Chethan Ramamurthy, MDHematology/Oncology
Josephine Taverna, MDHematology/Oncology
Robyn Scherber, MDHematology/Oncology
University Health is the leader in an ever-changing healthcare environment. As our doctors and researchers make breakthroughs in cancer treatment, we can offer you and your family the life-saving benefits of these discoveries.
Accredited OB/GYN Cancer Fellowship
University Health is home to a new fellowship for doctors training to become gynecological oncologists. Launched in July of 2020, this fellowship trains doctors after they’ve completed their residency in OB/GYN. This unique program is ACGME-certified.
Gynecological Cancer We Treat
Because gynecology includes the whole female reproductive system, this type of cancer can affect any of these organs or regions.
We treat all of the following gynecological cancers:
Recognizing Gynecologic Problems
Being in tune with your body and noticing when something doesn’t seem right will help you get treatment before the problem becomes worse. Understand these warning signs and call your doctor to see if you need further testing.
- Abnormal vaginal bleeding
- Bleeding after menopause
- Bleeding between periods
- Frequent and urgent need to urinate, or a burning sensation during urination
- Increased vaginal discharge
- Itching, burning, swelling, redness or soreness in the vaginal area
- Pain or pressure in your pelvis that differs from menstrual cramps
- Sores or lumps in the genital area
- Vaginal discharge with an unpleasant or unusual odor, or of an unusual color
A Cancer Team Focused on You
Our focus is on you. Cancer care at University Hospital is unique because our cancer doctors are personally available to you whenever you need them. You don’t have to go through a nurse or a front desk to speak with us – just call us on our cell.
Testing & Diagnosis
Testing and diagnosing gynecological cancer may vary depending on which organ is affected. But diagnosing any gynecologic problem requires a pelvic exam done by a gynecologist. During a pelvic exam, your doctor will check your vulva and the interior reproductive organs. This includes a Pap smear, bimanual exam and rectovaginal exam.
Getting regular Pap tests can help catch cervical precancer cells before they become cancer. Pap tests can find abnormal cells that may become cancerous in a few years. If your doctor suspects precancerous cells, they may issue a biopsy for further testing to confirm a diagnosis.
Your doctor may also perform a colposcopy, which uses a magnifying tool with a light to better examine your reproductive tissue.
Cervical cancer treatment
Treating cervical cancer can help prevent it from spreading. Depending on the nature of the cancer and your own preferences, your oncologist may recommend:
- Chemotherapy uses powerful medicine to kill the cancer cells in the cervix and outside of the cervix, if the cancer spread.
- Radiation uses high-energy X-rays aimed at the tumor to kill it
- Surgery if the cancer has not spread outside of the cervix. This gives your doctor a better chance of completely removing the cancer from your body. University Health uses robotic and minimally invasive surgical techniques.
The endometrium is the lining of the uterus. To diagnose endometrial cancer, your doctor may request any of the following:
- Biopsy of the endometrial tissue, in which a piece of the endometrial tissue is removed to be further analyzed in a lab.
- Dilation and curettage (D&C), a procedure in which your doctor dilates your cervix and scrapes off some tissue with a spoon-shaped tool. The tissue is sent to the lab for testing. This procedure requires local or general anesthesia and may cause cramping and bleeding for a few days after.
- Transvaginal ultrasound, in which your doctor will insert a thin transducer covered with plastic or latex and gel into your vagina. This tool creates images through your vaginal walls to find abnormal cells or growths.
Endometrial cancer treatment
Depending on the location and stage of the cancer, your overall health, and your preferences, your doctor can recommend a suitable treatment plan.
Your oncologist may recommend:
- Biologic therapy, also called immunotherapy, uses medicine to help your immune system fight the cancer cells
- Chemotherapy uses powerful medicine to kill the cancer cells and may be used after surgery
- Hormone therapy stops your body’s natural hormones from feeding the cancer cells. This might be a good option if you can’t or don’t want to have surgery.
- Radiation therapy uses X-rays to target and kill cancer cells
- Surgery is the most common treatment for endometrial cancer. Your doctor removes the uterus and cervix (hysterectomy).
In addition to a routine pelvic exam, your doctor may ask for more testing to diagnose ovarian cancer. These tests may include:
- An ultrasound, either transvaginal or abdominal. The sonogram will show cysts, tumors or fluid in the abdomen around the ovaries.
- CT scan, which shows detailed 3-D images of your pelvis and abdomen
- CA-125 blood test, which determines how much of a protein called CA-125 is in your blood. A high (elevated) CA-125 may be a sign of tumor cells.
- Biopsy, though this is very rarely used to check for ovarian cancer before surgery. If there is cancer in the ovary, a biopsy may break the cover of the ovary and allow the cancer cells to spread. Instead, your doctor may do a biopsy of tissues around the ovary to see if cancer has spread.
- Genetic testing, which tests blood, saliva or pieces of the tumor. The results will help your doctors make the most effective treatment decisions.
Ovarian cancer treatment
Depending on the stage of ovarian cancer, your doctor may recommend:
- Chemotherapy uses powerful medicine to kill the cancer cells and may be used after surgery
- HIPEC (hyperthermic intraperitoneal chemotherapy) targets chemotherapy within the peritoneal cavity
- Surgery is generally required for advanced ovarian cancer. We use robotic and minimally invasive surgical techniques.
Uterine sarcoma is a rare form of gynecological cancer that starts in the muscle lining of the uterus. This is not to be confused with endometrial cancer, which starts in the lining of the uterus.
Some symptoms of uterine sarcoma are:
- A mass in the vagina you can feel
- Frequent urination
- Pain in the abdomen
- Unusual bleeding, such as bleeding after sex or between periods (most common)
Uterine sarcoma treatment
Your entire healthcare team will work together to find the best treatment plan for you. This may include your gynecologic oncologist, radiation oncologist, nurses, dieticians, social workers and more.
Depending on the stage of the cancer and your overall health, your team may recommend:
- Hormone therapy
Vaginal cancer most often affects women over the age of 60 and is one of the rarest forms of gynecological cancer. Women across South Texas trust us with their vaginal cancer treatment, so our team has a deep understanding of the care it requires.
In addition to a pelvic exam and Pap test, testing for vaginal cancer may include:
- Your doctor may need to send samples of your vaginal tissue to a lab to get a more detailed analysis of the cells. Once the lab returns your results, your doctor will discuss your treatment options.
Vaginal cancer treatment
If you are diagnosed with vaginal cancer, you have several treatment options available. Your doctor will consider your age, overall health and desire to get pregnant in the future when planning your care.
Treatment options may include:
- Chemotherapy given alone or with radiation therapy can help shrink the cancer and help prevent it from spreading.
- Radiation therapy targets high-energy X-rays at the tumor to shrink it. Your doctor may implant a radioactive device in your vagina to continuously administer radiation for a certain amount of time.
- Surgery might be used if the cancer in your vagina spread to the lymph nodes in the groin and pelvis. University Health uses robotic and minimally invasive surgical techniques.
Your gynecologist will be able to detect signs of vulvar cancer during routine pelvic exams. The vulva is the outer part of the female reproductive system, so vulvar cancer is considered a type of skin cancer.
Early signs of vulvar cancer will most likely be undetectable to you, but your gynecologist will be able to see them. Your doctor may require the following tests to confirm a diagnosis:
- Pap test
- If your gynecologist detects cancer cells, they might issue more testing before confirming a diagnosis.
- Vulvar cancer treatment
Your doctor will take into account your preferences, age, health, and the stage of your cancer while planning your treatment. They might recommend:
At University Health, we use robotic and minimally invasive surgeries to treat some gynecologic cancers. Our goal is to give you the best care possible while leaving as much tissue intact as possible.
Support for Women with Gynecological Cancer
If you are diagnosed with a form of gynecologic cancer, you don’t have to face it alone. The Purple Heals Support Group meets once a month and is led by OBGYNs and UT Health oncologists.
These meetings welcome anyone in the San Antonio area diagnosed with gynecologic cancer, including:
- Cervical cancer
- Ovarian cancer
- Uterine cancer
- Vulvar cancer
You do not need to be getting treatment at University Hospital to join this group. Group meetings are held every third Wednesday of each month from 6-8 p.m. Parking is free and refreshments are provided. These meetings might be virtual or cancelled due to COVID-19. For more information, please call 210-450-9500.
Medical Arts & Research Center
Conference Room B (next to H-E-B Pharmacy)
8300 Floyd Curl Drive
San Antonio, TX 78229
Our connection with UT Health San Antonio gives you access to treatment and clinical trials not available anywhere else. To treat your condition, our cancer surgeons collaborate with gynecological surgeons to perform delicate procedures.
- OVAL clinical trial for ovarian cancer
- The gynecological cancer team at University Health is currently enrolling participants in this study
- Moonstone study for ovarian cancer
- The gynecological cancer team at University Health is participating in this study
- Not enrolling new participants