The focus of the team of clinicians who form the Gynecologic Oncology Program at Smilow Cancer Hospital is to provide comprehensive and compassionate care for women with gynecologic cancers. Women diagnosed with vulvar, vaginal, cervical, uterine, fallopian tube, or ovarian cancers are provided with exceptional care from Yale’s experienced team of gynecologic oncologists at the hospital’s dedicated Women’s Center. In addition, the team also treats soft tissue tumors of the pelvis, gestational trophoblastic disease, as well as women with precancerous changes that have been identified in the vulva, vagina, and cervix, including dysplasia and carcinoma in situ, or premalignant changes of the endometrium, including adenomatous hyperplasia. The physicians of the Gynecologic Oncology Program offer a wide spectrum of advanced strategies for the diagnosis and treatment of gynecologic cancers, including colposcopy evaluation, conformal radiotherapy, and novel, targeted chemotherapies. The multidisciplinary program has experts from the obstetrics, gynecology, and reproductive sciences; radiation oncology; radiology and biomedical imaging; genetics; pathology; pharmacy; and social work. A dedicated patient coordinator facilitates patient appointments and communication, coordinates services, and supports each patient and their family. Surgery for previously untreated gynecologic cancer Surgical treatment of cancer is the most common option for previously untreated cancers. These operations include radical hysterectomies for cervical cancer, cytoreductive surgery for ovarian cancer, radical vulvectomies for vulvar cancer and total abdominal hysterectomies, bilateral salpingo-oophorectomies, and lymphadenectomies for the staging and treatment of endometrial cancers. Conventional laparoscopic and robotic surgery is available to women in need of surgery for uterine cancer, as well as for removal of the uterus, tubes, and ovaries. Prophylactic surgery, including hysterectomy, bilateral salpingo-oophorectomy, or bilateral salpingectomy with ovarian conservation, is also available to women looking to prevent ovarian cancer occurrence. Preservation of fertility in women with gynecologic cancers whenever possible is always a priority. We perform radical trachelectomies in women with early-stage cervical cancer who desire fertility preservation. For women with early-stage, low-grade endometrial cancers, hormonal therapy is prescribed. Chemotherapy Management The Gynecologic Oncology Program provides a full spectrum of chemotherapeutic agents used in the management of ovarian cancer, fallopian tube cancer, uterine cancer, mesenchymal tumors of the uterus, cervical cancer, vaginal cancer, and vulvar cancer. These chemotherapeutic agents may be used either for primary treatment or treatment of recurrent disease. Neoadjuvant chemotherapy, i.e., chemotherapy prescribed before surgical treatment, is often used for women with advanced ovarian cancer to reduce the s

The Oligometastatic Cancer Program at Smilow Cancer Hospital consists of a multidisciplinary team of nationally recognized physicians and clinicians who are experts in providing care for patients with oligometastatic cancer. Oligometastatic cancer is a concept in oncology that describes a state of cancer progression in which the cancer has spread, but only to a few specific areas. Unlike widespread metastatic disease, where cancer has spread extensively to distant organs, oligometastasis involves a more localized and contained pattern of metastatic spread. Effectively, oligometastatic cancer represents a middle ground between localized cancer (cancer of one area) and widespread metastatic cancer. The clinical significance of identifying patients with oligometastatic cancer lies in its potential for more targeted and aggressive treatment approaches. Unlike widespread metastatic disease, where the primary goal may be palliative or to control symptoms, oligometastatic cancer offers patients an opportunity for interventions that can lead to a cure. This identification has been facilitated by advancements in imaging technologies, particularly the use of positron emission tomography (PET) scans. These sophisticated imaging techniques enable our clinicians to detect and visualize small numbers of metastatic sites that might be overlooked by conventional imaging methods. Here at Smilow Cancer Hospital, our multidisciplinary teams treat oligometastatic disease using the following treatment types: Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Hepatic Artery Infusion (HAI) The concept of oligometastatic cancer has gained increasing attention in the field of oncology, leading to clinical trials and extensive research aimed at refining its definition, understanding its behavior, and determining optimal treatment strategies. It is important to note that all cancer types are different and do not show an oligometastatic pattern, and the relevance of this concept varies across different tumor types. The management of oligometastatic cancer requires a personalized and multidisciplinary approach, considering factors such as the primary tumor type, the location of metastases, overall patient health, and treatment goals. Our team of clinicians collaborates directly with patients to identify the presence of oligometastatic disease, establish a tailored treatment plan, and enhance outcomes for patients in this unique stage of cancer progression. For gastrointestinal oncology-related appointments, view the profile of Kiran Turaga, MD, MPH . For gynecologic oncology-related appointments, visit the profile of Elena Ratner, MD, MBA .

Yale’s Department of Obstetrics, Gynecology and Reproductive Sciences is dedicated to helping women at all stages of life. A global leader in women’s health, Yale is known for its innovative contributions to diagnosis and treatment, including: Developing the first fetal echocardiography Pioneering the first obstetrical ultrasound Developing the first fetal blood sampling and first fetal transfusion Offering the first chorionic villus sampling in New England Co-authoring the first U.S. study for first-trimester risk assessment Developing the first comprehensive first-trimester risk assessment program in New England Inventing fetal monitoring and many prenatal diagnostic and treatment techniques Our physicians tap into the broad expertise of our entire institution to provide compassionate, customized care for all of our patients, from adolescence through adulthood. Through eight subspecialty areas, we offer the most advanced diagnostics and therapies that harness the latest advances in technology. Recent clinical research includes a new emphasis on therapeutic vaccines in gynecologic oncology, novel treatments for endometriosis and menopause, a comprehensive patient safety program in maternal-fetal medicine, and an advanced fetal therapy program. Specialized care is offered in the following areas: Family planning Gynecologic oncology Gynecologic specialties Maternal-fetal medicine Obstetric specialties & midwifery Pediatric & adolescent gynecology Reproductive endocrinology & infertility Urogynecology & reconstructive pelvic surgery Maternal-fetal medicine service offers 24-hour on-site dedicated space for complex pregnancies and fetal care First in Connecticut to perform in-utero laser therapy in pregnancies complicated by twin-to-twin transfusion syndrome Outstanding survival outcomes for all types of gynecologic surgery, from open to robotic Pioneer in caring for patients with sexual intimacy issues after cancer surgery Fetal therapy program Midwifery and birthing center