5 Reasons MSK Excels at Treating Gynecologic Cancers

Memorial Sloan Kettering surgeons Oliver Zivanovic, Kara Long Roche, Ginger Gardner, and Yukio Sonoda

MSK surgeons are highly skilled at treating even the most difficult gynecologic cancers.

Summary

Learn why our specialists are among the best in the world at treating cervical canceruterine (endometrial) cancer, and ovarian cancer.

In its 2019–2020 listing of the nation’s best hospitals, U.S. News & World Report ranks Memorial Sloan Kettering as number one for gynecology. This recognition of excellence reflects the dedication and expertise MSK brings to people with cervical cancer, endometrial cancer, and ovarian cancer, including pioneering many advances that today are the standard of care. Find out why MSK stands out at improving outcomes and preserving quality of life for people with gynecologic cancers.

1. Highly-Skilled Surgeons and Oncologists Who Specialize Exclusively in Gynecologic Cancers

Surgeons Mario Leitao (left) and Nadeem Abu-Rustum

Surgeons Mario Leitao (left) and Nadeem Abu-Rustum have vast experience in treating people using minimally invasive methods.

MSK has a team of about 50 highly specialized doctors dedicated solely to the treatment of gynecologic cancers. This includes surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists who collaborate closely. “We meet every week to consult on the details of every complex diagnosis and to decide on the best treatment,” says Nadeem Abu-Rustum, Chief of the Gynecology Service.

Doctors at MSK perform among the largest number of gynecologic cancer procedures in the world, making us the best at treating even the most difficult cases. For example, MSK’s ovarian cancer surgery team is the first in the nation that’s dedicated to managing advanced ovarian cancer. This group specializes in removing advanced disease that has spread beyond the ovaries. The team is especially skilled in radical debulking surgery. In this procedure, doctors remove as much tumor tissue as possible to boost the effectiveness of chemotherapy in reaching and destroying ovarian cancer.

“Ninety percent of women with advanced ovarian cancer at MSK are optimally debulked. This means that the amount of tumor remaining after the procedure is very small — less than 1 centimeter in diameter,” Dr. Abu-Rustum explains. “More important, 70% have all visible tumor removed. Studies at MSK and around the world show that removing this volume of cancer tissue has led to improved survival for patients.”

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2. Methods for Speeding Recovery and Preserving Quality of Life

MSK pioneered a way to reduce the number of lymph nodes removed during surgery for early-stage cervical and endometrial cancers. Rather than taking out a large number of lymph nodes to make sure that the cancer has not spread, doctors use a technique called sentinel lymph node mapping. The approach removes fewer nodes and greatly reduces the risk of leg lymphedema. This common, often debilitating side effect involves swelling and skin changes. Sentinel lymph node mapping “has been rigorously studied. It has been shown that there is no difference in survival between the historical surgical approach and sentinel node mapping,” Dr. Abu-Rustum says. “It is a huge benefit if more women can be spared unnecessary lymph node removal and the resulting side effects.”

In addition, MSK surgeons often use minimally invasive methods, such as laparoscopic and robotic surgery, which involve keyhole-size incisions, resulting in less pain and blood loss, a shorter hospital stay, and a faster recovery. Surgeons now do many procedures at the Josie Robertson Surgery Center, a state-of-the-art facility for short-stay cancer surgery. Patients return home to complete their recovery as soon as possible — either the same day or the next.

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3. Access to a Range of Clinical Trials and New Treatments

MSK medical oncologist Claire Friedman

MSK medical oncologists, such as Claire Friedman, are leading a range of clinical trials testing immunotherapy for gynecologic cancers.

Clinical trials can offer people with gynecologic cancers access to treatments that are not widely available elsewhere. Currently, MSK is conducting 35 clinical trials for women with gynecologic cancers, testing new drugs and drug combinations, surgical approaches, and strategies for preserving quality of life during and after treatment. One especially active field is immunotherapy. MSK scientists and doctors played a leading role in developing immunotherapies that have transformed the treatment of melanoma, lung cancer, and other cancers. Now this therapeutic approach is giving new hope to people with gynecologic cancers.

The ovarian cancer team is also running clinical trials on the use of heated intraperitoneal therapy (HIPEC) for certain people with advanced ovarian cancer. In HIPEC, heated chemotherapy is given directly in the belly at the end of surgery.

In addition, MSK researchers are at the forefront of research that could soon impact gynecologic cancer care. This includes investigating whether many ovarian cancers start developing in the fallopian tubes and whether removal of those tubes could prevent the disease. Other researchers are looking for ways to understand and treat lymphedema. MSK is the only cancer center with a dedicated lymphedema laboratory focused on understanding and treating this debilitating condition. 

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4. Genetic Testing to Guide Treatment and Assess Risk

Many of MSK’s recent gynecology patients have benefited from a powerful diagnostic test called MSK-IMPACT™. This test provides essential genetic information about a tumor that doctors can use when making a diagnosis and considering treatment options. In some cases, the test results may identify women who are candidates for a clinical trial. With MSK-IMPACT, MSK doctors can offer the best treatment for each person.

The Clinical Genetics Service guides people who may be at a higher risk for a gynecologic cancer due to inherited genetic mutations, such as the BRCA mutations. This includes risk assessment, genetic counseling, and genetic testing.

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5. Programs to Preserve Fertility and Sexual Health

MSK’s Survivorship Center offers an array of services to help preserve fertility and sexual health in women undergoing treatments for gynecologic cancers. And MSK surgeons have pioneered ways to remove cervical tumors while retaining the uterus, so women preserve the option to have children later. The surgical team has done more than 200 such operations, called radical trachelectomy, and many of these women later had children. “The success rate with this approach is very high. MSK is now a referral center for young women with uterine cancer who want to maintain their fertility,” Dr. Abu-Rustum says.

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Comments

The best of the best. Dr Kara Long Roche and Dr. Claire Friedman, they save my life. I LOVE THEM.

Dr. Abu-Ruustum is literally the best doctor, EVER! I can never thank him enough for the treatment I received. You are amazing!

Hey what about the contribution of expert GYN pathologists?

Thank you for your comment. We appreciate the invaluable contributions of MSK’s pathologists in providing outstanding patient care. The story was only meant to touch on a few factors that made MSK #1 in gynecololgy. That’s why some specialists (pathologists, radiation oncologists, radiologists) are acknowledged in the first item but not discussed in more detail. We decided to focus on a few treatment approaches that we thought our readers would be interested to learn more about.

One of the reasons for the success of MSK’s gynecological surgical team is Dr. Ginger Gardner. She is smart, compassionate and quite simply the very best!

MSK’s Oncologists are amazing professionals. Dr. Paul Sabbatini is one of the finest oncologists in the nation. His quality of care and level of expertise is second to none.

Pity there is no mention of the nursing staff or the allied health staff who are absolutely vital to patients' treatment and to their positive hospital experience as a whole.

Thank you for your comment. We agree wholeheartedly about the invaluable work of MSK nurses, as well as medical staff such as our social workers, integrative medicine experts, physical therapists and many others! The story was only meant to touch on a few factors that made MSK #1 in gynecology.

Dr. Abu Rustum is the best doctor ever. He performed surgery on me twice for vulvar melanoma. I can never thank him enough for saving my life.

Dear Rochelle, we’re so glad you were happy with your care at MSK. We have forwarded your comment to Dr. Abu Rustum. Thank you for your comment and best wishes to you.

No one saw it, until I arrived at MSK to see Dr. Abu Rustum. Saved In the nick of time (stage IIIc endometrium cancer)! Heartfelt gratitude cannot begin to convey my joy with the kindness and outstanding care at MSKCC.

Dear Gayle, we’re glad to hear you had a good experience at MSK. We will forward your comment to Dr. Abu-Rustum. Best wishes to you and thank you for sharing your story.

Dr. Abu Ruston saves my life.

Given a diagnosis at another hospital of less than a year to live, so far it’s been almost six years.

Besides being a superb surgeon he is kind and caring.

Dear Marcia, we’re glad to hear you had a good experience at MSK. We will forward your comment to Dr. Abu-Rustum. Best wishes to you and thank you for sharing your story.

Dr. Jennifer Mueller performed my BSO surgery. It’s hard enough being diagnosed with a BRCA 1 mutation so a compassionate, approachable expert was paramount in my decision making. (Especially when I never had surgery before). Thank you Dr. Mueller and all of the MSK staff.

Dear Lisa, we’re glad to hear you had a good experience at MSK. We will forward your comment to Dr. Mueller. Best wishes to you and thank you for sharing your story.

Every day I thank the team of caring doctors, nurses, technicians and administrative staff for making my surgery, treatment, recovery and subsequent after care a tolerable experience in a very scary and stressful environment. The effort given to be kind, compassionate, concerned and patient is unbelievable. Thank you all for saving my life.

Dr. Yukio Sonoda did a fantastic job performing the da Vinci robotic total hysterectomy on me - he removed my Fico Grade 1A endometrial tumor and I went home the same day as the surgery. Nurse Alex Wagner was always there to support me as well as Dr. Sonoda’s amazing surgical team! It has been a year now and I continue to be grateful and appreciative of the support and health care MSK has provided. Thanks so much!

Dear Rebecca, we’re so glad to hear you were happy with your care at MSK. We have forwarded your comment to Dr. Sonoda and Nurse Wagner. Thank you for your kind works and best wishes to you.

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