Penn Gynecologic Oncology offers the latest advances in chemotherapy for treating ovarian cancer. Our gynecologic oncologists are board certified in obstetrics and gynecology, and have completed additional training required for oncology. This training includes all currently available forms of treatment, including surgery and chemotherapy and clinical research therapies.
Bone Marrow and Stem Cell Transplant
Bone marrow and stem cell transplantation may be autologous or allogeneic. A bone marrow and stem cell transplant is a method of replacing immature blood-forming cells that are destroyed by treatment with high doses of chemotherapy or radiation. The stem cells, which are taken either from the bone marrow itself or from the bloodstream, are given back to the person after their cancer treatment to help the bone marrow recover and resume producing healthy blood cells.
Chemotherapy may be given before or after surgery, or on its own as a treatment for ovarian cancer.
A type of regional chemotherapy used to treat ovarian cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, the anticancer drugs are carried directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.
Treatment with more than one anticancer drug is called combination chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
In addition to managing your medical oncology treatment, our gynecologic oncologists at the Jordan Center for Gynecologic Cancer work closely with dedicated chemotherapy nurse practitioners. Nurse practitioners offer specialized care for those undergoing chemotherapy, making sure they receive seamless, coordinated care from the first chemotherapy session through follow-up care.
Immunotherapy is designed to repair, stimulate, or enhance the immune system's responses. The body's immune system helps to prevent disease, but it can also play a role in preventing cancer from developing or spreading. The goal of immunotherapy is to enhance the body's natural defenses and its ability to fight cancer.
Immunotherapy often has fewer side effects than conventional cancer treatments because it uses the body's own immune system to:
- Target specific cancer cells, thereby potentially avoiding damage to normal cells
- Make cancer cells easier to recognize and destroy
- Prevent or slow tumor growth and spread of cancer cells
Vaccine therapy treats cancers that have already occurred. They are intended to delay or stop cancer cell growth, shrink tumors, prevent cancer from coming back or eliminate cancer cells that have not been killed by other forms of treatment. Cancer treatment vaccines are sometimes made with cells from the patient's own tumor, are modified in the lab and then given back to the patient to stop, destroy or delay the cancer.
Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead. Through clinical trials:
- Diagnosing cancer has become more precise.
- Radiation and surgical techniques have advanced.
- Medications are more successful.
- Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.
- Strategies to address the late effects of cancer and its treatment are improving quality of life.
Radiation therapy uses high-energy X rays to kill uterine cancer cells. Penn Radiation Oncology uses the latest equipment and technology available to treat ovarian cancer. Our radiation oncologists are recognized leaders in techniques that target radiation precisely to the treatment area while sparing normal tissue.
At Penn, women with gynecologic cancer have access to new and advanced treatment options and ongoing clinical trials in radiation therapy. As part of our commitment to advancing cancer care in patients, radiation oncologists are also interested in understanding how radiation treatment affects the quality of life for cancer patients.
Radiation oncologists at Penn Medicine use both internal and external forms of radiation therapy to treat cancer. Brachytherapy is an internal therapy in which the radiation source is placed inside the body.
Brachytherapy involves placing radioactive implants, such as metal pellets, seeds, ribbons, wires, needles, capsules, or tubes in small sealed holders inside the body. The implants may be left in the body for only a short time, or may be left in place permanently. This allows the doctor to give a high dose of radiation to a smaller area than is possible with external radiation treatment.
Conformal Radiation Therapy
Conformal radiation therapy gives doctors more control when treating tumors. In conformal radiation, a special computer uses CT imaging scans to create 3-D maps of the location of the cancer in the body. The system permits the delivery of radiation from several directions, and the beams can then be shaped, or conformed, to match the shape of the cancer. Conformal radiation therapy limits radiation exposure to nearby healthy tissue as well as the tissue in the beam's path.
Image-Guided Radiation Therapy (IGRT)
Image-guided radiation therapy (IGRT) uses frequent imaging during a course of radiation therapy to improve the precision and accuracy of the delivery the radiation treatment.
In IGRT, the linear accelerators (machines that delivers radiation) are equipped with imaging technology that take pictures of the tumor immediately before or during the time radiation is delivered. Specialized computer software compares these images of the tumor to the images taken during the simulation to establish the treatment plan. Necessary adjustments can then be made to the patient's position and/or the radiation beams to more precisely target radiation at the cancer and avoid exposure to the healthy surrounding tissue.
Intensity-Modulated Radiation Therapy (IMRT)
At Penn, our radiation oncologists use intensity-modulated radiation therapy (IMRT) to treat uterine cancer. This advanced mode of high-precision radiotherapy utilizes computer-controlled linear accelerators to deliver precise radiation doses to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. In many cases, radiation therapy is capable of killing all of the cancer cells.
Using 3-D computed tomography (CT) images in conjunction with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by controlling, or modulating the intensity of the radiation beam in multiple small volumes. The therapy allows higher radiation doses to be focused on regions within the tumor while minimizing the dose to surrounding normal critical structures.
Positron Emission Tomography (PET)
PET scans create computerized images of chemical changes, such as metabolism, that take place in tissue. This helps in locating a tumor, because cancer cells have a higher metabolism than other tissues in the body.
Through the combined matching of a CT scan with PET images, there is an improved capacity to discriminate normal from abnormal tissues. Radiation oncologists also use the PET images to check the effectiveness of radiation treatments on the cancer cells.
Surgery is an essential part of treatment for many women with ovarian cancer. Caught in its earliest stages, surgery may be the only treatment necessary for ovarian cancer.
Depending upon the stage of cancer, surgical options for ovarian cancer may involve:
At Penn, our minimally invasive techniques, such as robotic-assisted surgery, have become the standard of care for treating gynecologic cancers. For some types of cancer, surgeons remove the body of the uterus and the cervix in a procedure known as a hysterectomy.
A hysterectomy may be performed as an open procedure, known as an abdominal hysterectomy, with the uterus removed through an incision in the abdomen. If lymph node sampling is needed, this can be done through the same incision as the abdominal hysterectomy.
When the uterus is removed through the vagina, it is called a vaginal hysterectomy. Often done as a minimally invasive procedure using a laparoscope, the vagina and any lymph nodes can be removed using a laparoscope.
A variety of surgical options are used to perform a hysterectomy. Penn surgeons consider the patient's medical history, stage of cancer and current health condition to determine the type of surgery needed.
- Abdominal hysterectomy
- Vaginal hysterectomy
- Laparoscopic hysterectomy
- Laparoscopically assisted vaginal hysterectomy
- Robotic-assisted hysterectomy
In a partial, or supracervical, hysterectomy just the upper part of the uterus is removed. The adjacent tissues are left intact and the cervix is left in place.
In a simple hysterectomy, the loose connective tissue around the uterus (parametrium), the tissue connecting the uterus and sacrum (uterosacral ligaments) and the vagina remain intact.
In a radical hysterectomy, the entire uterus as well as the tissues next to the uterus (parametrium and uterosacral ligaments) and the upper part (about an inch) of the vagina (near the cervix) are removed.
Usually performed abdominally, radical hysterectomy can also be performed through the vagina. Most patients undergoing a radical hysterectomy also have a lymph node dissection, in which lymph nodes are removed either through the abdominal incision or by laparoscopic lymph node sampling.
A unilateral salpingo-oophorectomy is a surgery to remove one ovary and one fallopian tube.
Bilateral salpingo-oophorectomy is surgery to remove both ovaries and both fallopian tubes.
An omentectomy is a surgery to remove the omentum (a piece of the tissue lining the abdominal wall).
Pelvic exenteration is a radical surgery that removes all organs from the pelvic region. It is not a common surgery, but may be used to treat cancer that has spread to surrounding reproductive and pelvic organs.
Lymph Node Biopsy
A lymph node biopsy is the removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.
Integrative Medicine and Wellness Programs
At Penn, our integrative medicine and wellness services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative medicine and wellness programs offer you ways to enhance the quality of your life, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.
Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. Our cancer team works with you and your family to integrate these supportive programs into the overall care plan, while ensuring your health and safety.
The Abramson Cancer Center's range of integrative supportive services is designed to help you cope with the cancer experience and improve your overall sense of well-being.
Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.
The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.
Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients. Palliative care can be used to complement traditional cancer therapies, or can be used when curative therapies are no longer an option to treat symptoms and improve quality of life.
Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care. Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families.
Penn Home Care and Hospice Services
Penn Home Care and Hospice Services offer a full range of home health care needs by partnering three top-level home health care services under one roof:
Penn Home Care and Hospice Services offer an array of specialized therapies and medications for patients with cancer and cancer-related conditions.