MSK Named a Best Hospital for Gynecology by U.S. News

Gynecologic oncologist Nadeem Abu-Rustum
Summary

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.

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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.

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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.

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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.

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Comments

How would your team handle a squamous cell carcinoma that has arisen in a field of lichen sclerosus?

Dear Liz, because every case is unique, we cannot offer specific recommendations without knowing more details about the patient's medical history and cancer diagnosis. If you would like to make an appointment for a consultation regarding your treatment options, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

I test positive for high risk HPV. I am scheduled for a LEEP procedure. At what point do I seek a doctor at MSK? Does your Westchester branch handle this type of case?

Dear Donna, our facility in West Harrison does not offer general gynecology care. However, if and when you receive a diagnosis of cancer, you are welcome to make an appointment with one of our specialists there by calling our Physician Referral Service at 800-525-2225. To learn more about the services offered at MSK Westchester in West Harrison, please visit https://www.mskcc.org/locations/westchester-west-harrison. Thank you for reaching out to us.

My colpoctomy biopsy revealed high grade in situ squamous cells in cervix CIII despite negative HPV test results, but a prior year showed positive HPV results along with then negative colpoctony results. Can I schedule appointment?

Dear Donna, for more information and to make an appointment, please contact our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

I have returned cancer Vaginal adenocarcinoma (squamous mucosa). It is sitting on urethra. the surgery Is impossible, I need to keep urination function. I'm looking for alternative way. May you help me???

Dear Marina, we're sorry to hear about your diagnosis. If you would like to make an appointment with an MSK doctor to discuss treatment options, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.

Approximately 1 week ago I had surgery on My ovary and after the surgeon reviewed the pathology report I believe I was diagnosed with Squamous cell carcinoma (SCC) of the ovary . I'm told this is extremely rare in general and especially for someone who is 30 years old . Further complicating the issue is that I'm 22 weeks pregnant . Im told That there are at best a handful of women pregnant w SCC if any at all. I'm looking for guidance for possible chemo treatment during the pregnancy , post pregnancy and any other options to bring my pregnancy to full term without harming the Baby. Thank you .

I have recently been diagnosed with a complex cyst on my right ovary. The doctor would like to wait 6 weeks and perform another vaginal ultrasound. This cyst was identified on an abdominal cat scan in about 2 weeks ago by my gastoenterologist for abdominal pain i n the opposite side of where cyst was found.. I am scheduled bilateral knee replacement in exactly 6 wks. My gyno said to go ahead with knee replacement but from what I've read, if the cyst turns out to cancer and I need chemo, the chemo may affect the cement used on my knee replacement. What should I do?

Dear Michele, unfortunately we are unable to provide personal medical advice on our blog. We recommend that you discuss this with your orthopedic surgeon. Thank you for your comment, and best wishes to you.

My mom is 63 and recently had a hysterectomy 5 weeks ago due to squamous cell carcinoma of the ovary. Which specialist would you recommend for medical advice and chemotherapy treatment?

Dear Carrie, we're sorry to hear about your mother's diagnosis. We have several doctors who specialize in this type of cancer. If you mother would like to make an appointment for a consultation, she can call 800-525-2225. The referral experts at that number will be able to determine which of our doctors she should meet with. For more information on making an appointment, you can go to https://www.mskcc.org/experience/become-patient/appointment . Thank you for your comment, and best wishes to you and your family.

Hi,
I am 57 years old and have just had a biopsy and waiting for results on a cervical thickening and have a mass on my left ovary. Have been in menopause for about three years. Does MSK consult about genetic cancer treatment if I need it. I havehadlyme disease for 45 years and am positive for MTHFR.

Dear Paula, by "genetic cancer treatment," we're not sure if you mean providing treatments that are targeted at particular genetic mutations in a tumor or providing care for patients who have genetically inherited cancer, but we provide both of these things for appropriate patients. If you'd like to learn more about making an appointment after you get your biopsy results, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information. Thank you for your comment, and best wishes to you.

Hi, I am 63 years old, post menopausal and was recently diagnosed with complex atypical endometrial hyperplasia. I had abnormal bleeding and discharge and the doctor recommended I have a hysteroscopy and D&C. Also the transvaginal ultrasound revealed thickening of the endometrium. Cervical and uteran polyps were removed that turned out to be benign. I have never taken estrogen after menopause. My doctor explained that with this condition , the risk of developing cancer is increased. I am scheduled for a radical hysterctomy at the end of August but came across your article while researching my condition. I would like to have the hysterctomy at MSK and be treated there if in fact it turns out I do have cancer. Please let me know if that is possible.i am concerned because I read that with this condition cancer was found to be present in four out of ten women.

Dear Patricia, we're sorry to hear you're going through this. If you would like to speak to someone about the possibility of having surgery at MSK, you can call 800-525-2225 during business hours or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.

I have 2 cyst on my right overy one is 4cm and stable the other was b 3cm now a cat scan Saud it grew 1/4 inch I have some spotting on and off and they told me my uterus liner it thicker I've had byopsy on my uterus 4 times all were normal at one time they told me the cyst were complex and they were bigger now they are abit smaller and stable I heard b so many good things about MSK I people that did go there and had great experience I want go conebgwt b checked out but it's hard for me to find a way there thank you please advise me on what I can do alice

Dear Alice, we're sorry to hear that you're going through this. If you are not able to travel to MSK, you may want to look at the National Cancer Institute's list of designated cancer centers, to find one that is closer to where you live. You can find the list here: https://www.cancer.gov/research/nci-role/cancer-centers Thank you for your comment, and best wishes to you.

My heart belongs to Sloan Kettering.
Dr. Abu-Rustum was my saving grace with the great help of the Lord. Dr. Abu-Rustum is amazingly talented. I will never forget how he saved my life after being diagnosed with stage 4 Ovarian.
Dr. Sabbatini was my oncologist. He, too, is one talented doctor. His knowledge in this field is stupendous. I miss seeing both of them along with all the amazing nurses and staff.
It's been nine years with no evidence of disease and no reoccurrences. Hugs to Sloan !!!!
Thank you for giving me the opportunity to see all my children get married and the births of two grand children.

Dear Janice, we're thrilled to hear you're doing well! Thank you so much for sharing these kind words. We will forward your message to your doctors. Best wishes to you!

I put my life in Dr. Abu-Rustum/MSKCC hands in 2004. I was stage IIIc. It was a very long tough road but I am strong and healthy now. Thanks to that sweet, caring man!

Dear Nancy, we're glad to hear you're doing well. We will share your comment with Dr. Abu-Rustum. Thank you for your comment, and best wishes to you!

I was diagnosed with endometrial Cancer and a laparoscopic hysterectomy is scheduled next week. My issue is I am 5'6 and 300 lbs and my surgeon does not seem that confident. Do you know of anyone that has experience operating on the obese? I understand there is an increased risk but there have to be ways to mitigate that. I want to have the best possible chance and my surgeon seems daunted.

Dear LJ, we're very sorry to hear about your diagnosis. All of our gynecologic surgeons have experience treating obese patients, including many with laparascopic procedures. If you would like to make an appointment for a consultation, you can call 800-525-2225 or go to https://www.mskcc.org/experience/become-patient/appointment for more information on making an appointment. Thank you for your comment, and best wishes to you.

Hello- I recently had a pelvic ultrasound due to abnormal periods for the last three months. The ultrasound results came back with: 1.9 cm heterogeneous lesion abutting the left ovary and left aspect of uterus with internal and peripheral vascularity is of uncertain etiology. Gynecologist thinks it's probably a fibroid but not sure. Also have 0.7 cm hyperechoic lesion in the endometrial cavity most likely a polyp. I don't like that neither of these are definitive & are maybe's. Recommendation is get retested in 4-6 months. Would this be something I could see one of the Docs at MSKCC to get a second opinion?

I have a mass in my uterus post menopause, it
has gotten larger in the years since menopause.
they only give me ultrasounds and say if its not spotting don't worry and it could be just a fribroid.
my ovary is pulsing now and I feel swollen glands in my neck. cant I get a 2nd opinion on the mass at MSK?

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