Gynecologic Cancer is the fourth volume in the MD Anderson Cancer Care Series, featuring the current standard approach to gynecologic cancer care from the experts at MD Anderson Cancer Center.
Designed for the practicing oncologist, this clinical guidebook allows for quick, authoritative access to the latest and best multimodality therapies. Topics covered in this volume include primary prevention and early detection, preinvasive diseases of female lower genital tract, pathology and imaging of gynecologic malignancies, treatment of vaginal, cervical, endometrial, uterine cancers. Discussions also address fertility-sparing options for treatment of women with gynecologica cancers as well as sexuality in women with gyn malignancies. Each of the 20 chapters ends with an up-to-date list of suggested readings, as well as "key practice points" highlighting the most principles and practices of each chapter for at-a-glance reference. More than 80 illustrations complement the text. This thorough, practical volume is the essential clinical guide for the oncologists, surgeons, and all physicians involved in the care of patients with gynecologic cancer.
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Multidisciplinary Care of Patients with Gynecologic Cancers
David M. Gershenson, M.D., John J. Kavanagh, M.D., Patricia J. Eifel, M.D., and Elvio G. Silva, M.D.
Prevention and Early Detection of Endometrial and Ovarian Cancers
Karen H. Lu, M.D.
Preinvasive Disease of the Lower Genital Tract
Andrea Milbourne, M.D., and Michele Follen, M.D., Ph.D.
Selected Topics in Gynecologic Pathology
Anais Malpica, M.D., Michael T. Deavers, M.D., and Elvio G. Silva, M.D.
Imaging of Gynecologic Malignancies
Revathy Iyer, M.D.
Contemporary Treatment of Vaginal and Vulvar Cancers
Patricia J. Eifel, M.D., and Thomas W. Burke, M.D.
Treatment of Early Cervical Cancer
Charles F. Levenback, M.D.
Treatment of Locally Advanced Cervical Cancer
Anuja Jhingran, M.D., Patricia J. Eifel, M.D., and Pedro T. Ramirez, M.D.
Lois M. Ramondetta, M.D., Diane C. Bodurka, M.D., Michael T. Deavers, M.D., and Anuja Jhingran, M.D.
Treatment of Endometrial Cancer
Lois M. Ramondetta, M.D., Thomas W. Burke, M.D., Russell Broaddus, M.D., Ph.D., and Anuja Jhingran, M.D.
Surgery for Ovarian Cancer
Judith K. Wolf, M.D., and J. Taylor Wharton, M.D.
Chemotherapy for Epithelial Ovarian Cancer
Michele L. Donato, M.D., Xipeng Wang, M.D., John J. Kavanagh, M.D., and David M. Gershenson, M.D.
Treatment of Rare Ovarian Malignancies
Jubilee Brown, M.D., and David M. Gershenson, M.D.
Gestational Trophoblastic Disease
Hui T. See, M.D., Ralph S. Freedman, M.D., Ph.D., Andrzej P. Kudelka, M.D., and John J. Kavanagh, M.D.
Fertility-Sparing Options for Treatment of Women with Gynecologic Cancers
Pedro T. Ramirez, M.D.
Quality of Life and Sexual Functioning
Diane C. Bodurka, M.D., and Charlotte C. Sun, Dr.P.H.
Palliative Care for Gynecologic Malignancies
Florian Strasser, M.D., ABHPM, Michael W. Bevers, M.D., and Eduardo Bruera, M.D.
© 2006 Springer-Verlag New York, Inc. All rights reserved. ISBN 0-387-28794-9.
The treatment of gynecologic cancers has improved owing to strong multidisciplinary efforts over the years. These efforts have resulted in a sharp reduction in both the incidence and mortality of invasive cervical cancer and marked improvements in early detection of the disease. Now, emphasis is being placed on fertility preservation, and options are being explored in cervical cancer as well as in other cancers where this may be possible. The treatment of vulvar cancer, which can be quite debilitating in its advanced stages, has followed an approach similar to that of breast cancer, where radical surgery has given way to a multimodal approach that emphasizes quality of life as well as survival.
The introduction of paclitaxel was a major development in the primary treatment of ovarian cancer. This monograph also describes the appropriate use of other cytotoxic drugs for the treatment of recurrence or for palliation. As this book goes to press, there is more cogent evidence that intraperitoneal platinum-based therapy is likely to become a part of the standard treatment in this disease. In addition to therapy advances, there have been improvements in diagnostic tools and their application in ovarian cancer.
We would like to acknowledge Walter Pagel, director of the Scientific Publications department at MD Anderson Cancer Center, for his role in continuing to make the MD Anderson Cancer Care Series a success. We would also like to thank the volume editors,
Drs. David M. Gershenson, Patricia J. Eifel, John J. Kavanagh, and Elvio G. Silva, and the authors of this first monograph on gynecologic cancer for their significant efforts to assemble what we believe will be a most useful and important resource for any physician who diagnoses and treats gynecologic cancer.
Aman U. Buzdar, M.D.
Ralph S. Freedman, M.D., Ph.D.
This book represents the culmination of a process that has evolved over almost 6 decades since Felix Rutledge and Gilbert Fletcher first stepped onto the scene at MD Anderson Cancer Center. Their shared vision of a multidisciplinary approach to caring for gynecologic cancer patients has not only persisted to the present but has, indeed, flourished.
Gynecologic Cancer is the most recent—but not the only—work to detail the practice of gynecologic cancer care at MD Anderson. Proceedings of MD Anderson’s Clinical Conferences on Cancer focused on gynecologic cancer were published in 1962, 1969, and 1987. These books principally outlined the MD Anderson multidisciplinary approach to the clinical management of gynecologic malignancies. In addition, Dr. Fletcher’s Textbook of Radiotherapy, published in 1980, and a 1976 textbook authored by Dr. Rutledge, J. Taylor Wharton, and Richard Boronow—Gynecologic Oncology—further described treatment techniques and recommendations.
Over the past several years, the face of MD Anderson’s Gynecologic Oncology Multidisciplinary Program has changed markedly. The faculty is much larger in number and considerably more diverse. Although evidence-based medicine is the guiding principle in clinical decision making, a myriad of clinical scenarios exist for which there is no single therapeutic strategy. In such instances, differing viewpoints are healthy, and the wealth of experience gained from a large-volume practice is a tremendous asset. Also, the value of the peer-review process used in our Multidisciplinary Planning Conference and Clinic cannot be overestimated.
Of course, the treatment recommendations and practice guidelines included in this text are anchored on past clinical trial research and are continually updated as results of new trials become available. Although the clinical trial portfolio of our multidisciplinary group is ever changing and little discussed here, research-driven patient care is of critical importance in advancing our mission.
Also, we would like to acknowledge and thank Dawn Chalaire, ChaRhonda Chilton, Stephanie Deming, Kim M. Dupree, Manny Gonzales, Vickie J. Williams, and Chris Yeager of the Department of Scientific Publications for editing and compiling this volume.
On behalf of all the contributors to this book, it is a pleasure to present this new work that reflects MD Anderson practice early in this new millennium. And finally, we dedicate this book to all the women with gynecologic cancer who have undergone treatment at MD Anderson over the past 60-plus years.
David M. Gershenson, M.D.
Patricia J. Eifel, M.D.
John J. Kavanagh, M.D.
Elvio G. Silva, M.D.
© 2006 Springer-Verlag New York, Inc. All rights reserved. ISBN 0-387-28794-9.
There is perhaps no better model of the importance of multidisciplinary interactions in the care of cancer patients than that found in the management of gynecologic malignancies. From the critical importance of primary surgical cytoreduction of advanced ovarian cancer preceding the administration of cytotoxic chemotherapy to the now-standard use of cisplatin as a radiosensitizer delivered with external-beam radiation therapy in the treatment of locally advanced cervix cancer, oncologists involved in the care of gynecologic cancer patients must understand the optimal utilization of multiple treatment modalities.
For more than 5 decades, the gynecologic cancer program at MD Anderson Cancer Center has been an innovative leader in helping to establish the standards of care in this group of malignancies and in developing novel surgical, pharmacological, and radiotherapeutic
approaches to improve both the survival and quality of life of women diagnosed with a gynecologic cancer.
This well-written and comprehensive text describes the current management of female pelvic tumors, with chapters authored by nationally and internationally recognized senior leaders in their fields, as well as by more junior MD Anderson faculty who will soon be responsible for the new advances that will, without question, characterize the future of clinical research in gynecologic malignancies.
Maurie Markman, M.D.
© 2006 Springer-Verlag, New York, Inc. All rights reserved. ISBN 0-387-28794-9.