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Prof. Tanja N. Fehm, MD, is a specialist in gynecologic oncology at the University Hospital Düsseldorf and Director of the Clinic for Gynecology and Obstetrics with the DKG-certified Gynecological Cancer Center.
With a long tradition in pre-stage and advanced gynecologic cancers, patients are treated by the interdisciplinary team led by Prof. Fehm with an individual treatment concept specifically designed for the respective clinical picture.
Gynecological Cancer Center Düsseldorf
The Gynecological Cancer Center at the University Hospital in Düsseldorf is characterized by interdisciplinary treatment concepts and state-of-the-art therapy procedures. Patients with gynecologic cancer receive the highest level of medical and psychological care at the Cancer Center, and they benefit from a long tradition of experience. Medical innovations and findings are integrated into patient care as early as possible. The patients' wishes and fears are given first priority in therapy planning, and detailed information is provided. Above all, the possibility of minimally invasive therapy in many cases represents a great advantage and a gentler procedure for the patient's recovery process.
In addition, the possibilities of personalized medicine are constantly being further developed, and much emphasis is placed on basic research into the development of cancer.
Pre-Stage Cancer
Before a malignant tumor develops, so-called pre-stage cancer can form, which in some cases develop into cancer later on. For example, if cell changes occur in the cervix, this can become apparent prematurely during the cancer screening examination. In addition, cells can change due to infection or irritation. This change is called dysplasia, and some of these forms can degenerate into cancer cells in the long term.
The most common cause of malignant degeneration is infection with the human papillomavirus or HPV. The virus is transmitted during sexual intercourse, and there are several known types of HPV. Some can cause superficial changes that are harmless, while others bring a high risk of degeneration. Most women come into contact with the HP virus during their lives, and the immune system can often get rid of the viruses itself. However, cancer develops over time in some cases, which is why markedly dysplastic areas should be treated as part of the dysplasia consultation. Using laser procedures or an electric loop, the areas can be removed using a minor procedure under short anesthesia.
Cervical Cancer
In cervical cancer, cells of the lower part of the uterus undergo malignant changes. The cervix, or neck of the uterus, is the connection between the uterus and the vagina. The most common reason for cancer of the cervix is infection with high-risk HPV types. If diagnosed early, cervical cancer is often easily treated. If the cancer stage is too advanced to use laser therapy alone, surgery is usually performed with removal of the area and potentially affected lymph nodes. This may be followed by radiation therapy. For very advanced, inoperable stages, treatment is often radiation therapy alone.
Uterine Cancer
Uterine cancer means that the mucosal cells inside the uterus degenerate. The mucous membrane is also called the endometrium, so the cancer is technically called endometrial carcinoma. The disease often occurs after menopause and is accompanied by risk factors such as hormone treatments with estrogen and obesity. A typical early symptom is vaginal bleeding after menopause, which should be examined more closely in any case. Endometrial carcinoma is primarily treated by surgery. Depending on the stage, radiotherapy may then be considered. However, hormone therapy or chemotherapy may also be considered if cancer can no longer be treated surgically.
Ovarian Cancer
Ovarian cancer is usually discovered very late and thus at an advanced stage. This is because the rather unspecific symptoms such as an increase in abdominal girth, bloating, and abdominal pain only appear after some time and are also misinterpreted at first. Therefore, before surgery, ultrasound examination, computer tomography, and, in the case of particular questions, PET-CT are used. Surgery is performed by gynecologic oncologists at our center and should include as a goal the absence of a tumor in the abdomen. Even in the case of far advanced findings, it is possible today to achieve this goal through an interdisciplinary approach. Usually, surgery is followed by chemotherapy, supplemented by so-called personalized therapies. Highly specialized treatment has made it possible to improve therapy results compared to the past significantly.
Endoscopic Surgery Procedures
Endoscopic surgeries are carried out using the so-called keyhole procedure. In this procedure, small instruments and a camera are inserted into the abdominal cavity through minimal incisions using laparoscopy. Tumors can now also be treated in a minimally invasive manner. The Uniklinik Düsseldorf is a specialized center that enables minimally invasive tumor treatment. The advantage is a faster recovery process for patients due to smaller wound areas.
Breast Cancer Center
Degeneration of the mammary gland is the most common cancer in women and can occur at all ages. In most cases, the degeneration is sporadic, but in some patients, genetic factors can lead to the development of breast cancer. Therefore, genetic testing and counseling are recommended, especially in young patients, those with a family history, and those with multiple or bilateral breast cancers. In this regard, the BRCA gene mutation is of great importance and is looked at more closely in both breast cancer and ovarian cancer.
There are very different forms of breast cancer and many other treatment options. These include classic, breast-conserving surgery with postoperative radiation, complete breast removal, and various chemotherapy procedures. The kind of therapy used and which individual choices are available depends on breast cancer and is precisely adapted to the patient.
Benign Gynecological Diseases
Benign gynecologic diseases include benign cysts on the ovaries and fibroids of the uterus. Cysts are fluid-filled cavities and can often be observed on a wait-and-see basis and based on ultrasound checks if there are no symptoms. Myomas are benign growths of the muscular layer of the uterus and are very common. They may be associated with increased menstrual pain, bleeding, and pressure on the urinary bladder or intestine. Cysts and fibroids can be surgically removed if they show excessive growth. There are various options and minimally invasive methods. Symptomless fibroids usually do not require treatment.
