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Chief of gynecologic oncology at Great Lakes Cancer Care Collaborative discusses cancers of the female reproductive tract
By Christopher Motola
Q: Tell us a bit about your practice.
A: I’m a gynecologic oncologist. I treat cancers of the female reproductive tract. So that would be ovarian cancer, fallopian tube cancer, uterine cancer, endometrial cancer, cervical cancer and vaginal cancer.
Q: How treatable are these cancers, generally speaking?
A: For uterine and endometrial cancer — they’re probably the most common cancers we treat in the female reproductive system. About 75% to 85% of these patients are diagnosed with early-stage disease because they present with the symptom of bleeding. For ovarian cancer, the majority of those patients, 70% to 80%, present with advanced stage disease. And that’s because the symptoms are a bit vague and non-specific. They often present with bloating and abdominal pain, which can easily be chalked up to constipation or dietary changes. They’ll often see their primary, get referred to a gastroenterologist, eventually get imaging and then finally get diagnosed. So their prognosis is not as good, unfortunately.
Q: Do we screen for these cancers during OB-GYN visits?
A: The screening that we do have for the female reproductive system is cervical cancer. The pap test is a good screening tool for that. For the other cancers? There isn’t a very good screening for those.
Q: Generally what age group are you dealing with?
A: We deal with young women who develop cancers up to women in their mid-to-late 80s. So there’s definitely a big age range for the types of patients that we see. Oftentimes we’ll treat even pre-malignant conditions like cervical dysplasia. So that population will be a little bit different than that of our uterine and ovarian cancers.
Q: Is gynecologic oncology a surgical subspecialty?
A: We do surgery. It’s actually the only specialty that does both surgery and chemotherapy. So if they need both for a female reproductive tract cancer, they could see us for both.
Q: Do you feel that gives you some unique perspectives on cancer treatment?
A: I’d say you develop a very unique relationship with your patients. You get to know them, you often get to operate on them. And then those patients that need treatment beyond surgery, you’re able to give them chemotherapy. So you might spend a lot of time together and get to know each other and develop a close relationship with those patients. It helps them be able to trust you and your clinical judgments as opposed to getting your surgery from one physician, then going to have to get your chemotherapy from another physician. So it’s unique in that regard. It’s also one of the things that drove me to this specialty.
Q: Is there any particular reason the specialty developed that way where others didn’t?
A: It’s probably because it’s a very niche specialty. It’s just GYN and it’s just chemotherapy for GYN. Whereas with other kinds of oncology they’ll often treat different disease sites. Or for surgical oncology they’ll operate on many different types of cancers. So I think it’s just because it’s so specialized.
Q: Has COVID-19 affected your specialty’s ability to diagnose cancers in a timely manner?
A: When the first wave hit in 2020 it was really challenging. We didn’t have a lot of understanding of COVID-19. We didn’t know how it would affect patients who were getting chemotherapy. So in the beginning there was a little bit of a delay in operating on patients. Now with the arrival of the vaccine and our better understanding of the disease, it’s not really hindering our treatment and care of patients.
Q: Does chemotherapy have an effect on a patient’s ability to recover from COVID-19?
A: If a patient on chemo did develop a COVID-19 infection their immune system isn’t as strong as a patient’s who isn’t on chemo. But in our experience, we haven’t seen any patients have unusually severe reactions if they’re on chemo and get COVID-19.
Q: Since there aren’t screening tests for many of these cancers, what symptoms should women be concerned with?
A: For cervical cancer, getting the screenings and pelvic examinations involving the vulva and vagina. If there’s abnormal bleeding outside of their menstrual cycle or are post-menopausal and have bleeding, that’s really a red flag. And then people that develop these weird bloating abdominal fullness, or have a distended abdomen and can’t get their pants on even though they’re losing weight, those are some symptoms you should look out for. And of course patients know their own bodies best. So they should advocate for themselves if they feel something is wrong. Advocate for a thorough examination and work-up.
Q: You’re fairly new to Kaleida. What made you want to join up with them?
A: I was just looking for a new opportunity to improve and bring my experience to the community outside of a cancer institute.
Q: How do they differ?
A: Access to clinical trials is a big one. I keep my working relationships with the institute to make sure I can refer them to someone who can get them in a clinical trial even if I can’t get them in myself.
Lifelines
Name: Stacey Akers, M.D.
Position: Chief of gynecologic oncology at at Great Lakes Cancer Care Collaborative
Expertise: Specializes in gynecology oncology, does surgeries at Millard Fillmore Suburban Hospital. She is part of General Physician PC, UBMD and Great Lakes Cancer Collaborative
Hometown: Birmingham, Alabama
Education: University of South Alabama College of Medicine
Affiliations: Kaleida Health System; Catholic Health System
Organizations: Society of Gynecologic Oncology; Erie County Medical Society; Buffalo OB-GYN Society
Family: Husband, four children
Hobbies: Skiing, baking
