DiSaia and Creasman Clinical Gynecologic Oncology

Immunotherapy in gynecologic malignancies

In 1893, William Bradley Coley reported the case of a German immigrant with a neck sarcoma that was deemed inoperable and yet disappeared after an erysipelas infection ). Coley hypothesized that the immune response provoked by the bacterial infection led…

Molecular hallmarks of cancer

Key points 1. Malignant cells develop from molecular abnormalities in growth control. 2. The molecular abnormalities are in one or more of 10 key pathways. 3. These altered pathways provide important targets for new therapeutic agents. 4. Angiogenesis, PARP, immunologic…

Targeted therapy and molecular genetics

Key points 1. The development of new and effective therapies should be rooted in a clear understanding of tumor biology. 2. Bevacizumab, a humanized monoclonal antibody to human vascular endothelial growth factor, was the first US Food and Drug Administration–approved…

Complications of disease and therapy

Key points 1. Women with gynecologic cancers can have significant complications from their cancer and/or treatments. 2. Vaginal bleeding is usually controlled with packing although arterial embolization may be needed to control severe hemorrhage. 3. Ureteral obstruction can be treated…

Cancer in pregnancy

Key points 1. Data from the Surveillance, Epidemiology, and End Results database indicate that cancers during the reproductive ages, in order of decreasing frequency are breast, melanoma, thyroid, cervix, and lymphoma. 2. The most critical period for cancer treatment during…

Breast diseases

Key points 1. Women who present with a breast mass require triple assessment , which comprises physical examination, breast imaging with mammography and ultrasound, and pathologic or cytologic evaluation. Discordant results require further investigation and careful follow-up. 2. Breast cancer…

Epithelial ovarian cancer

Key points 1. Ovarian cancer is the most lethal of all gynecologic cancers. Elderly women are more likely to develop ovarian cancer than are young women. 2. Oral contraceptives decrease the incidence of ovarian cancer substantially. 3. Ovarian cancer may…