A Comprehensive Approach to Gynecologic Cancer Care

Access to clinical trials. A prestigious designation in minimally invasive surgery. A dedicated gynecologic tumor board. A revamped system that is changing the way patients recover from surgery.

Hoag offers an unrivaled level of expertise and sophistication for the prevention, diagnosis and treatment of gynecologic cancer. All five of Hoag’s gynecologic oncologists are leading experts in cancer treatment, and each is quick to point out that the rest of the medical team – the nurses, anesthesiologists, genetic counselors, social workers and nurse navigators – are the best in their fields.

“Being at a high-volume center is critical to the successful treatment of your cancer. And that’s what we offer here at Hoag,” said Alberto Mendivil, M.D., a gynecologic oncologist. “At the same time, ‘high volume’ does not mean ‘factory.’ While patients receive expert care, they also receive the benefits of personalized care that comes with being part of a community hospital.”

That nurturing community hospital approach is evident in some of the outreach programs by Hoag’s gynecologic oncology team. For example, Hoag is reaching out to pediatricians and parents to discuss a vaccine to prevent human papilloma virus (HPV), which is the cause of nearly all cervical cancer cases.

“We talk about ‘curing cancer’ but really prevention is so much more valuable,” said gynecologic oncologist Tiffany Beck, M.D. “The HPV vaccine is most effective before people become sexually active. We go out to the community to educate parents and pediatricians about the HPV vaccine and what it means to the future of these kids’ health.”

Hoag is also at the forefront of curtailing ovarian cancer, which kills about 14,000 women a year. By offering clinical trials to test possible therapies and a unique program to help women who are at high risk of developing the disease, Hoag is dedicated to finding better ways to treat cancer – and more effective ways to prevent cancer from developing.

“Because the medical community doesn’t have an effective screening test for ovarian cancer, by the time a cancer is diagnosed, it is usually at an advanced stage. To be able to identify this risk and prevent it from happening is a real gift,” said Lisa Abaid, M.D., co-director of gynecologic oncology for Hoag’s Breast & Ovarian Cancer Prevention Program.

In other areas of gynecologic cancer care, with the support of philanthropy, Hoag is bringing world-class medicine to a local setting. For instance, Hoag is involved in several clinical trials to provide the best and most advanced care for patients. And Hoag is a designated Center of Excellence in Minimally Invasive Gynecology (COEMIG™).

“Very few hospitals have received this designation, so for a community hospital this is particularly unique,” said John (Jeb) V. Brown, M.D., medical director of Hoag’s Gynecologic Robotics Program. “We have made minimally invasive robotic-assisted surgery a priority because it improves outcomes, reduces surgical risk and speeds up recovery time for our patients. They know that when they come here, they are being treated by teams who are dedicated to ensuring the best possible outcomes.”

Minimally invasive and robotic surgery techniques are particularly important for pregnant patients who are diagnosed with cancer, Dr. Mendivil said. Gynecologic cancers affect an estimated four to eight of every 100,000 pregnancies. Minimally invasive procedures have made it possible to treat these women without harming their unborn babies.

While robotic surgery has reduced recovery time, more could be done to help women back on their feet after surgery. Physicians in Europe have discovered that what patients do pre-operatively can determine how well they recover post-operatively. Hoag has brought Europe’s evidenced-based model to Orange County with the Enhanced Recovery After Surgery (ERAS) program.

Gone are the requirements that patients fast for extended hours before surgery. Patients are advised to quit smoking, improve their diet and increase their exercise before surgery. And instead of fasting for 12 hours, patients are asked to drink high-carb beverages up until three hours before surgery. All of these adjustments help them develop the strength they need to “perform” better after surgery.

“This is a fundamental shift from the way we used to do things,” Dr. Mendivil said. “Fasting is antiquated, and we have been proving that we shouldn’t follow that anymore. It inhibits the body’s own immune system.”

Of course, Hoag also does more than treat gynecologic cancer. Hoag’s multidisciplinary team takes a thorough and comprehensive approach to the management of complex benign pelvic conditions, as well as the full spectrum of gynecologic malignancies.

“Many disorders can lead to the formation of a pelvic mass, so it’s important to diagnose the cause of the mass to determine an appropriate treatment plan,” said gynecologic oncologist Kristina Mori, M.D. “What we offer at Hoag is the expertise and team approach to help patients reach the best possible outcomes.”

From Hoag Hospital, Newport Beach, Ca: https://www.hoag.org/about-hoag/news-publications/hoag-for-life/spring/2018/a-comprehensive-approach-to-gynecologic-cancer/#~z3i2k11