused by human papillomavirus (HPV) infection that is spread through sexual contact, though only a small number of those infected will develop cervical cancer.
- Smoking: Women infected with HPV who also smoke cigarettes have a higher risk.
- Weakened Immune System: Women who have a weaker immune system are at a higher risk for HPV infection and cervical cancer.
- Birth Control: Using birth control pills for more than 5 years may increase the risk of cervical cancer.
What are the symptoms of cervical cancer?
If you are experiencing any of these symptoms, consult your doctor.
- Unusual vaginal bleeding or discharge, including any bleeding outside of your menstrual cycle or after menopause.
- Pelvic pain or discomfort, including pain during intercourse or pressure or fullness in the pelvis.
- Swelling of the legs (more advanced cases)
- Difficulty urinating or having bowel movements (more advanced cases)
- Blood in the urine (more advanced cases)
Screening for Cervical Cancer
The American Cancer Society recommends patients begin screening at age 25 and continue until at least age 65.
The preferred screening option is a primary HPV test every 5 years. Other screening options include:
- Self-collected HPV testing, every 3 years.
- HPV and Pap co-testing, every 5 years.
- Pap test, every 3 years.
Patients 65 and older may be able to stop screening. For most screening methods, you can stop screening if your last two tests have been normal. If you are screening with the Pap test, you can stop if your last three tests have been normal.
Prevention of Cervical Cancer
Check out these prevention activities to lower your risk of cervical cancer.
- Talk to your doctor about the HPV vaccine. The vaccine helps prevent infections with the types of HPV that cause cervical cancer.
- Kick the habit. Putting out that cigarette can lower your risk.
- Get screened. A Pap smear or HPV test can detect cancer or pre-cancer early.
- Use barrier protection. Using a condom and limiting
- your number of partners can reduce your risk.
The American Cancer Society recommends patients begin screening at age 25 and continue until at least age 65.
How is cervical cancer treated?
Treatment for cervical cancer is highly individualized and depends on several factors, including the stage of the cancer, the size and location of the tumor, whether the cancer has spread, your overall health, and whether fertility preservation is a consideration. Most patients are treated by a multidisciplinary team that may include gynecologic oncologists, medical oncologists, and radiation oncologists.
The main treatment approaches for cervical cancer include surgery, radiation therapy, chemotherapy, and in some cases targeted therapy or immunotherapy. More than one type of treatment is often used, either at the same time or in sequence.
Cervical Cancer Treatment by Stage
Early-Stage Cervical Cancer (Early stages such as Stage IA to IB1)
For cancers detected at an early stage and confined to the cervix, surgery is often considered. This may include the removal of abnormal tissue or more extensive surgery depending on tumor size and depth. In select patients who wish to preserve fertility, fertility-sparing procedures may be considered.
Radiation therapy may be recommended after surgery if pathology findings suggest a higher risk of recurrence. In some early-stage cases, radiation therapy can be used instead of surgery.
Locally Advanced Cervical Cancer (Stages IB2 through IVA)
For larger tumors or cancers that have spread beyond the cervix but not to distant organs, combined radiation therapy and chemotherapy is the most common treatment approach. Chemotherapy is typically given at the same time as radiation to help the radiation work more effectively.
Radiation therapy usually includes:
- External beam radiation therapy (EBRT) to the pelvis
- Internal radiation therapy (brachytherapy), in which radiation is placed directly near the cervix
This combined approach has become the standard of care for locally advanced cervical cancer.
Advanced or Recurrent Cervical Cancer (Stage IVB or recurrent disease)
When cervical cancer has spread to distant parts of the body or returns after initial treatment, systemic therapies are often used. These may include:
- Chemotherapy
- Targeted therapy
- Immunotherapy
Treatment selection is based on prior therapies, tumor characteristics, and your goals. Clinical trials may also be an option for some patients.
Uterine/Endometrial Cancer
What is uterine cancer?
Uterine cancer is an umbrella term for cancers that start anywhere in the uterus (womb).
Endometrial cancer is a specific type of uterine cancer that begins in the endometrium, the inner lining of the uterus (the small, hollow, pear-shaped organ in a woman's pelvis in which a fetus develops). Endometrial cancer is by far the most common type of uterine cancer. Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids) and are detected early due to abnormal bleeding.
All endometrial cancers are uterine cancers, but not all uterine cancers are endometrial cancers.
How is uterine cancer staged?
Uterine cancer is staged using the FIGO (International Federation of Gynecology and Obstetrics) staging system. The stage of the cancer is determined by examining tissue removed by surgery.
Stage I
Uterine cancer in this stage is found in the uterus and has not spread to other parts of the body.
- Stage IA cancers are found in the endometrium, which is the inner lining of the uterus. They may have grown less than halfway through the myometrium, which is the underlying muscle layer of the uterus.
- Stage IB cancers have grown from the endometrium more than halfway into the myometrium.
Stage II In this stage, the cancer has spread to the tissues around the cervix, but not the other parts of the body.
Stage III
Stage III endometrial cancers have spread beyond the uterus, but are still in the pelvic area.
- Stage IIIA cancers have spread to the outer surface of the uterus and/or the fallopian tubes or ovaries.
- Stage IIIB cancers have spread to the vagina or the tissues around the uterus.
- Stage IIIC1 cancers are growing in the body of the uterus. The cancer may have spread into nearby tissues but is not in the bladder or the rectum. It is also in the pelvic lymph nodes, but not the lymph nodes around the aorta.
- Stage IIIC2 cancers are similar to stage IIIC1 but have spread into the lymph nodes around the Aorta.
Stage IV
Cancers in stage IV have spread to the rectum, bladder, or distant organs.
- Stage IVA cancers have spread to the inner lining of the rectum or bladder. They may or may not have spread into the lymph nodes. They have not spread to distant sites.
- Stage IVB cancers have spread to the lymph nodes in the groin, the upper abdomen, and/or distant parts of the body.
How is uterine cancer treated?
Treatment for uterine cancer depends on several factors, including the type of cancer, how far it has spread (stage), how aggressive it appears (grade), and your overall health and personal preferences. Your care team will work closely with you to create a treatment plan that is right for you.
Surgery for Uterine Cancer
Surgery is the most common first treatment for uterine cancer. For most patients, this means removing the uterus (called a hysterectomy). In many cases, the fallopian tubes and ovaries are also removed. Nearby lymph nodes may be checked to see if the cancer has spread. For some patients with early-stage cancer, surgery alone may be all that is needed.
Radiation Therapy for Uterine Cancer
Radiation therapy uses high-energy rays to kill cancer cells. It may be given after surgery to lower the risk of the cancer coming back or used instead of surgery if surgery is not an option. Radiation can be delivered from outside the body or internally, depending on your situation.
Chemotherapy for Uterine Cancer
Chemotherapy uses medications to destroy cancer cells or stop them from growing. It is often given after surgery for higher-risk cancers or if the cancer has spread or returned. Chemotherapy may be given through a vein or as pills, sometimes along with radiation therapy.
Hormone Therapy for Uterine Cancer
Some uterine cancers grow in response to hormones. Hormone therapy can help slow or stop cancer growth and may be an option for certain cancers, especially in patients who want to preserve fertility or when surgery is not recommended.
Targeted Therapy and Immunotherapy for Uterine Cancer
Newer treatments, such as targeted therapy and immunotherapy, focus on specific features of cancer cells or help the immune system better recognize and attack cancer. These treatments may be used for certain uterine cancers, especially if the cancer has advanced or returned, and often depend on special testing of the tumor.
Ovarian Cancer
Ovarian cancer is a type of cancer that begins in or near the ovaries, which are part of the female reproductive system. The ovaries make eggs and female hormones such as estrogen and progesterone.
There are several types of ovarian cancer. The most common type, called epithelial ovarian cancer, begins in the cells lining the ovaries or Fallopian tubes. Less common types include germ cell tumors, which start in egg-producing cells, and stromal tumors, which begin in the tissue that produces hormones.
What are the symptoms of ovarian cancer?
Ovarian cancer can be difficult to detect early because symptoms are often vague and may be mistaken for other digestive or urinary issues. Symptoms are more concerning if they are new, persistent, and occur frequently, such as:
- Bloating or swelling of the abdomen
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- Frequent or urgent urination
- Fatigue
- Changes in bowel habits
- Unexplained weight changes
If these symptoms last for more than a few weeks or worsen over time, consult your physician.
What causes ovarian cancer?
In many cases, the exact cause of ovarian cancer is unknown. Ovarian cancer develops when cells in or near the ovaries or Fallopian tubes acquire changes (mutations) in their DNA. These changes cause the cells to grow and divide uncontrollably, forming a tumor that can spread to other parts of the body.
What are the risk factors of ovarian cancer?
Risk factors for ovarian cancer may include:
- Increasing age, especially after menopause
- A family history of ovarian, breast, or colorectal cancer
- Inherited genetic mutations such as BRCA1, BRCA2, or Lynch syndrome
- Never having been pregnant or having a first full-term pregnancy after age 35
- Use of estrogen hormone therapy after menopause
- Obesity
Genetic counseling and testing may be recommended for people with a strong family history of cancer.
How is ovarian cancer diagnosed?
There is no routine screening test for ovarian cancer for people at average risk who do not have symptoms. Diagnosis usually involves a combination of:
- A pelvic exam
- Imaging tests, such as ultrasound, CT scan, or MRI
- Blood tests, including the CA-125 test (which may be elevated in some people with ovarian cancer)
- Surgery and biopsy to confirm the diagnosis and determine the type and stage of cancer
The stage describes how far the cancer has spread and helps guide treatment decisions.
How is ovarian cancer treated?
Treatment for ovarian cancer is individualized and depends on the type of ovarian cancer, its stage, overall health, and treatment goals.
Common treatments include:
- Surgery to remove as much of the cancer as possible
- Chemotherapy, often given after surgery and sometimes before
- Targeted therapy, which focuses on specific features of cancer cells
- Hormone therapy, in certain situations
- Participation in clinical trials, which may provide access to new therapies
Cancer Treatment Options
Most treatment plans combine several of these approaches. Your Virginia Cancer Specialists care team builds a plan around your specific diagnosis — explore each option below, or browse all treatments & services.
Chemotherapy
Chemotherapy uses powerful medicines to destroy cancer cells or slow their growth, and it remains one of the most widely used and effective cancer treatments. It can be given on its own or alongside surgery, radiation, or other therapies.
- Given by IV infusion or as pills, in planned cycles with recovery time between
- Delivered in our offices by our medical oncology team, close to home
- Often used to shrink a tumor before surgery or lower the risk of recurrence after
Radiation Therapy
Radiation therapy uses precisely targeted, high-energy X-rays to destroy cancer cells while sparing nearby healthy tissue. Virginia Cancer Specialists offers advanced, state-of-the-art radiation for a wide range of cancers and select benign conditions.
- Painless outpatient treatments that usually take only minutes a day
- Planned and delivered with image guidance by our APEx-accredited radiation oncology team
- Can be the main treatment, or support surgery and chemotherapy
Surgery to Treat Cancer
Surgery is one of the oldest and most effective treatments for cancer. For many cancers, removing the tumor offers the best chance for a positive outcome, often combined with other therapies before or after the operation.
- Used to diagnose, stage, and treat cancer, and to relieve symptoms
- Minimally invasive and robotic-assisted techniques when appropriate
- Coordinated with your medical and radiation oncologists as one care plan
Immunotherapy
Immunotherapy helps your body’s own immune system recognize, target, and destroy cancer cells. Over the past decade it has transformed treatment for many types of cancer.
- Works with your immune system rather than attacking cells directly
- Usually given by IV infusion in our offices
- May be used alone or with chemotherapy, radiation, or targeted therapy
Targeted Therapy
Targeted therapy focuses on the specific genes, proteins, and other molecular features that help cancer cells grow and survive. By attacking what makes a cancer unique, it can be highly effective with fewer effects on healthy cells.
- Guided by biomarker and genomic testing of your cancer
- Taken as pills or given by infusion
- Often paired with chemotherapy, hormone therapy, or immunotherapy
Hormone Therapy
Hormone therapy treats cancers that use the body’s natural hormones to grow — most commonly breast and prostate cancers — by lowering hormone levels or blocking their effects.
- Usually pills or injections rather than infusions
- Can lower the risk of recurrence after surgery or radiation
- Managed by your medical oncology team, sometimes over months or years
Specialized Programs
CAR T-Cell Therapy Program — one of the most advanced treatments for certain blood cancers: your own immune cells, re-engineered to fight the disease.
Scalp Cooling — cold-cap therapy that can significantly reduce hair loss during many types of chemotherapy.
Clinical Trials & Research — access to tomorrow’s treatments today through the Virginia Cancer Specialists Research Institute.
Physicians
Find physicians and care teams who support this specialty area.
Locations
Find Virginia Cancer Specialists locations connected to patient care across the region.
Arlington
Monday through Friday 8:30 a.m. to 5:00 p.m.
571.350.8400
703.528.0338
1100 N. Glebe Rd., Suite 1600, 3 Ballston Plaza
Bristow
Monday through Friday 8:30 a.m. to 5:00 p.m.
571.350.8400
571.222.2202
9450 Innovation Drive
Fairfax
Monday through Friday 8:30 a.m. to 5:00 p.m
571.350.8400
703.280.9596
8613 Route 29
Fauquier
Monday through Friday 8:30 a.m. to 5:00 p.m.
571.350.8400
540.316.9921
210 W. Shirley Ave., Suite 111
The Supportive Cancer Care Team works in close partnership with each patient’s primary oncology team to ensure patients receive coordinated, comprehensive, seamless support that complements their current medical treatment. Patients have easy access to a team of compassionate experts – palliative care physicians, pain management specialists, social workers, nutritionists, nurse navigators, clinical coordinators, research coordinators, financial counselors, and many others who provide guidance, education, and emotional support every step of the way.
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Goals of Supportive Cancer Care
Virginia Cancer Specialists’ Supportive Cancer Care Program has 3 key goals:
Hallmarks of Our Supportive Cancer Care Program
While the primary goal is to improve quality of life for the patient and family throughout the treatment process, there are various ways in which this can be accomplished:
- Focusing on symptom management, including treating pain, insomnia, anxiety, respiratory and gastrointestinal problems
- Fostering open and honest communication
- Understanding the patient’s hopes and expectations
- Facing the realities of treatment and how it affects one’s life, including finances, employment, and more
- Providing support to caregivers and family
Patient Stories
Read patient stories and gain insight into their experiences, as well as the support they received from our dedicated care team.
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