MSK’s outstanding care has led U.S. News & World Report to rank us as number two in the nation — and number one on the East Coast — for gynecology in its 2016-2017 Best Hospitals issue. Our specialists are the best in the world at treating cervical cancer, endometrial cancer, and ovarian cancer and have pioneered many advances that improve outcomes and preserve quality of life for patients.
Earlier this month, the U.S. News & World Report 2016-17 listing of Best Hospitals ranked Memorial Sloan Kettering a best hospital for gynecology — number two in the nation and number one on the East Coast. This recognition of excellence reflects the dedication and expertise MSK brings to treatment for people with cervical cancer, endometrial cancer, and ovarian cancer, including pioneering many advances that today are the standard of care.
Nadeem Abu-Rustum, Chief of the Gynecology Service, explains what is distinctive about gynecologic care at MSK.
What makes the gynecologic cancer care your team offers stand out from other hospitals?
We have a team of about 50 highly specialized oncologists who dedicate their lives to the treatment of these cancers. Our care team includes surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists. We meet every week to consult on the details of every complex diagnosis and to decide on the best treatment. This allows our patients to have the best chance of survival while maintaining, as much as possible, a high quality of life.
MSK specialists are the best in the world at treating even the most difficult cases. For example, our ovarian cancer surgery team is the nation’s only group solely dedicated to the removal of metastatic ovarian cancer that has spread beyond the pelvis. We have developed expertise in radical debulking surgery, in which we remove as much ovarian tumor tissue as possible to boost the effectiveness of chemotherapy in reaching and destroying cancer. The procedure usually involves removing the ovaries as well as the uterus, cervix, fallopian tubes, and any other areas containing disease tissue.
Eighty percent of women with advanced ovarian cancer at MSK are “optimally debulked,” meaning the amount of tumor remaining after the procedure is very small (less than one centimeter in diameter). Studies at MSK and around the world show that removing this volume of cancer tissue has led to improved survival for patients.
Many of our recent gynecology patients have benefited from a powerful diagnostic test called MSK-IMPACT. This test provides essential genetic information about the cancer that can guide diagnosis and treatment choices, and, in some cases, identify patients who are candidates for a clinical trial. This enables us to provide optimal treatment for each patient. Apart from the genetic testing, MSK patients in general have access to a large number of clinical trials testing new treatments we’re currently studying.
What are some of the ways your team helps ease recovery after gynecologic cancer?
We pioneered a method for reducing lymph node removal during surgery for early-stage cervical and endometrial cancers. This approach greatly reduces the risk of lymphedema — a common side effect that involves swelling and skin changes — and is becoming widely adopted at many institutions. In addition, our surgeons often use minimally invasive methods such as laparoscopic and robotic surgery that involve keyhole-size incisions, which may result in less pain and blood loss, a shorter hospital stay, and a faster recovery. We also have implemented a program that has reduced infections at surgical sites to very low rates.
We now do many procedures at the Josie Robertson Surgery Center, a state-of-the-art facility for short-stay cancer surgery. This allows our patients to return home as soon as possible — either the same day or the next — to complete their recovery. We carefully manage everyone before and after surgery, closely tracking their condition to ensure they are recuperating on schedule.Back to top
What does your team do to help women preserve their ability to have children after cancer?
Since 2001, we have pioneered ways to remove cervical tumors while retaining the uterus, allowing women to preserve their fertility. Our team has done more than 150 such operations, and many of these women later had children. Our success rate with this approach is very high, and we are now a referral center for young women with uterine cancers who want to maintain their fertility.Back to top