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Johns Hopkins Bayview News - Robotic-Assisted Hysterectomies Benefit Cancer Patients

Winter 2013

Robotic-Assisted Hysterectomies Benefit Cancer Patients

By: Sara Baker
Date: February 4, 2013

Maureen Stefanski, cancer survivor
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Maureen Stefanski, cancer survivor

Cancer. It’s a diagnosis that we all fear hearing. When Maureen Stefanski, a 56-year-old Dundalk, Maryland, resident, first learned she had uterine cancer last October, she and her husband were terrified. But thanks to an innovative surgical intervention and lymph node mapping procedure she received in November, Stefanski is now cancer free, and has a “new lease on life” just a few short months after her initial diagnosis.

Robotic-Assisted Hysterectomy

This year alone, an estimated 50,000 women will be diagnosed with cervical or uterine cancer. For most of these women, a hysterectomy is the preferred method of treatment, especially for women in their 50s and 60s who are past their childbearing years. In a hysterectomy, surgeons remove the uterus and cervix. In patients with uterine cancer, the ovaries and pelvic lymph nodes also are usually removed. While traditional hysterectomies used to require a rather large incision, at least three nights in the hospital, and many long weeks of recovery, the minimally invasive robotic-assisted hysterectomy procedure at Johns Hopkins offers a shorter recovery, less pain and smaller incisions, so patients can return to their normal lives much faster.

“I would encourage all patients to consider minimally invasive surgery,” says Edward Tanner, M.D., a gynecologic surgeon who specializes in women’s cancers. “All of the data suggests that patients who have robotic-assisted hysterectomies do quite well.” This robotic procedure is an option for almost all hysterectomy patients, and is the preferred method for patients who are obese or have other medical complications.

In addition to patient benefits like smaller incisions, less need for pain medication, and a shorter hospital stay (usually only one night), the robotic approach also gives surgeons a better view of the procedure, enabling them to be more precise in removing the areas affected by cancer. Dr. Tanner also is the first surgeon in the area to perform a new technique, called sentinel lymph node mapping, during hysterectomies. In this procedure, Dr. Tanner injects a dye that is taken into the lymph nodes around the uterus, allowing him to determine which lymph nodes are most likely to be involved in the cancer and need to be removed. He is currently training other Johns Hopkins surgeons to use this technique.

Life Goes On

Stefanski is a doer; when faced with a problem, she wants to know how to fix it, and she wants to get moving on it immediately. After her initial diagnosis in October, Stefanski’s gynecologist referred her to Dr. Tanner. “By the time my husband and I came out of that first meeting in November, we were so relieved,” she says. “We were impressed with Dr. Tanner’s level of expertise, but also with how down to earth and genuine he is. He took the time to explain all aspects of the procedure, and he told us about himself. I felt like I really knew who would be doing my surgery.” On the same day as her initial consultation, she was able to schedule her surgery for later in the month.

Just two weeks after surgery, Stefanski says she has to hold herself back. Her incisions, which required no stitches, are healing well and have caused no pain. She was back to work full time after two weeks. Now she can focus on what matters most to her, her husband and four daughters—she hosted a bridal shower for one of her daughters just 12 days after surgery. Dr. Tanner instructed her to limit her activities for the first six weeks, but she hopes to return to one of her other passions—tap, jazz and ballet dancing—very soon.

And the best part? Her two-week follow-up appointment indicated that the cancer had been completely removed, and there is no need for further treatment. Stefanski will continue to see Dr. Tanner regularly for the next several years to monitor her condition. “I feel truly blessed,” she says.

Signs and Symptoms

Early medical intervention will improve your chance of a healthy recovery from uterine or cervical cancer. It’s important to understand the symptoms so you know when to talk to your doctor.

The most common symptom of uterine cancer is abnormal vaginal bleeding. Uterine cancer can occur at the onset of menopause, but usually occurs after menopause. There are usually no noticeable symptoms of cervical cancer, making it critical for women to have regular Pap smears to check for changes in cervical cells. See your doctor if you experience:

  • Vaginal bleeding after menopause
  • Heavy or prolonged vaginal bleeding before menopause
  • Unusual vagina discharge, which may include bloody streaked mucous
  • Pain or discomfort while urinating
  • Pain during intercourse
  • Pain in the pelvis

Leading the Field

The Johns Hopkins gynecologic oncology program offers women a multidisciplinary team of experts who can coordinate all aspects of treatment, including surgery, pathology, hemotherapy, radiation therapy, imaging and treatment for recurrence. Patients who are cared for by gynecologic oncologists have better survival rates than patients who are not treated by a cancer specialist. “We are trying to find the best ways to move the field forward,” says Dr. Tanner. “At Hopkins, patients also benefit from the availability of clinical trials.”

To schedule an appointment with a gynecologic oncologist, call 443-997-0400 (select option 1, then option 3).