Gynecologic OncologyOnly a specialist in gynecologic oncology can best manage the effective diagnosis and treatment of gynecological cancers. Dr. Mirhashemi specializes in the management of a variety of cancers such as cervical cancer, endometrial/uterine cancer, menopause/hormonal replacement therapy, pelvic masses, ovarian cancer, vaginal cancer, vulvar cancer and uterine sarcoma. The three common cancers in the female reproductive tract are ovarian cancer, uterine cancer and cervical cancer. Dr. Mirhashemi can also treat precancerous conditions such as cervical dysplasia.
Dr. Mirhashemi and his team work diligently to provide the patient with the latest techniques in gynecologic oncology treatment, offering the latest and most innovative methods of cancer treatment. This team of gynecologic oncologists provides patients a full range of treatment for gynecologic cancers. Dr. Mirhashemi also manages the treatment of pelvic masses, where there is a suspicion of ovarian cancer. Patients who have an ovarian mass or an ovarian cyst need an experienced gynecologic oncologist to perform their surgery. This way, if cancer is detected, the specialist will be involved in every step of treatment.
Cervical cancer is the only gynecologic cancer that can be prevented with regular screening, with pap smears detecting precancerous areas on the cervix. Screening with Pap smears has drastically reduced the incidence of cervical cancer by detecting problems in the early pre-cancerous phase. Dr. Mirhashemi and his team provide patients with the latest and most updated diagnostic and treatment methods for abnormal Pap smears and cervical cancer. The treatment of cervical cancer includes traditional surgery that preserves fertility, when possible, to aggressive surgery coupled with radiation therapy and chemotherapy when needed. Dr. Mirhashemi is a leader in cervical cancer treatment, routinely participating in research studies for the management of early stage, advanced and recurrent cervical cancer.
| Endometrial/Uterine Cancer
Uterine cancer is diagnosed as a result of abnormal uterine bleeding. Most uterine cancers start in the endometrium, or lining of the uterus. Endometrial cancer is the most common of all gynecologic cancers. Uterine sarcomas that form in the wall of the uterus are not as common. Common symptoms of uterine cancer include abnormal bleeding in post-menopausal women or irregular bleeding in pre-menopausal women. Dr. Mirhashemi offers the latest in early diagnosis and a full range of treatment options. Usually, patients can be cured by surgery alone. However, a gynecologic oncologist like Mirhashemi works closely with radiation specialists when radiation therapy is needed, providing his patients with access to innovative treatments for advanced and recurrent uterine cancer and the latest in research in cancer treatment.
| Menopause/Hormonal Replacement Therapy
Menopause usually happens in woman's life, between the ages of 45 and 55 years. The ovaries stop producing eggs and menstrual periods end. Changes in hormone levels can lead to common symptoms of menopause, which include hot flashes, vaginal dryness, low libido, weight gain, irritability and sleep disturbances. Menopause is a normal part of a woman's life and usually does not require treatment. However, some women experience bothersome symptoms with menopause, for which effective treatments are available.
Hormone replacement therapy is most often used for women who are going through menopause. Women have traditionally used hormone replacement therapy, specifically synthetic estrogen therapy, to treat menopause symptoms and to help prevent osteoporosis. For those women needing hormone replacement therapy, the use of bio-identical hormones may be more helpful than synthetic ones. However, no two women are alike and the hormone replacement therapy can be adapted to fit a woman’s individual body and hormone levels. Hormones are made in a variety of strengths and dosage forms including capsules, topical creams and gels, suppositories and sublingual troches or lozenges. With the help of Dr. Mirhashemi, a woman can start and maintain a hormone replacement therapy that closely resembles what her body has been doing naturally for years and manage the effects of menopause.
| Pelvic Masses
Most ovarian growths are discovered during pelvic examinations or in pelvic ultrasounds or CAT scans. The ovary in reproductive women goes through monthly egg formation, ovulation and corpus luteum formation changes. Follicles are normal if they measure up to 2.5 centimeters and are generally not regarded as cysts of the ovary. Corpus luteum size can easily reach 3 -3.5 centimeters and still be considered normal. Simple pelvic masses in reproductive women that measure less than 8 centimeters in size should always be monitored for at least 4-6 weeks to see if there is a change in the size of the mass. Regression indicates a normal physiologic process that usually resolves itself. Simple pelvic masses are usually not associated with cancer and can be monitored for a brief period of time. Pelvic masses of the ovary that measure over 8 centimeters in reproductive women, and over 2 centimeters in post-menopausal women or younger girls, usually require surgery to obtain tissue for pathology and rule out the chance of cancer.
| Ovarian Cancer
Ovarian cancer is the most serious of all gynecologic cancers since it exhibits very few early symptoms, which results in it being commonly diagnosed only in advanced stages. Symptoms may include pressure or fullness in the pelvis, abdominal bloating, changes in bowel or bladder habits that worsen over time as well as persistent digestive problems such as upper abdominal discomfort, distention, and gas pains. However, since these symptoms are non-specific, it is difficult to detect ovarian cancer before it’s too late.
Vaginal cancer is very rare, affecting only 1% - 2% of te women in the United States yearly. There are two types of vaginal cancer: squamous cell carcinoma (usually found in women ages 60 to 80) and adenocarcinoma (usually found in women ages 12 to 30). Squamous cell carcinoma develops in the skin lining of the vagina and is usually caused by the human papilloma virus (HPV), which is sexually transmitted. Adenocarcinoma has been linked to exposure to diethylstilbestrol (DES), a drug given to women, from 1945 until the early 70’s, who were at high risk for miscarriage. The most common symptoms of vaginal cancer are abnormal vaginal bleeding and discharge, painful urination and pain during intercourse. The biggest risk factor is for developing vaginal cancer is a history of genital or venereal warts, usually caused by HPV, which is a sexually transmitted disease. Another risk factor of vaginal cancer is a history of vaginal radiation therapy.
| Vulvar Cancer
Another rare cancer in women, vulvar cancer involves the outer part of a woman's vagina, the inner or outer labia. Most women with vulvar cancer are over age 50. Overall prognosis for vulvar cancer is positive; early detection can improve it. All women should perform a vulvar self-exam monthly. If lumps, bumps or lesions are discovered, patients should see a doctor. There may be severe burning, itching or pain in vulva. Additionally, the skin may look white and feel rough. The key to successful treatment of vulvar cancer is early detection. The biggest risk factor for vulvar cancer is a history of genital or venereal warts, which is caused by HPV, a sexually transmitted disease. Other risk factors include a history of chronic vulvar itching.
Uterine sarcoma is a very rare cancer that develops in the uterine muscles or tissues that support the uterus. Uterine sarcoma is different from endometrial cancer, where cancer cells start growing inside the lining of the uterus. Being exposed to x-rays can increase the risk factor of developing uterine sarcoma. Other risk factors for uterine sarcoma include past treatment with radiation therapy to the pelvis, treatment with tamoxifen for breast cancer. Possible symptoms of uterine sarcoma include abnormal bleeding from the vagina. Medical help should be sought if any of the following problems occur:
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