Diagnosing and treating cancers of the ovary, fallopian tube, uterus, cervix, vagina and vulva as well as gestational trophoblatic disease, the team meets Tuesday mornings to evaluate new patients referred for second opinions or care. Patients can see an Institute (or Institute-affiliated) physician any day of the week and have their cases presented at the Tuesday conference.

Qualifications of Members
  
The Institute assembled a team of gynecologic oncology experts that makes its program one of the best in the nation. Included are national leaders in the field who are recognized experts in the treatment of gynecologic cancers and serve as active members of national cooperative groups. Several team members are included among the nation’s “Best Doctors” and “Who’s Who in Medicine.” In addition, they are contributors to and editors of books on the surgical and medical management of gynecologic tumors. They design and conduct clinical trials and translational research as part of our National Cancer Institute-designated comprehensive cancer center.

Team Members
 
Robert Morris, M.D., (Team leader), Gynecologic Oncology
Zaid Al-Wahab, M.D., Gynecologic Oncology
Rouba Ali-Fehmi, M.D., Pathology
Hussein Aoun, M.D., Radiology
Gunter Deppe, M.D., Gynecologic Oncology
Kaleford Hong, M.D., Radiology
Harold Kim, M.D., Radiation Oncology
Steven Miller, M.D., Radiation Oncology
Leigh Ann Solomon, M.D., Gynecologic Oncology
Paul Tranchida, M.D., Pathology

Debbie Abraham, R.N. MDT Coordinator
Jennifer Barrick, M.S., Genetic Counseling
Sarah Dagenais, Nurse Practitioner
Nancie Petrucelli, M.S., Genetic Counseling

The team also includes representatives from the Institute's Clinical Trials Office and the Cancer Genetic Counseling Service.

Clinical Trials

Members of the Institute’s Gynecologic Oncology Multidisciplinary Team are leading or participating in several clinical trials through which eligible patients may benefit. Investigations include screening and early detection of ovarian cancer, combined modality treatments for locally advanced cancers of the cervix and vulva, clinical trials of combined chemotherapy and radiation therapy for advanced endometrial cancer, novel radiation therapy approaches such as intensive modulated radiation therapy (IMRT), novel chemotherapy combinations for ovarian cancer, novel biologic therapies and novel surgical management. In addition, the team has continuous interaction with the Phase I program referring appropriate patients desiring to enroll in trials of novel chemotherapeutic agent.

Cancer Genetics

When appropriate, patients may be referred for a cancer genetics evaluation.  It is estimated that between 5 and 10 percent of gynecologic cancer cases, specifically cancers of the ovary and endometrium (uterus) are hereditary, meaning the risk to develop the disease is being passed on in the family through their genes.  Patients who have hereditary gynecologic cancer may be at an increased risk for other cancers.  Furthermore, their relatives may be at an increased risk to develop these cancers as well.  Through careful examination of one’s family history, our cancer genetics specialists can determine the likelihood that the cancers in the family are hereditary, can advise patients about the appropriateness of cancer genetic testing and can give them information about their personal and family cancer risks, including their options for prevention, early detection, and treatment.

Patient Participation

Any patient with a gynecologic malignancy will benefit from a consultation with the Institute’s Gynecology Oncology Multidisciplinary Team. Patients who will benefit the most include those with:

• Newly diagnosed gynecologic cancers needing surgery, radiation and /or chemotherapy;
• Signs suspicious for a gynecologic malignancy such as a complex pelvic mass, malignant ascites and/or elevated Ca-125;
• Vulvar, vaginal or cervical lesions suspicious for malignancy on pelvic exam;
• Early cervical cancer interested in fertility-sparing surgery;
• Pelvic masses and endometrial cancer interested in minimally invasive surgery;
• Recurrent gynecologic cancers being considered for surgery, radiation or chemotherapy;
• An interest in clinical trial participation;
• Complicated preinvasive disease of the lower genital tract (a separate session on Thursday morning is dedicated to patients with suspicious abnormal PAP smears and dysplasias of the cervix, vagina and vulva); or
• Any gynecologic cancer who specifically requests being seen by the multidisciplinary team at the Institute to initiate treatment or for a second opinion.
• A personal and/or family history suggestive of hereditary gynecologic cancer, which includes any of the following:
  • Ovarian cancer at any age.
  • Endometrial (uterine) cancer before age 50.
  • The presence of related cancers (e.g., ovarian   cancer and breast cancer or endometrial (uterine) cancer and colon cancer).

On Appointment Day

On the day of appointment, each patient receives personal attention from the Institute’s Gynecologic Oncology Multidisciplinary Team staff person and the appropriate team member. A team physician evaluates the patient, reviews all records, requests any needed additional testing, and presents the case to the multidisciplinary team.

After the team conference, this physician shares the team’s recommendations with the patient and family members the same day. If other testing is required or if other specialists need to be seen as part of the proposed therapy those appointments are made the same day or as soon as is convenient for the patient.

Appointments
 
Referring physicians or patients should call (800) KARMANOS (1-800-527-6266). A specially trained program coordinator schedules appointments and answers questions. The patient should bring the following to her appointment:

• Relevant medical records from recent care provided outside the Institute;
• Any previously performed radiologic testing pertinent to the tumor in question including chest X-rays, CAT scans of the chest, abdomen and pelvis, pelvic ultrasounds. If patient has had a whole body PET scan, she should bring the films and reports for review;
• Pathology slides and reports; and
• Any recent pulmonary functions tests, EKGs, and blood tests.

The Gynecologic Oncology Multidisciplinary Team program is located at the Barbara Ann Karmanos Cancer Institute’s Wertz Center. Valet parking and ample security are provided.