Clinical Services, Englewood Health Physician Network

Cervical Cancer Update from Dr. Steven Brower

A Message from Dr. Steven Brower, Medical Director of The Lefcourt Family Cancer Treatment and Wellness Center and Chief of Surgical Oncology and HPB Surgery.

January is Cervical Cancer Awareness Month, and I am pleased to share with you more information on how we address this health challenge at The Lefcourt Family Cancer Treatment and Wellness Center. We are committed to seamless care and access for your patients, so please don’t hesitate to contact us to help facilitate a referral or appointment.

Prevention and Screening

HPV is thought to be responsible for more than 90% cervical cancers, as well as most anal, vaginal, vulvar, and penile cancers. Thankfully, HPV vaccination is highly effective and is a major game changer in the ability to manage cervical cancer prevention. The HPV vaccine is recommended for boys and girls between the ages of 9 and 14 years. The vaccine is also suggested for people up to the age of 26 who have not already received the vaccine or completed the series of shots. In addition, although catch-up vaccinations for adults aged 27 to 45 years are not formally recommended, some in this older age group might benefit from vaccination, so consultation with their physician is recommended. Patient education for preventing HPV, such as promoting the use of condoms or informing about sexually transmitted infections, also is helpful.

When it comes to screening, we follow the joint recommendations of the American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology. Women younger than 21 years old do not need regular screening; women ages 21-29 should receive cytology (Pap smear) every three years; and women ages 30-65 should have both HPV testing and cytology testing together every five years (preferred) or cytology alone every three years. Women 65 and older do not need screening following adequate negative prior screening and women of any age do not need screening after hysterectomy.

Treatment

Using staging guidelines that were last updated in 2019, our gynecologic cancer team collaborates to design individualized treatment strategies for women diagnosed with cervical cancer.

Surgery: Growing research indicates that minimally invasive surgery may not achieve the same outcomes as traditional open surgery in certain early cervical cancer patients. We evaluate each patient carefully on a case-by-case basis to determine the best surgical approach.

Radiation Therapy: Several 2019 studies have shown that the use of brachytherapy (radiation delivered inside the body directly adjacent to the cancer) has been declining in the United States and may be linked to worse outcomes for cervical cancer patients. However, our radiation oncologists’ expertise has led to outstanding survival and success rates for patients with cervical cancer. We have become a major referral center for patients requiring complex brachytherapy procedures for cervical cancer. Many times these procedures are no longer being performed at other hospitals in the region, including major academic medical centers in New York City.

Systemic Therapy: Platinum-based chemotherapy remains the most effective systemic treatment. We also utilize immunotherapy and targeted biologic therapies. Eight-fi ve percent (85%) of cervical cancer patients whose tumors express PD-L1 may benefit from immunotherapy treatment. All patients with advanced cervical cancer at Englewood Health are automatically tested for this predictive marker. Immunotherapy has led to many patients living for several years with advanced cervical cancer. In addition, anti-angiogenic therapy is recommended in certain patients. Patients with advanced and metastatic cervical cancers are often responsive to this approach. Our Englewood team has worked extensively with these therapies and we have seen out-
standing results.

Our Team

Our gynecologic cancer team is led by Nimesh Nagarsheth, MD, Medical Director of Gynecologic Oncology as well as Medical Director of Robotic Surgery. Other key members are Maxwell Janosky, MD, medical oncologist, and David Dubin, MD, Chief of Radiation Oncology. The team benefits from a close collaboration with gynecologists in the Englewood Health Physician Network. Tracy Scheller, MD, and Galit Steinberg, MD, are both based on our hospital campus. We also recently welcomed Wendy Hurst, MD, a well-known and respected gynecologist with a practice in the city of Englewood, to our physician network.

Referrals

We are honored to care for your patients in need of oncology consultations or treatment. We welcome the opportunity to continue this care with the optimistic hope for improvement in survival and quality of life for women with cervical or other gynecologic cancers. To refer a patient to our women’s cancer program, please call our main cancer center phone number, 201-608-2266. Please do not hesitate to contact me at any time if I can be of assistance.