University Health System: Compassionate Physicians Deliver Advanced Gynecologic Research and Treatment

By Jenn Webster
Tuesday, July 2, 2019

At University Health System, physicians offer therapies that can benefit patients with complex gynecologic diseases and conditions, making the system a referral hub for the surrounding area. Fueling these treatments are insights gained from leading-edge research and clinical trials performed by physician-scientists with a keen interest in advancing cancer care for every stage of the disease. University Health System is already a well-respected program where women receive diagnosis and treatment for conditions ranging from abnormal bleeding and endometriosis to ovarian, uterine and cervical cancer — and the range of treatments they offer is growing. The gynecology specialists at University Health System treat cancers of the cervix, fallopian tubes, ovaries, vagina, vulva and uterus, as well as noncancerous gynecologic disease, such as endometriosis. They have a wide arsenal of tools, including robotic surgery, to use against these diseases.

Georgia A. McCann, MD, gynecologic oncologist at University Health System and Assistant Professor in the Department of Obstetrics and Gynecology at UT Health San Antonio, includes robotic surgery among her many areas of specialization.

“Our primary focus for robotic surgery is treating endometrial cancer, but we do perform robotic surgery for complex benign gynecological conditions,” she says. “We also offer robotic surgery for people who are seeking a minimally invasive procedure for better recovery from their pelvic surgery.”

At University Health System, patients can find well-trained physicians with deep experience in laparoscopic and robotic surgery. Offering less pain and swifter recovery times, robotic surgery can be a great advantage for select patients. And the range of candidates is growing — Dr. McCann is working on opening robotic surgery up to people who would previously have been ineligible due to comorbidities.

Referral for potential cancer diagnosis can be frightening, but University Health System’s physicians see patients quickly and provide a consistent, reassuring experience throughout diagnosis and treatment.

“We usually see patients within two weeks after referral,” Dr. McCann says. “We conduct a formal exam, hold a conversation with them and review their records from the referring provider. We spend a lot of time with each patient going over the etiology of her disease. We discuss treatment options, and while we do make a professional recommendation, we also seek to include patients as active participants in their care by providing a range of options and making sure they understand each treatment approach.”

Patient empowerment is especially important in cases of recurrent disease, Dr. McCann says. These patients typically feel frustrated, fearful and disempowered. However, University Health System oncologists continue to see patients throughout their disease course, offering options and seeking their input throughout their treatment.

“In recurrent cancer, our treatment options may be mostly palliative,” Dr. McCann explains. “In that setting, there could be various treatment options, such as the best supportive care for quality of life. Chemotherapy, immunotherapy or radiation could be options. We present patients with choices, talking through the risks and benefits of each approach so they have a good understanding and can make informed decisions.”

This frankness is welcomed by patients who come to University Health System with advanced disease. Dr. McCann and her colleagues emphasize from the first appointment that they will give patients clear, honest information to help them make sound decisions.

“Once I preface that at the beginning of the relationship, they open up immediately,” she says. “They appreciate being an active member of their own medical team. They appreciate knowing what’s happening and why we make the recommendations we do.”

“Our gynecologic oncology program provides treatment for the whole patient. We are there with them through diagnosis and surgery if indicated, we administer their chemotherapy, and we draw on other specialties as needed. We know and understand all their medical problems, and often we manage most of these while they’re in treatment. Afterward, when there’s no evidence of cancer, we continue to see patients for five years — but often, they choose to keep coming back to us because they’re so happy with their gynecologic care.”
— Georgia A. McCann, MD, gynecologic oncologist at University Health System and Assistant Professor in the Department of Obstetrics and Gynecology at UT Health San Antonio

A Hub for Advanced Research

As its reputation grows on the national level, the health system is ramping up its research program, building a women’s and children’s health tower with additional patient rooms and surgical suites and adding a gynecologic oncology fellowship program to attract the nation’s most talented graduates and faculty.

Dr. McCann is spearheading an effort to begin clinical trials and further extend the findings of medical research to area patients.

“Over the past year, we have expanded the options we can offer our cancer patients, and we’re looking forward to the developments that will continue into next year,” she says. “Our gynecologic oncology group is collaborating with pharmaceutical companies to develop and open clinical trials for patients. As time goes by, we aim to become a hub of clinical research in San Antonio.”

Among these trials, the Juno investigational CAR T cell product studies are particularly relevant for women with ovarian cancer. The study is investigating the effectiveness of cyclophosphamide followed by intravenous and intraperitoneal autologous T-cell infusions. The T-cells are genetically engineered to secrete IL-12, a cytokine that attacks MUC16 protein, which is present in about 70 percent of ovarian cancers.

Another exciting line of research is an ovarian cancer screening trial in collaboration with MD Anderson Cancer Center. Open to postmenopausal women with intact ovaries and no history of ovarian cancer, the trial seeks to develop an accurate screening test for ovarian cancer. Researchers believe they have discovered a noninvasive screening method for this disease, which is notorious for its tendency to be discovered late in its progression.

“This screening uses annual blood tests measuring the CA 125 value to identify a trend over time,” Dr. McCann says. “It’s very straightforward. It opens a welcome avenue to potentially prevent ovarian cancer. Women answer a few quick questions and have their blood drawn. Depending on the result, the screening is repeated annually, though we ask some women to return in three months.”

Other lines of research investigate PARP inhibitors and immunotherapy, Dr. McCann adds. Trials such as these provide unique opportunities for women who otherwise would have to travel to Houston or beyond to access experimental therapies for their disease.

“In July 2020, we’ll open the doors to our fellowship program in gynecologic oncology. This represents the highest level of medical education and training available. Residents graduating from OB/GYN programs can come train with us. This step gives us national recognition, and also helps us develop our residency platform.”
— Georgia A. McCann, MD, gynecologic oncologist at University Health System and Assistant Professor in the Department of Obstetrics and Gynecology at UT Health San Antonio

Multidisciplinary Care for Complex Disease

Patients with complex and advanced diseases make up a large proportion of the women Dr. McCann and her colleagues see because University Health System has become the San Antonio referral center for patients whose cancer is particularly complicated. Patients may include women who have had previous surgeries or radiation treatment, whose disease may involve multiple organs or those with other health conditions complicating treatment.

The multidisciplinary approach at University Health System, led by specialists such as Dr. McCann, fortifies the team’s ability to help women with challenging pathology. Together, these specialists translate the insights gained through research and experience into personalized treatment plans.

“One unique thing about our program and the surgeons who operate here is the multidisciplinary nature of the care we provide,” Dr. McCann says. “We meet weekly at multidisciplinary tumor boards; providers from oncologists and surgeons to palliative care specialists and case managers are present. We look at a patient’s total needs — we don’t just focus on the cancer. It’s a unique collaboration as far as cancer care delivery.”

This collaboration extends into the operating room, where five or six surgeons may assemble to perform an aggressive procedure for patients with complex pelvic pathology, Dr. McCann says. Some procedures may require multiple organ removal; others may be complicated by prior radiation, widespread disease or pelvic fistulas that need repair.

“It takes an army of physicians, surgeons and nurses to deliver that kind of care,” Dr. McCann says. “This is something unique to us. Patients are referred to us because we can muster multispecialty teams to treat exactly these conditions.”

Purple Heals

Soon after arriving at University Health System, Georgia A. McCann, MD, gynecologic oncologist at University Health System and Assistant Professor in the Department of Obstetrics and Gynecology at UT Health San Antonio, met a young woman who had been diagnosed with advanced ovarian cancer. During three years of treatment, the woman impressed Dr. McCann with her coping skills and ability to turn her experience into advice and solace for others.

“I put her in touch with other patients after their diagnoses,” Dr. McCann says. “She could speak with them and provide comfort, advice and support. She would do it without question.”

After the patient died, Dr. McCann founded a support group, Purple Heals, for women with gynecologic cancer. The group, typically consisting of 15–20 patients and survivors, meets monthly. Members need not be University Health System patients. Often, they are joined by family members and medical providers.

“The magic is when other patients can explain to family members what their relative is going through,” Dr. McCann says. “It’s a unique opportunity to see the other side.”

Purple Heals meets on the third Wednesday of each month at 6 p.m. in the Medical Arts & Research Center Conference Room B at 8300 Floyd Curl Drive in San Antonio. Visit UTHealthcare.org/purple for more information.


To learn more, visit universityhealthsystem.com/GYNreferrals.