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
Are there any diagnostic tests
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
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
cerous conditions like endometrial hyperplasia
or those found in an abnormal
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
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
Does gynecologic cancer affect
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
What can I do today to reduce
my risks of developing a gynecologic
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
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
To learn more about gynecologic
oncology at NYP Brooklyn Methodist’s
Cancer Center, visit www.nyp.org/
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
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