The physicians and researchers of the Gynecologic Oncology Program work as a team to provide comprehensive care to our patients who have the most complicated cancers – beginning with a weekly review of new cases.
We provide comprehensive, multidisciplinary evaluation, treatment and follow-up of patients with suspected or proven pre-invasive or invasive gynecologic malignancies including ovarian, endometrial, cervical, vulva, vaginal and trophoblastic cancers.
Our robust program:
- serves thousands of patients annually – more than 1,000 major surgeries each year;
- features an active clinical group that is tied closely to the laboratory work and findings of our Gynecologic Oncology Laboratory – a National Cancer Institute site for gynecologic cancer biomarker research.
Each week, a multidisciplinary tumor board reviews new cases of gynecologic malignancies and advises appropriate evaluation and management.
Specialty clinical services provide comprehensive, focused care for patients:
- with abnormal cervical or vaginal cytology;
- who have a family history of ovarian cancer or molar pregnancy and gestational trophoblastic diseases. A unique facet of our program, setting us apart from most, is the inclusion of dedicated gynecologic pathologists and the specialized services of medical and radiation oncologists – further enhancing our multidisciplinary model.
Specialists in gynecologic pathology perform tissue diagnosis from gynecologic surgeries that provide critical guidance for cancer management. Medical oncologists and radiation oncologists, who specialize in gynecologic cancer, provide the latest therapies for treatment using the latest research findings and state-of-the-art technologies – such as radiation brachytherapy for gynecologic cancer.
Communication within the team, with the patient and with their referring physician is the key to the care that we provide. Our physicians work closely with referring physicians to provide an informed and seamless continuum of care that meets each patient’s individual needs.
The Gynecologic Oncology Program is a service of the Gillette Center for Women’s Cancers at Dana-Farber/ Brigham and Women’s Cancer Center – a collaboration of one of the world’s leading cancer institutes with one of the world’s leading hospitals.
Our combined resources enable patients who are suspected or known to have a gynecologic cancer – and those who are at high-risk – to receive the latest diagnostic tests and treatments available as well as access to the most up-to-date research information that our faculty bring “bench to bedside.”
Excellence and Innovation In Clinical Services
Our specialized centers include:
Familial Ovarian Cancer Center
The Familial Ovarian Cancer Center is a referral center for women who have an increased risk of developing ovarian cancer or other gynecologic cancers, based on family history or other risk factors.
At the Center, patients receive a comprehensive evaluation of their risk as well as exams and blood tests, including testing for elevated levels of CA 125. CA 125 testing was developed by our group and is the first and only biomarker for ovarian cancer currently available.
Care is provided by a team that includes gynecologic oncologists, genetic counselors, and surgical oncologists along with the availability of radiologists and social workers. An individualized treatment plan is developed for each patient that aims at reducing their risk while providing regular, careful surveillance. Blood samples are also stored for the patient, allowing for future testing as new blood tests are developed. Patients with a proven genetic risk for ovarian cancer may be advised to undergo prophylactic surgery.
New England Trophoblastic Disease Center
The New England Trophoblastic Disease Center evaluates and manages patients with molar pregnancy and gestational trophoblastic disease. This Center is recognized internationally as a foremost resource for advancing the understanding and treatment of gestational trophoblastic diseases.
Through a National Cancer Institute grant, the Center was established for the diagnosis and treatment of trophoblastic disease. The Center’s registry is the largest of its kind in the Western hemisphere and is used in on-going clinical investigations following more than 3,000 patients diagnosed with this disease since 1965.
Using information collected from the registry, physicians and researchers with the New England Trophoblastic Disease Center have published more than 200 articles over the past four decades and have been instrumental in pinpointing ways of detecting and treating the disease in symptomatic patients and developing a worldwide resource network.
Through blood and urine tests developed to detect elevated human chorionic gonadotropin (HCG) levels, a sensitive marker of the disease, the physicians of the Center are able to determine the presence of the disease and the least toxic treatment regimen for the patient.
Pap Smear Evaluation Center
The Pap Smear Evaluation Center evaluates, manages, and treats patients with abnormal cervical or vaginal cytology. The Center uses the latest innovations to provide advanced evaluation through the use of colposcopy, HPV testing and state-of-the-art evaluation for more specific diagnosis of possible cervical pre-cancer or cancer.
While providing evaluation services for physicians within Dana-Farber/Brigham and Women’s Cancer Center, the Pap Smear Evaluation Center is also renowned as a major referral center for more complicated cases. The Center also is a resource for consultative second opinions, reevaluating test results and providing confirmation of a diagnosis.
Pioneering Research
Researchers of the Gynecologic Oncology Laboratory, established 25 years ago specifically for the research of ovarian cancer, are national and international leaders in advancing the understanding of the early detection and pathogenesis of ovarian cancer and other gynecologic cancers and are solely dedicated to this research.
In 2004, the Laboratory received a prestigious Specialized Program of Research Excellence (SPORE) grant from the National Cancer Institute to focus on research aimed at the early diagnosis and prevention of ovarian cancer.
Gynecologic Oncology Laboratory initiatives include:
Monitoring CA 125 Levels in Patients Diagnosed with Ovarian Cancer
In 1983, researchers at the Gynecologic Oncology Laboratory discovered that CA 125, a protein shed by the ovaries into the blood, became elevated when ovarian cancer was present. The researchers also found that CA 125 levels rise with uterine fibroids, endometriosis, inflammation and menstruation, therefore making it an unreliable marker for early ovarian cancer in the general population. CA 125 is the first and only screening biomarker for ovarian cancer that is currently available and, while the test has shown limited effectiveness in detecting early cancer, it is extremely valuable in monitoring the regression, progression or recurrence of a tumor in women already diagnosed with the disease.
Researching New Ovarian Cancer Biomarkers
Current research at the Laboratory also involves the development, evaluation, and validation of new markers that can augment the sensitivity and specificity of CA 125. The Early Detection Research Network of the National Institutes of Health has designated the Gynecologic Oncology Laboratory as the lead site for the development of new biomarkers for ovarian cancer. Using cDNA microarray and protein chip systems, the group has identified four potential markers – prostasin, osteopontin, Ep-CAM, and alpha one
haptoglobin – that appear elevated in women who have ovarian cancer compared to those who do not. Also, with their involvement in the multi-center Cancer Genetics Network, researchers at the Laboratory have the benefit of access to thousands of samples from women with a strong genetic or family risk of ovarian cancer that will contribute to their studies.
Using Proteomics to Unlock Key to Biomarkers
In searching for biomarkers in blood or urine, researchers at the Gynecologic Oncology Laboratory are using proteomics, a field devoted to cataloguing the tens of thousands of proteins in cells and discovering their functions. A mass spectrometer is the main tool of proteomics, sorting out proteins in a biologic sample – ranking them by size and amount. Through this cataloguing, researchers at the Laboratory hope to distinguish the distinctive patterns, or fingerprints, of proteins in ovarian and other gynecologic cancers leading to earlier diagnosis of these diseases. Protein sequencing has enabled researchers to identify some of the proteins that are responsible for certain patterns. Because it is difficult to find one protein that presents itself 100 percent of the time, the challenge for researchers is to discover multiple protein markers that, together, can indicate an ovariann or other cancer and can therefore be used as a screening tool.
Fellowship Training
The goal of the Gynecologic Oncology Fellowship Program is to train individuals to be highly
competent in the evaluation and management of all aspects of a gynecologic malignancy and to prepare fellows to perform laboratory and clinical investigation to advance the understanding of reproductive malignancies.
The three-year fellowship involves clinical time with the Gynecologic Oncology Program as well as laboratory investigation in the Gynecologic Oncology Laboratory, with a focus on the study of the pathogenesis of ovarian cancer using molecular biologic techniques.
The Gynecologic Oncology Program attracts a large number of patients with complex and challenging reproductive malignancies and exposes fellows to substantial and diverse clinical experience in the management of gynecologic tumors.
Dana-Farber/Brigham and Women’s Cancer Center is a program of Dana-Farber/Partners CancerCare, a collaboration in adult oncology among three world leaders in cancer diagnosis and treatment – Dana-Farber Cancer Institute, Brigham and Women’s Hospital and Massachusetts General Hospital. Through this adult oncology collaboration, some of the world’s leading specialists coordinate research, training and aspects of patient care to fight cancer.
Connecting You to Dana-Farber/Brigham and Women’s Cancer Center
If you would like more information about our physicians, or to make a referral to the Gynecologic Oncology Program at Dana-Farber/Brigham and Women’s Cancer Center, please call 1-877-DFCI-BWH. To make an appointment, you also may use our on-line request an appointment form.
Brigham and Women’s Hospital and Dana-Farber Cancer Institute continue to be world-class leaders in the areas of gynecology and cancer. U.S.News & World Report® repeatedly names Brigham and Women’s Hospital among the top five in Gynecology and Dana-Farber Cancer Institute among the top five in cancer.
- Ross S. Berkowitz, MD, Director, Gynecologic Oncology Program
- Christina A. Bandera, MD, Associate Gynecologist
- Daniel W. Cramer, MD, ScD, Director, OB/GYN Epidemiology Center
- Sarah Feldman, MD, MPH, Director, Pap Smear Evaluation Center
- Colleen M. Feltmate, MD, Associate Gynecologist
- Elizabeth I. O. Garner, MD, MPH, Associate Gynecologist
- Donald P. Goldstein, MD, Founder, New England Trophoblastic Disease Center
- Samuel C. Mok, MD, PhD, Director, Gynecologic Oncology Laboratory
- Michael G. Muto, MD, Associate Gynecologist
- Alex Ng, PhD, Associate Director, Gynecologic Oncology Laboratory
- Ursula A. Matulonis, MD, Director, Medical Gynecologic Oncology
- Susana M. Campos, MD, MPH, Medical Oncologist
- Akila Viswanathan, MD, Radiation Oncologist
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