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Gynecological Cancer

Every year approximately 75,000 women in the United States are diagnosed with some form of a malignant tumor of the female genital tract that includes the uterus, cervix, ovaries, fallopian tubes, and vulva/vagina. The first sign of gynecologic cancer usually pertains to vaginal bleeding, especially following menopause. A gynecologic oncologist, a physician with advanced fellowship training in the use of surgery and chemotherapy for the evaluation and management of malignant tumors of the female pelvis, usually makes the diagnosis.

At the University Of Miami Miller School Of Medicine, a group of nationally recognized physicians in the fields of gynecologic oncology, radiation oncology, pathology, and radiology meet regularly as The Gynecologic Cancers Site Disease Group at the Sylvester Comprehensive Cancer Center. Of this purpose of this group is to provide a comprehensive review of patients with malignant gynecologic cancers to develop an individualized plan of therapy for each one.

The Gynecologic radiation oncology team at the University of Miami School Of Medicine has multiple tools available to them to optimize the care of patients afflicted with gynecologic malignancies. External beam radiation therapy is often utilized the treatment of these cancers. We utilize the latest in 4D CT, Pet CT fusion and 3T MRI imaging to optimize our identification of target areas.

External beam radiation is often delivered utilizing intensity modulated radiation therapy or IMRT. All of our radiation linear accelerators are Varian Rapid ARC® capable of delivering the next generation of IMRT called intensity modulated arc therapy or IMAT. This enables us to more accurately deliver radiation to tumors while minimizing the dose model surrounding structures receive. We also utilize image guided radiation therapy or IGRT. This includes the daily imaging of not just the bones but often the tumor to ensure the accuracy of radiation delivery. We have multiple means of image guidance at our disposal, including cone beam CT, KV portal imaging, Calypso® and the Elekta Clarity 3d Ultrasound system.

Often the management of gynecologic malignancies requires the use of internal radiation. This involves the insertion of radioactive source(s) into hollow applicators temporarily implanted into the female pelvic organs by the radiation oncology team (brachytherapy implant). The brachytherapy may be given with the patient being hospitalized for several days (low-dose-rate or LDR implant) or more commonly as an outpatient in which the patient returns home the same day (high-dose-rate or HDR implant). We have the ability to utilize all of the above listed technologies, including 4D CT, Pet CT fusion and 3T MRI and ultrasound imaging to optimize our identification of target areas. We also have the Nucletron Oncentra® treatment planning system combined with a Nucletron HDR Ir192 remote afterloader. This allows us to inverse plan our brachytherapy and utilizes all available imaging to achieve the best outcomes for patients.
The radiation oncology team is headed by Dr. Aaron Wolfson M.D. and Dr. Lorraine Portelance M.D..

To learn more, please visit the Gynecological Cancer Library.