Endometrial Cancer: “We Treat Almost All Robotically”
“During the last several years, minimally invasive procedures have become the mainstay for many gynecologic cancers,” said Janet Rader, MD, FACOG, Medical College of Wisconsin gynecologic oncologist and chair of Obstetrics and Gynecology. The trend has had a major impact on patient quality of life. “Women who come to us are often apprehensive,” Dr. Rader said. “Following surgery, many are surprised and pleased, because they feel better than anticipated.”
Some of the biggest changes have come for women with endometrial cancer, which arises in the lining of the uterus. “We now treat almost all endometrial cancers robotically,” Dr. Rader said. “The da Vinci Surgical System®
is a wonderful tool for invasive cancers where we need to do a hysterectomy with removal of lymph nodes.” Janet Rader, MD, FACOG
Most pre-cancers and early gynecologic cancers can be treated with minimally invasive techniques. Ovarian cancers, which frequently present with large, widespread tumors, usually require open surgery. However, women who are at very high risk of developing ovarian cancer may choose to have their ovaries removed as a preventive measure. “We can treat these women laparoscopically,” Dr. Rader said, “and the surgery can be done as an outpatient procedure.”
“We can provide some treatments using standard laparoscopy, while others may need other forms of treatment such as chemotherapy and radiation. Gynecologic oncologists at Froedtert & The Medical College of Wisconsin focus on providing patients with the best treatment for their specific disease,” Dr. Rader said.
What’s Next: Defining the Best Options
In the coming years, gynecologic oncologists will continue to explore minimally invasive therapies. According to Dr. Rader, randomized clinical trials will give physicians a better understanding of which patients will benefit most from traditional surgeries, laparoscopic interventions and robotic surgical procedures.
Laser Surgery Reduces Impact of Throat, Mouth Cancers
“Cancers of the throat and mouth involve the structures important for speaking, breathing and swallowing,” said Becky Massey, MD, Medical College of Wisconsin head and neck oncologist. “Anything we can do to decrease the impact of treatment on those structures is really important to our patients’ quality of life.”
New endoscopic laser technology allows many patients with laryngeal cancer to receive treatment without a major open procedure. Using rigid and flexible instruments inserted through the mouth, surgeons remove many early stage tumors, while sparing healthy tissues.
The difference can be dramatic. “Complicated reconstructions used to be the norm, using tissue from legs or arms to rebuild the tongue or throat around the voice box,” Dr. Massey said. “With endoscopic laser surgery, many patients heal on their own without reconstruction.”
Becky Massey, MD
Patients with tongue or tonsil cancers can also benefit. “Just five or 10 years ago, we often had to divide the jaw bone to access the back of the tongue. Now, laser microsurgery allows us to treat these cancers through the mouth.”
One of the biggest benefits of laser surgery is that it can be repeated. “In the past, if laryngeal cancer came back after radiation or chemotherapy, the next step was almost always removal of the whole voice box,” Dr. Massey said. “Laser surgery allows us to keep removing small cancers that recur without a laryngectomy.”
What’s Next: More Patients Eligible
“As endoscopic technology improves, we will be able to remove larger tumors with less and less impact on patients,” Dr. Massey said. “Robotic techniques will allow us to operate in smaller spaces of the head and neck where we now have less access.”
Special Report 2012 866-680-0505 11
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