Treatment Options

Minimally invasive gynecologic cancer surgery

If you need surgery, the gynecologic oncologists at NewYork-Presbyterian Brooklyn Methodist Hospital Cancer Center take a minimally invasive approach whenever possible. You may have laparoscopy, which can sometimes be performed as an outpatient procedure and which is associated with smaller incisions, less blood loss, and a shorter recovery time than open abdominal surgery.

Our surgeons are exceptionally skilled at performing robotic gynecologic cancer surgery. NewYork-Presbyterian Brooklyn Methodist has the latest state-of-the-art robotic surgery systems.

Cervical cancer surgery

  • Removing cervical precancers. If you have precancerous cells in the cervix, you may have cryosurgery (freezing the abnormal cells), laser surgery (which "burns" the cells), or conization (surgical removal of a cone-shaped section of tissue containing cancer.
  • Preserving childbearing ability. If you have cancer that is stage I or greater and you wish to retain your ability to have children, your surgeon will let you know if you can have radical trachelectomy — removal of the cervix and the upper part of the vagina, leaving the body of the uterus in place.
  • Hysterectomy. Our surgeons also perform a hysterectomy for cervical cancer, removing the uterus but leaving the ovaries in place, if appropriate.
  • Robotic cervical cancer surgery. Your surgeon may be able to use robotic surgery to remove your cancer or your uterus.

Ovarian cancer surgery

Treatment for ovarian cancer most often includes surgery to remove the ovaries, fallopian tubes, and uterus — an operation called "hysterectomy with salpingo-oophorectomy." Our surgeons are very skilled in this procedure as well as "debulking surgery" — extensive removal of tissue in the abdomen that contains ovarian cancer cells. Optimal debulking surgery raises your chance of longer survival. In some instances, ovarian cancer debulking surgery can be performed using laparoscopic or robotic-assisted techniques.

Uterine (endometrial) cancer surgery

Hysterectomy is the most common treatment for uterine cancers. Our surgeons often perform this procedure using robotic and laparoscopic approaches. If you are interested in having children in the future, your surgeon will discuss your options with you to see if your surgery can preserve your fertility. Your surgeon will also remove lymph nodes in your pelvis to see if they contain cancer cells; this process, called staging, will determine if you need treatment other than surgery.

Vaginal cancer surgery

Most women with vaginal cancer have surgery to destroy or remove the tumor. Your gynecologic oncologist will choose the least invasive surgery possible to treat your cancer, depending on its type and extent of growth.

  • Laser surgery. If you have precancerous cells on the surface of the vagina, you may be able to have laser surgery to destroy these cells.
  • Vaginectomy. If your tumor has grown more deeply into the vaginal wall, you may have vaginectomy to remove all or part of the vagina.
  • Hysterectomy. Women with more advanced vaginal cancer may need to have the vagina and entire body of the uterus removed.
  • Robotic vaginal cancer surgery. Your surgeon may be able to use robotic surgery to remove your cancer or your uterus.

Vulvar cancer surgery

Surgery is a common treatment for vulvar cancer. Our gynecologic oncologists aim to remove the least amount of tissue possible to treat your vulvar cancer, with the goal of minimizing deformity while maintaining your sexual function and quality of life. More extensive vulvar cancers may need more extensive surgery. Your gynecologic oncologist will let you know which surgical approach is best for you.

  • Laser surgery may be done to destroy precancerous cells on the surface of the vulva.
  • Local excision. With this approach, the surgeon removes cancer and some of the tissue around it, leaving the rest of the vulva intact.
  • Vulvectomy. If your tumor has grown more deeply into the vulva, you may have vulvectomy to remove part or all of the vulva, depending on the extent of the tumor's growth.
  • Ultrasound surgical aspiration. With this surgical procedure, your doctor breaks up the tumor into small pieces using very fine sound vibrations. The small pieces of tumor are washed away and removed by suction. This procedure causes less damage to nearby tissue.

A commitment to fertility preservation

If you wish to become pregnant after your treatment is over, we have expertise in fertility-sparing surgery whenever feasible that can preserve the ability to have children without compromising your outcome. We can collaborate with infertility specialists to review your fertility preservation options. Embryo freezing and egg freezing are sometimes available before you begin your cancer treatment, and in vitro fertilization afterward.

Chemotherapy & immunotherapy

Most women with ovarian cancer and others with a gynecologic cancer that has spread need chemotherapy to kill any cancer cells remaining in the body. While many hospitals refer patients who need chemotherapy for gynecologic cancer to other facilities, the team at NewYork-Presbyterian Brooklyn Methodist Hospital Cancer Center gives your chemotherapy in our dedicated Infusion Center, in the same Center for Community Health location. Studies have shown that patients do better when their gynecologic oncologist is involved in all aspects of their care. Our doctors also use:

Abdominal chemotherapy. Your doctor will let you know if you are a candidate for intraperitoneal chemotherapy, which we give directly into the abdomen to kill cancer cells. This may be an option for women with advanced ovarian cancer. First, the surgeon removes as much cancerous tissue as possible. Then chemotherapy is given into the abdomen — either during the surgery to remove the tumor or in a separate surgery afterward.

Topical chemotherapy. Some vulvar precancers (such as vulvar intraepithelial neoplasia) are treated with topical chemotherapy, applied as a cream or lotion.

Minimizing hair loss during chemotherapy

The DigniCap® Scalp Cooling System is a patented medical cooling device that offers people with cancer the ability to minimize hair loss during chemotherapy, improving well-being and quality of life. DigniCap provides continuous cooling effectively and safely. NewYork-Presbyterian Brooklyn Methodist Hospital Cancer Center is the only center in Brooklyn to offer DigniCap.

Targeted therapies

We may be able to offer you a treatment that targets the abnormal molecules driving the growth of your cancer. Precision medicine — tailoring treatment to the biology of your tumor — enables us to offer targeted therapies for some gynecologic cancers, such as PARP inhibitors for some women with advanced ovarian cancer.

Hormonal therapy

Some women with uterine cancer receive hormonal therapy to inhibit tumor growth. Your doctors will let you know if this is an option for you.

Immunotherapy for gynecologic cancers

Patients with certain types of advanced cervical cancer or advanced ovarian cancers with specific genetic features may receive pembrolizumab, a type of immunotherapy. This treatment boosts the ability of your immune system to detect and kill cancer cells. This immunotherapy is given intravenously.

Radiation therapy

If your cancer can be treated with radiation therapy, we offer a variety of approaches, all of which share the goal of destroying cancer cells while sparing as much healthy tissue as possible. These include:

  • External beam radiation therapy. Radiation beams are finely targeted to your tumor. You can receive these treatments in our state-of-the-art radiation therapy center.
  • Brachytherapy. Some women are candidates for brachytherapy (the placement of radiation-containing sources directly in or near tumors to kill cancer cells), which we apply directly to a tumor in the operating room.
  • Presurgical radiation. In very few cases, women with uterine sarcomas receive radiation therapy before surgery to shrink the tumor.