Helping Patients Live Longer with a Better Quality of Life
Gynecologic oncology is a specialized field of medicine that focuses on cancers of the female reproductive system. These include cancers that arise in the ovaries, uterus, cervix, vulva and vagina. All women are at risk for gynecologic cancers, a risk that increases with age.
“Each subset of gynecologic cancers is unique with different risk factors and different symptoms at presentation,” says Dr. Navya Nair, a gynecologic oncologist with the LSU Health Sciences Center, Department of Obstetrics and Gynecology. “GYN oncology is an interesting field, while being both complex and challenging. It is a unique specialty because we are surgeons and we also administer chemotherapy, which allows us to understand the disease process from both the surgical and the medical perspectives.”
The gynecologic oncology team at LSU Health Sciences Center uses a comprehensive approach to cancer treatments based on patient-centered care. “When a woman is diagnosed with gynecological cancer, it is a very vulnerable time for her,” Dr. Nair says. “Knowing that the same physician will perform her surgery, oversee her chemotherapy and follow her for surveillance is very comforting to our patients. Throughout the process, naturally a strong doctor-patient relationship develops as we do our best to bring about the best medical outcome for each patient.”
Board-certified in obstetrics and gynecology and board eligible in gynecologic oncology, Dr. Nair specializes in the use of surgery and chemotherapy to treat women with gynecologic cancers. In addition, she is actively involved with the clinical trials program at the Louisiana Cancer Center. “More women today are surviving gynecological cancers than ever before,” she says. “Genetic testing, more effective surgeries, more tolerable chemotherapy and better targeted therapies are helping patients live longer.”
“It is our goal as GYN oncologists to reduce barriers to cancer care and improve the quality of cancer care,” Dr. Nair says. “Women are a vital part of the community and each family. Helping them regain their health in turn helps to keep their families and their communities strong.”
Women are referred to a GYN oncologist by their primary care doctor or OB-GYN if the results of a pelvic examination suggest a suspicion of cancer. A variety of imaging tests, such as ultrasound, CT scans, MRI and PET scans, may be used to assess the suspicion. Diagnostic testing, such as a biopsy or intra-operative pathology, will confirm the diagnosis. “Many times, we will not know if a pelvic mass is cancerous until it is removed,” Dr. Nair says. “If we do find cancer based on intra-operative pathology, we go on to perform the cancer staging or debulking surgery as this provides the best chance at extending a woman’s life expectancy. We want each woman to lead her life with dignity and to be able to deal with cancer on her terms.”
In many cases of ovarian cancer where the diagnosis is carried out at a late stage, the prognosis for long-term survival has been poor. However, new advances in understanding tumor biology have led to the development of targeted agents, which are able to pinpoint the signaling pathways of cancer cells, stroma and vasculature in tumor tissues.
“The cancer treatment options within the past 10 years have exploded,” Dr. Nair says. “The imaging is so much more sophisticated, and we have made great technological advancements in both surgical and medical treatment options. For example, for some patients with cancers of the uterus, we are able to perform sentinel lymph node biopsies by injecting dye into the cervix to follow the lymphatic drainage and target which specific lymph nodes to remove. This allows us to spare the patient the morbidity of a full lymph node dissection but allows us to obtain the cancer staging information that is needed to determine her adjuvant treatment plan. We have seen advancements in chemotherapy and non-chemotherapy treatments and improvements in chemotherapy-related side effects. There are also more non-chemotherapy options such as immunotherapy, hormone therapy and targeted therapies (that target cancer cells in various stages of growth).”
Dr. Nair earned her medical degree from at New York University School of Medicine and completed her residency in gynecology and obstetrics at Emory University. In 2018, after finishing a fellowship at Mount Sinai School of Medicine in gynecologic oncology, she joined LSU Health Sciences Center, Department of Obstetrics and Gynecology. “After completing my medical training, I felt the need to return to Louisiana,” she says. “There is a severe shortage of GYN oncologists in this state. I believe every woman should have access to healthcare and quality of life.”
Working as a Team
At LSU Healthcare Network, the GYN oncology team includes a highly qualified team of physicians, pathologists, radiologists, radiation oncologists, radiation therapists and nurses. Dr. Nair has spearheaded starting a GYN oncology tumor board, which includes University Medical Center doctors from LSU and Tulane to meet in an interdisciplinary conference where cancer patients have their unique cases discussed. These various oncologic specialists meet biweekly to discuss difficult and complex cases resulting in the most effective and comprehensive treatment recommendations.
Staying Current with Research
With a strong interest in global women’s health, Dr. Nair has worked in India, Ethiopia and Liberia to implement cancer prevention programs and improve access to cancer care. She developed her research interests in cancer public health by collaborating with the Centers for Disease Control and Prevention and the Georgia Center for Oncology Research and Education.
Several months ago, Dr. Nair started an oncology journal club, which includes doctors from LSU, Tulane and Ochsner. “At each meeting, we discuss how to apply the latest research published in our field and incorporate this research into our practice,” she says. “Last month we discussed a new maintenance treatment for women diagnosed with advanced ovarian cancer who have the BRCA gene mutation. In these patients, the treatment was shown to result in a 70 percent lower risk of disease progression or death. These are practice-changing articles.”
Navya Nair, M.D., MPH
LSU Healthcare Network
3601 Houma Blvd., Suite 203
Metairie, LA 70006
MEDICAL SCHOOL: New York University
RESIDENCY: Emory University, Gynecology & Obstetrics
FELLOWSHIP: Mount Sinai School of Medicine, Gynecologic Oncology