Gynecologic Oncology is one of five divisions in the Department of Obstetrics and Gynecology at the University of Florida College of Medicine, Gainesville, Florida. Dr’s Richard Boothy and Shazir Beshir specializes in the treatment of patients with invasive gynecologic cancers including cancers of the uterus, cervix, vagina, ovary, fallopian tube, vulva, and gestational trophoblastic disease. I utilize surgery, radiation therapy and chemotherapy for the treatment of gynecologic cancers. Patients are seen on Monday, Wednesday, and Friday at the UF Health Women’s Center Medical Plaza.
As experts in gynecologic cancers, the fellowship-trained University of Florida physicians at the Gynecologic Cancer Program have a long history of treating the most challenging patients. They provide specialized treatment, delivered in one of the most advanced cancer facilities in the nation: Shands at the University of Florida, rated as one of the “Best Hospitals in America” for cancer care by U.S.News & World Report.
The Gynecologic Cancer Program provides a truly multidisciplinary approach to cancer care, the kind of approach available only at an academic medical center. The Program is headed by Jacqueline Castagno, MD, of the University of Florida Department of Obstetrics and Gynecology. She is fellowship-trained and board-certified in gynecologic oncology by the American Board of Obstetricians and Gynecologists. She collaborates with other UF specialists, including:
- Radiation oncologists
- Medical oncologists
- A board-certified fertility preservationist
- Dedicated pathologists with specialization in endometrial, ovarian and cervical cancers
- Certified genetic counselors
- Interventional radiologists who interpret images and perform procedures
This team comprises the Gynecologic Oncology Tumor Board, which meets weekly to discuss individual cases and develop comprehensive, multidisciplinary treatment plans tailored to the unique medical needs of each patient. In addition, the clinicians and scientists of the UF College of Medicine and the UF Health Science Center are involved in original research to continuously enhance clinical strategies for the diagnosis, treatment, and prevention of cancer.
The physicians and staff of the UF Gynecologic Cancer Program provide patients with comprehensive care to improve their quality of life both during and after treatment.
We offer extensive support services, including:
- Tumor board team of specialists
- Psychological counseling
- Outpatient rehabilitation, including physical therapists who are experts in pelvic rehabilitation
- Multidisciplinary Cancer Survivor Program provides resources to assist cancer survivors in adjusting to life after cancer
- Tissue bank for genetic analysis
- UF Cancer Genetics Program with certified genetic counselors and nurse specialists who provide cancer risk assessments to individuals and families with a history of cancer
Treating Gynecologic Cancers with Advanced Academic Health Center Resources
Medical advances leading to more effective treatments have greatly enhanced the five-year survival rate of women with ovarian cancer when diagnosed in the early stages.
Because women with a family history of ovarian and/or breast cancer are at increased risk of developing ovarian cancer, genetic testing may be provided through the UF Cancer Genetics Program, which includes certified genetic counselors and nurse specialists. This team can then develop plans for long-term monitoring and care.
Surgery is the first line of treatment for ovarian cancer. Depending on the type and stage of cancer, as well as the patient’s desire to have children, this surgery may include the removal of the ovaries, uterus, fallopian tubes, nearby lymph nodes, and omentum.
- Focus on sparing the uterus and healthy ovary in women with stage I cancer
- Egg removal and freezing prior to surgery are available
- Tumor debulking is performed to remove as much of the cancer as possible
- After surgery, a combination of chemotherapy is used to destroy the remaining cells
- Intravenous chemotherapy
- Intraperitoneal chemotherapy application in the cavity where the tumor resides, greatly improves outcomes
The UF Gynecologic Cancer Program treats the most complex cases of cervical cancer, including squamous cell, invasive adenocarcinoma and recurrent cancer of the uterine cervix.
Treatment options for cervical cancers depend on the stage of the disease, the patient’s age, and the desire to have children. They include:
- Cryosurgery to destroy abnormal tissue such as carcinoma in situ
- Total hysterectomy
- Hysterectomy with salpingo-oophorectomy (unilateral or bilateral)
- Radical hysterectomy
- Pelvic exenteration
- Loop electrosurgical excision procedure, known as LEEP
- MRI-guided brachytherapy to target tumor site more precisely and reduce radiation dose to nearby tissue
- Image-guided radiation therapy following surgery to decrease radiation dose to small bowel
- Cisplatin-based chemotherapy is used in combination with radiation to significantly increase survival
Uterine cancers are the most common cancer of the female reproductive tract. Most uterine cancers are discovered early because of the warning signs, and the survival rate for all stages of uterine cancer is approximately 84 percent and 90 to 95 percent if discovered at its earliest
Surgery is the primary treatment for uterine cancer. Depending on the stage of the disease and the patient’s overall health, this may be performed through traditional surgery or laparoscopically. Procedures include:
- Total hysterectomy with bilateral salpingo-oophorectomy
- Radical hysterectomy
- Robot-assisted surgery for hysterectomy
- Lymphadenectomy to determine the presence of cancer cells in the pelvic lymph nodes
- Tumor debulking
Radiation therapy is often used after surgery or as the primary treatment modality when surgery is not an option. The UF Gynecologic Cancer Program uses two types of radiation therapy as part of treatment:
- External beam radiation, using image-guided Intensity Modulated Radiation Therapy (IMRT)
- MRI-guided brachytherapy with seeds planted internally into the uterus to deliver radiation to a very targeted area
Radiation therapy is performed both as part of inpatient care and on an outpatient basis. If the cancer cells are shown to have receptors for hormones, hormone therapy may be used to slow their growth. This includes the use of progestins to block the growth of endometrial cells and estrogen-blocking or binding drugs in combination with progesterone.