Gynecologic Surgery

According to the Centers for Disease Control, more than 80,000 women in the U.S. are diagnosed with a gynecologic cancer—either cervical, endometrial, vulvar or vaginal—each year. And, every year, more than 25,000 women die from gynecologic cancer.

As part of the Middlesex Hospital Surgical Alliance, our expert GYN surgeons have access to all of the advanced cancer treatments, technology and support staff at our state-of-the-art Cancer Center and Gynecologic Cancer Program. And, for especially complex cases, we have access to the knowledge of some of the top cancer specialists in the world at Mayo Clinic. So, you can be sure you’re getting the best GYN cancer care without having to travel far from home.

Gynecologic Cancer Conditions

Cervical Cancer

Cervical cancer is more common in other areas of the word than it is in the U.S., where cancer screening is more routine. However, estimates still predict approximately 13,000 new cases will be diagnosed in 2016.

Causes & Risk Factors

Most cases of cervical cancer are caused by the Human Papilloma Virus (HPV), which can be transmitted sexually or through skin-to-skin contact. Additional risk factors for cervical cancer include having many sexual partners, early sexual activity, having other sexually transmitted infections, smoking and a weakened immune system.

Symptoms & Diagnosis

The symptoms of cervical cancer may include vaginal bleeding, unusual vaginal discharge and pelvic pain. All symptoms should be discussed with your doctor. If you have a positive pap test, your doctor may request an additional test, such as a colposcopy, which allows doctors to take a closer look at the cells of the cervix and vagina.

Ovarian Cancer

Ovarian cancer occurs in the ovaries, which are part of the female reproductive system located in the pelvis. There can be noncancerous (cysts) or cancerous tumor growths in the ovaries that may spread to other areas of the body. This type of cancer causes more deaths than any other cancer of the reproductive system, possibly because it usually shows no symptoms until the disease is at an advanced stage.

Causes & Risk Factors

Certain factors may increase your risk of ovarian cancer, including age (it is more common in women ages 50-50), genetics, certain fertility treatments and hormone replacement therapies, use of an intrauterine device and smoking.

Symptoms & Diagnosis

Ovarian cancer is considered a “silent killer” because it often has no recognizable symptoms. However, when it shows symptoms, they may include persistent abdominal bloating, indigestion, nausea, loss of appetite, feelings of pressure in the pelvis or lower back, needing to urinate more frequently and feeling tired more often. If you’re experiencing these symptoms, your doctor will likely perform a pelvic exam and may order additional imaging tests, blood tests or exploratory surgery.

Endometrial Cancer

Endometrial cancer, or uterine cancer, is the most common gynecologic cancer in the U.S. There will be an estimated 60,000 or more new cases diagnosed in 2016 and potentially more than 10,000 deaths. However, endometrial cancer is quite curable when it is diagnosed early. Five-year survival rates for early Stage 1 endometrial cancer can be as high as 95%.

Causes & Risk Factors

The most common risk factor for endometrial cancer is being overweight. In fact, obesity increases the risk by more than 3 times. Age is another risk factor with 62 being the median age of women diagnosed. Additional risk factors include long-term use of high dosage menopausal estrogens, hormone therapy for breast cancer and smoking.

Symptoms & Diagnosis

Endometrial cancer usually occurs after menopause, so the most common symptom is postmenopausal bleeding. If your doctor suspects endometrial cancer, he or she will likely perform a pelvic examination and may order additional tests, such as an ultrasound, hysteroscopy or biopsy to confirm the diagnosis.

Vulvar & Vaginal Cancers

Vulvar and vaginal cancers are relatively uncommon and occur on the outer surface of the female genitalia, usually as a lump or sore on the vulva.

Causes & Risk Factors

Although it is unclear what causes vulvar and vaginal cancers, some common risk factors may be age (usually they are diagnosed around the age of 65), the human papilloma virus (HPV), smoking and being infected with HIV.

Symptoms & Diagnosis

Patients with vulvar cancer usually experience itching, bleeding, burning, pain and/or an enlarged mass on the vulva. Vaginal cancer patients typically present with abnormal discharge or bleeding that is painless, an abnormal pap smear or pain during intercourse.

Gynecologic Cancer Treatments


Surgical treatment of gynecologic cancers involves an operation to remove cancerous tissue. There are typically three surgical options, depending on the exact type of cancer and how advanced it is: they are traditional open surgery, minimally invasive laparoscopic surgery, which involves the use of small cameras and thin instruments to reduce the size of incisions needed, and minimally invasive robot-assisted surgery, which takes advantage of the da Vinci® Robot.


Chemotherapy for gynecologic cancers involves the use of medications, taken either intravenously or by pill, to shrink or kill cancerous cells.


Radiation treatments use high-energy rays to kill cancer cells. Our cancer center offers high-dose-rate brachytherapy to patients with certain GYN cancers. This procedure involves placing radioactive materials inside the body, making it highly effective and better tolerated than external radiation therapy. It is also more convenient for patients because it normally takes 15-20 minutes per treatment and is administered once or twice a week for a total of three to five treatments.

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