Abhishek Kumar, MD, is a hematology/oncology physician at Jacobi Medical Center and North Central Bronx Hospital in New York. He has a special interest in gynecological and genitourinary cancer.

Gynecological cancers are cancers that begin in the female reproductive system, which includes the ovaries, uterus, cervix, vagina, and vulva. This year, an estimated 110,070 women in the United States will be diagnosed with a gynecological cancer. Approximately 55% of these cancers start in the uterus, 20% start in the ovaries, and 15% start in the cervix.

Being diagnosed with a gynecologic cancer is often a stressful and difficult time. It’s important for you to have all of the information you need to make informed treatment decisions, as well as to find support resources.

Here are 7 questions to ask the doctor after a gynecologic cancer diagnosis:

1. 1. What is my prognosis? 

2. Asking your doctor about your prognosis, or chance of recovery, can give you information about your diagnosis, such as which organ the cancer started in, the type and grade of cancer, and the stage of cancer. This information, along with your medical conditions, any prior cancer treatments, and your overall health, helps determine your prognosis.

3. 2. Do I or my family members need genetic testing?

   The National Comprehensive Cancer Network recommends that any woman diagnosed with ovarian cancer, fallopian tube cancer, primary peritoneal cancer, and, in certain conditions, uterine cancer be tested for gene mutations. About 15% of people diagnosed with serous ovarian cancer have a mutation, or change, in the BRCA gene. Similarly, about 3% to 5% of women with uterine (or endometrial) cancer have Lynch syndrome, a type of inherited cancer syndrome.

   Cancers caused by a gene mutation may need to be treated differently. To help your health care team, ask family members if any of your blood relatives have been diagnosed with cancer, how old they were at diagnosis, and how you are related to them. In addition, some family members may also need to consider genetic counseling and genetic testing.

4. 3. Who will provide my treatment?

   Treatment of a gynecologic cancer is complex and requires a multidisciplinary team approach. This means different types of doctors often work together to create an overall treatment plan that combines different types of treatments. Your team of doctors may include a:

   • Gynecologic oncologist — A doctor who specializes in treating cancers of the female reproductive system

   • Medical oncologist — A doctor who gives chemotherapy and other treatment drugs

   • Radiation oncologist— A doctor who provides radiation therapy to treat cancer

   • Gynecologic surgeon — A doctor who specializes in treating gynecologic cancers with surgery

5. 4.  What treatment side effects should I expect?

   Gynecologic cancer and its treatments can cause side effects. Remember to ask each of your doctors about what short-term side effects and long-term side effects may arise from each treatment in the treatment plan. Short-term side effects happen during or right after a treatment. Long-term side effects may happen immediately and then continue for a long time, and late effects can occur months or years after treatment ends. Most doctor’s offices provide written material on potential side effects. If you’re not given the information, ask for it.  

6. 5. What support resources are available?

   Always remember that you are not alone in your journey. Your health care team is deeply involved in your care and can direct you to support resources. Other patients and your family members can provide an informal forum for expressing any worries and fears you may have. In addition, most cancer centers have support groups or can help you find one. Besides offering support, these groups can help you get involved in cancer advocacy, if you choose to do so.   

   Another very important aspect to consider is financial support. You should talk with your cancer center’s financial counselors so you clearly understand your treatment costs. Ask an oncology social worker or other health care team member about financial assistance programs, patient assistance programs, and organizations that provide financial resources and support.   

7. 6. Will I still be able to become pregnant?

   Fertility, which is the ability to have a child, can be an important concern, especially for younger patients. Many treatments for gynecologic cancers can affect fertility temporarily or permanently. If you have concerns, talk with your doctor before treatment begins. Depending on your type of cancer and its stage, there may be ways to preserve your fertility. Your doctor may refer you to a fertility expert who can discuss your options.

8. 7. Can I participate in a clinical trial?

   Participating in a clinical trial can have many benefits. A clinical trial can give you more treatment options and a way to contribute to the advancement of research on cancer. Talk with your doctor about how to find a clinical trial and the risks and benefits of joining a specific study.