Each year, more than 100,000 women receive a diagnosis of gynecologic cancer, and over 30,000 will succumb to their disease. The symptoms  of gynecologic cancer can be subtle, so  
 it is important for women of all ages, especially postmenopausal women, to be aware of their options for screening and treatment. Margaux Kanis, MD, a gynecologic oncologist at  
 NewYork-Presbyterian Brooklyn Methodist Hospital’s Cancer Center, answers some questions and walks us through some basic information that every woman should know.  
 COURIER LIFE, OCTOBER 22-28, 2021 15  
 What is gynecologic cancer? 
 Gynecologic  cancer  includes  cancers  
 of the ovary, uterus, cervix, vulva,  
 and vagina. I also treat gestational trophoblastic  
 disease, which is an umbrella  
 term for tumors that may form  
 during or after pregnancy. 
 What  are  some  symptoms  I  
 should watch for? 
 Each  cancer  can  present  differently, 
  but postmenopausal women are  
 often at the highest risk. 
 Uterine cancer often presents with  
 unusual uterine bleeding. It may also  
 present  with  an  enlarged  uterus  or  
 pelvic mass, which is usually detected  
 during  an  annual  gynecologic  exam  
 or  on  pelvic  imaging.  Even  a  single  
 episode  of  bleeding  after  menopause  
 should prompt a woman to see her gynecologist  
 to be evaluated. 
 Ovarian cancer often doesn’t present  
 with symptoms until the cancer  
 has progressed and has spread to surrounding  
 organs.  Even  when  symptoms  
 do develop, they can often be  
 vague and easy to be overlooked: bloating, 
  abdominal pain, fullness or early  
 satiety. Because of the “quiet” nature  
 of ovarian cancer symptoms, it is especially  
 important  to  continue  with  annual  
 gynecologic exams—even when  
 you are feeling fine. 
 Cervical cancer is usually detected  
 on routine pelvic exams via Pap smears  
 (or tests, named after Greek doctor  
 Georgios Papanikolaou who invented  
 the test). A Pap smear tests cells from  
 the cervix for cancerous or pre-cancerous  
 growth. HPV (Human Papilloma  
 Virus) is the leading cause of cervical  
 cancer, and for those 45 and under, the  
 HPV vaccine is highly recommend. 
 Vulvar cancers are often found in  
 older women/postmenopausal women.  
 Symptoms include itching, bleeding,  
 pain and nonhealing sores on the labia  
 or clitoris.  
 Are there any diagnostic tests  
 available? 
 The best screening tool we have is  
 a Pap smear performed by your regular  
 gyn or family practitioner. There is no  
 clinically proven screening method for  
 uterine, ovarian or vulvar cancers, but  
 it  is  important  to  communicate  early  
 and often with your gynecologist about  
 any changes or symptoms you may notice  
 in your body and reproductive organs. 
  If there is a suspicion of cancer,  
 your doctor may perform a biopsy and  
 order additional tests, such as an ultrasound, 
  CT  scan,  PET  scan  or MRI,  as  
 well as bloodwork.  
 When should I seek treatment  
 from  a  gynecologic  oncologist  
 rather than my gynecologist? 
 Most times, women are referred to  
 a gynecologic oncologist by their gynecologist  
 or primary physician.A gynecologic  
 oncologist has not only completed  
 medical school and four years  
 of residency, but an additional three  
 years in a gynecologic oncology fellowship  
 program. He or she should be double  
 board certified—in both obstetrics  
 gynecology and gynecologic oncology.  
 You should see a gynecologic oncologist 
 a physician like myself who specializes  
 in diagnosis and treating these  
 specific cancers if:  
       - 
 logic cancer (including ovarian, uterine, 
  cervical, vaginal or vulvar cancer,  
 or gestational trophoblastic disease) 
       - 
 nign  (non-cancerous)  growths.  A  gynecologic  
 oncologist is able to perform  
 complex pelvic surgeries using minimally  
 invasive  techniques,  including  
 laparoscopy and robotics. Minimally  
 invasive surgery allows for less blood  
 loss and faster recovery times for the  
 patient. 
        
 history of gynecologic cancers or a  
 known genetic mutation that predisposes  
 you to a gynecologic cancer, we  
 can provide surveillance or risk-reducing  
 surgery. Such mutations include  
 BRCA1, BRCA2, BRIP1, RAD51C/D,  
 PALB2, STK11 mutations and Lynch  
 Syndrome. 
 - 
 cerous conditions like endometrial hyperplasia  
 or those found in an abnormal  
 pap smear. 
 What types of clinical trials are  
 available now for gynecologic cancers? 
   
 I am currently the primary investigator  
 on all the clinical trials open for  
 gynecologic cancer at the Cancer Center  
 at NewYork-Presbyterian Brooklyn  
 Methodist Hospital. We work with the  
 Joint Clinical Trials Office, and I work  
 in collaboration with my colleagues at  
 Weill Cornell Medicine. I am currently  
 overseeing  six  different  clinical  trials  
 for gynecologic cancer treatment at  
 NYP Brooklyn Methodist. 
 What is a typical treatment for  
 gynecologic cancer? 
 Treatment varies depending on  
 cancer  type  and  stage.  It  usually  includes  
 a combination of surgery, chemotherapy  
 and radiation, all of which  
 are available here in the NYP Brooklyn  
 Methodist campus. 
 Does  gynecologic  cancer  affect  
 fertility? 
 As a woman and a mother, I understand  
 the importance of preserving fertility. 
   
 I offer fertility-sparing treatments  
 and surgery when appropriate. I also  
 work closely with reproductive endocrinology  
 and infertility specialists  
 to  preserve  ovarian  function  during  
 treatment.  
 What can I do today to reduce  
 my risks of developing a gynecologic  
 cancer? 
 Reducing  your  risk  of  developing  
 cancer—including  gynecologic  cancer— 
 is pretty straight forward: Maintain  
 a healthy weight by exercising  
 regularly and eating a healthy diet;  
 don’t use tobacco; and get your cancer  
 screenings!  
 There are some specific things a  
 woman can do to decrease her odds  
 against gynecologic cancer: see her  
 gynecologist every year for a pelvic  
 exam and Pap smear, and get an HPV  
 vaccine! 
 To  learn  more  about  gynecologic  
 oncology at NYP Brooklyn Methodist’s  
 Cancer Center, visit www.nyp.org/ 
 brooklyn/cancer-care/gynecologic-cancer, 
  or call 929-470-9600 to make an appointment. 
 Health and safety are always our  
 top priorities at NewYork-Presbyterian.  
 We have implemented vigorous policies  
 and procedures and are following all  
 governmental recommendations about  
 COVID-19. 
  
  
   
 ASK YOUR DOCTOR  
  TO TEST YOUR CHILD  
 FOR LEAD 
 Lead in peeling paint  
 poisons children. 
  •  Tell your landlord to fix peeling paint. It’s the law. 
  •  Wash floors, windowsills, hands,  and toys often. 
 GET YOUR CHILD TESTED AT AGES 1 AND 2. 
 CALL 311 TO LEARN MORE OR VISIT NYC.GOV/LEADFREE. 
 
				
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