Gynecologic Oncology Institute features high-tech robotic surgery & personalized 21st century molecular medicine, combined with a warm touch natural integrative approach and holistic care.
21st Century Cutting-Edge Treatment Options
Extensively Discussed & Applied to YOU as an Individual
Science-Informed Nutrition and Mind-Body Options
Hand-Held Guidance Throughout Your Experience
Dr Vasilev, our Medical Director and lead surgeon, is a quadruple board certified gynecologic oncologist.
He is frequently featured in articles and commentary about women's health concerns including cancer,
advanced robotic surgery, endometriosis and other topics in multiple media channels, magazines and news
In the end, what people say reflects the age-old saying "the proof is in the pudding". We walk the talk and help people emerge from the other end as quickly as possible, with personal support.
APPOINTMENTS ARE PERSONALLY-SCREENED & EXTREMELY LIMITED
FREE Records Review
If after review it is determined we can help you, a consultation will be scheduled as expeditiously as possible. If the fit is not there and we think you will be better served by someone else, we will help advise and guide you to the right physician.
Keyhole "minimally invasive surgery", which avoids open surgery and large incisions, is highly enhanced using robotically assisted technology using the Davinci surgical system. It makes the surgery far more precise because instead of straight instruments, which make instrument movements during surgery “herky-jerky” and imprecise far too often (similar to a novice eating with chopsticks), robotically assisted surgical instruments are finely controlled to avoid anything but smooth motion. In addition, the instruments have joints at the tips (like a hand and wrist) making them far more flexible for precision delicate surgery. Finally, the surgeon’s vision is magnified and in 3D, making the anatomy of the surgery much more clear. All of this translates to the ability to perform complex surgery safely and precisely, minimizing complications and optimizing healing. You benefit from a shorter hospitalization or sometimes can go home the same day.
Robotic surgery excellence for advanced cancer and endometriosis surgery demands far more than robotic training and certification. That’s the kindergarten level for beginners with the DaVinci surgical system. Experience matters in getting the result you want for difficult cancer surgery, re-operative surgery (multiple prior surgeries) and endometriosis excision surgery. It is not a matter of just how many cases the surgeon has performed but also how difficult they are. You can rest assured that Dr. Vasilev has more than 30 years of experience in advanced radical surgery, and has taught hundreds of physicians-in-training (residents and fellows) in precision radical techniques and surgeries deemed impossible by other surgeons. For almost a decade he has been using this advanced skillset using minimally invasive robotic surgery technology. The results can never be guaranteed but often can be nothing short of miraculous, combining radical yet meticulous surgery with 21st century robotic surgery technology and small incisions.
For both benign and malignant conditions surgery is often the fastest, best or sometimes the only route to cure. When this is the case, large incisions are usually no longer necessary. Using 21st century robotically assisted technology it is possible to avoid long healing times and accelerate recovery. Faster recovery, less blood loss, and usually much less tissue damage is the result of this highly precise robotic surgical approach.
Tiny incisions, often hidden below the bikini line and in the belly button, replace unsightly incisional scars in performing a hysterectomy. A few of the additional incisions may be visible but are the size of a pencil eraserhead and can heal in a way that they can be almost invisible. This less painful, rapid recovery, quality of life-preserving and body-image-preserving approach is availble for cancer and endometriosis surgery at the Gynecologic Oncology Institute. The surgery is done through small incisions and, in the majority of cases, the uterus can be removed via the vagina.
Robotically assisted minimally invasive laparoscopic surgery has many gynecologic applications. If you have rapidly enlarging fibroids, a suspicious ovarian mass or cyst, diagnosed cancer of the uterus, cervix or ovaries, endometriosis or other gynecologic surgical conditions, the Gynecologic Oncology Institute may be a good fit for you. Dr. Steven Vasilev MD is a surgeon with over 30 years of experience and, with his team and colleagues, can help you with surgery that offers the fastest possible recovery and the results you want. We specialize in bringing minimally invasive surgery to help heal difficult gynecologic conditions, including advanced cancer and endometriosis.
Studies show that recovery from minimally invasive surgery is much faster in terms of going home faster, getting back to your routine quicker and healing better with less external and internal scars. While this is true of laparoscopy as well, robotic surgery is performed with less torquing of the instruments at the muscle of your abdomen and less ripping and tearing internally. This means less pain and less tissue damage, which means healing is optimized. It’s all about recovery, to get back to life or the next phase of your treatment as soon as possible.
Advanced endometriosis and complex gynecology problems, such as large and rapidly growing uterine fibroids, as well as ovarian masses suspicious for tumors, require advanced skill pelvic surgeons to get the best outcomes. We offer treatment and surgery for these conditions and more. Dr. Vasilev’s uber experience and advanced skill-set in surgery transcend to the next level. He is often called upon to help where other surgeons have not succeeded. These skills, combined with high-tech robotics minimally invasive surgery and warm-touch integrative holistic support sets us apart. You get a shorter hospitalization or no hospital stay, and no open surgery incision to have to heal from.
Uterine myxomas, or fibroids, are very common. Up to 80% of all women have them. However, when they become very large or are rapidly growing there is an increased risk of cancer (sarcoma) and surgery to remove them becomes very challenging. We offer second opinions and work with your referring physicians to determine the best course of action, including advanced robotically assisted surgery.
Not all cysts of the ovary are dangerous, and some are “physiologic”, meaning they normally come and go with menstrual cycles. But those that persist or are growing or occur after menopause can be tumors, which can be benign or malignant. We offer all of the diagnostics to help determine which is which and offer advanced minimally invasive surgery where needed.
Some ovarian masses which have suspicious characteristics on ultrasound can be “low malignant potential” or “borderline”. These can be tricky in that some are actually overtly malignant, while others behave like they are benign. A gynecologic oncologist should be involved in your care in these situations for the best outcomes.
Endometriosis grows on and into tissues just like cancer, making excision as difficult as the most challenging cancer surgery. The tissues that can be affected are bowel, your bladder and the ureters (which connect the kidneys to your bladder). These are all delicate structures which require a very different skill-base for safe surgery, such as those of an oncologic surgeon.
For this reason, as well as the increased risk of ovarian cancer, you should consider a gynecologic oncologist to be involved in your surgery. Dr. Vasilev collaborates with other surgeons, including other endo-excision surgeons, to get you the best outcomes.
In addition to the above, in a significant percentage of cases, endometriosis can actually degenerate into or be associated with gynecologic cancer. When this happens it is usually later in life, but it is best when your surgeon can handle whatever is required during surgery. Experience matters and level of skills are critical. Today’s gold standard for endometriosis surgery is robotically assisted minimally invasive excision of endometriosis as part of an overall treatment plan which includes medical/hormonal treatments.
While simple laparoscopy can accomplish the same result in skilled hands, this is generally only true with less advanced endometriosis. Many argue this point, but robotic technology is inherently vastly superior and allows meticulous endometriosis excision under magnified 3-D view with instruments that are more like tiny little hands rather than straight scissors and graspers reminiscent of clunky chopsticks. The number of incisions can be very similar or exactly the same in skilled hands. For advanced endometriosis excisional surgery the Gynecologic Oncology Institute stands among the best under the leadership of Dr. Steven Vasilev and his team.
One in ten women have endometriosis, whether or not there are symptoms. Endometriosis is a benign condition and, while it is almost never life threatening, can behave like ovarian cancer by invading local organs like the bladder and bowel.
Symptoms are usually related to pelvic pain, but very often the main symptom is bloating. Bloating is often considered a symptom of ovarian cancer. So, how does one tell the difference? The problem is that you can't. The likelihood is that you are "OK" based on pure numbers and rarity of associated cancer....until it is not OK in any given individual.
While we know the risk of associated ovarian cancer or malignant degeneration to cancer of the endometriosis itself is very low (<1%), it is still a concern. Even 1% of the estimated 15 million women who have endo in the United States (one in ten women) means that up to a hundred thousand women may end up with a related cancer during their lifetime. Most often, this happens in older women and may be influenced by uncommon genetic mutations that are shared between cancer cells and endometriosis.
A gynecologic oncologist can help guide you to make sure you are at as low a risk as possible and operate to diagnose and remove endometriosis if the suspicion is high.
Gynecologic Oncology Institute is a referral center for concerns regarding endometriosis and cancer and are happy to help evaluate, reassure or treat when needed.
Maximize your chances to defeat your gynecologic cancer and/or reduce your risk of recurrence using our unique combination of standard therapies integrated with complementary holistic natural support towards a thriving survivorship. The goal is to “cancer-proof” or “anti-cancerize” your body as much as possible. Basically, this means making your body as inhospitable as possible to cancer growth, while using all available targeted precision therapies to interfere with cancer promoting pathways.
Endometriosis is also an inflammatory disease, like cancer, and that is partly why there is a connection between ovarian cancer and endometriosis. It is far more complicated than that, but integrative healing can help improve life and treatment for endometriosis as well.
Integrative healing includes nutrition, life-style modification, toxin avoidance, targeted supplementation, mind-body support, biofeedback and energy medicine. These cannot replace mainstream therapy. However, while “alternative” hype and junk therapy are useless, integrative natural holistic complementary healing is essential for your recovery and for thriving in survivorship.
After surgery and/or cancer treatment the goal is almost always to cure or at least promote good quality-of-life remissions, measurable in years. Having faith and a good attitude is important, but simply hoping the cancer will not return is not a good strategy for recurrence prevention. There are many natural approaches to cancer-proof your body to reduce the risk of recurrence as low as possible. In addition, there are biological therapies available for some cancers that also reduce risk of recurrence, or at least delay recurrence for many months or years.
For our cancer patients, YOU are different and unique. Every cancer is also different and not just based on what organ it came from (e.g. ovary)! Cancers differ at the genomic and molecular level. Both you and your cancer ALSO change over TIME. So why be treated like “everyone else” with the same old “standard” treatment plan? YOU deserve personalized therapy!
For example, it was recently reported that the median overall survival was eight years longer in ovarian cancer patients treated using molecular profiling. The future is here!
Cookie-cutter “one size fits all” medicine will soon be history. You owe it to yourself to discover the difference. Science-based cancer therapy combined with a personalized approach is the 21st century way to treat malignancies. It’s the ultimate way to optimize your chances to beat cancer and includes the very best of 21st century surgery, Western and Eastern medicine. Come see us: Survive and Thrive!
Our approach is very detailed and complex and is, by definition, very individualized. We take “personalized cancer therapy” and survivorship to the next level, as follows:
Cancer is partly genetic, but also largely related to lifestyle choices. In general, you have a large say-so in whether or not you get cancer. Screening and lifestyle choices modification goes a long way towards avoiding many cancers.
Today’s screening is advancing at a rapid pace and involves cutting edge molecular tools. It is appropriate for some, but not for all, depending on your risk. In some cases, like Angelina Jolie, risk reducing surgery can be lifesaving. All of this is highly individualized to you, and can apply to endometriosis patients as well.
Today’s surgery is far less invasive, even for bigger or more extensive gynecologic cancers which normally require large incisions. Minimally invasive surgery allows you to recover faster, get back to life quicker or get to the next phase of treatment (when required) much faster. For pre-cancers or extensive benign diseases, like advanced endometriosis or complex pelvic masses, robotically assisted surgery can make all the difference towards fast recovery.
Cancers are different from organ to organ, body to body, one point in time to another and from one area to another. This is all based on the genomic alterations or mutations that occur in cancer cells, which change over time and from one tumor to another. Techniques called next-generation sequencing (NGS) or molecular profiling can look for mutations that can be attacked precisely using the newest biologic agents. Testing can be done on tissue or blood (liquid biopsy), and usually both. This forms the basis for personalized treatment plans for cancer.
Anti-cancer nutrition and optimization of your microbiome is central to “cancer-proofing” your body as much as possible to prevent cancer or even reducing the risk of recurrence. Everyone is different but, in addition to a baseline optimization of your nutrition and microbiome, there are science-supported strategies that are based on biomarkers and genetic polymorphism analysis.
Integrative holistic medicine takes the best of natural and complementary support modalities to help reduce symptoms caused by disease, help get at the root cause of these symptoms and help you survive and thrive through treatment and far beyond. From nutrition to acupuncture, targeted supplements and herbals, mind-body techniques and much more, supporting and enhancing your disease-fighting ability is crucial to your success in beating any debilitating disease, including cancer.
After treatment is over there is much you can do to proactively enhance your mind and body to fight off disease and do everything possible to ward off recurrence. So, if your current post-treatment plan is “watchful waiting” with tumor markers and scans, you need an opinion at the Gynecologic Oncology Institute. Discover the difference!
Precision cancer treatment uses cancer’s genomic DNA blueprint against itself, targeting cancer with smarter more precise attacks than empiric chemotherapy.
Other than surgery and precision genomics based therapies for cancer, we offer:
Heated intraoperative intraperitoneal chemotherapy is fast becoming a standard of care option for treatment of advanced malignancies, including ovarian cancer. At Saint John’s we can offer you safe high-tech state-of-the-art HIPEC. If you have been diagnosed with ovarian or advanced endometrial cancer, this may be an option for you when combined with interval cytoreduction surgery. Our cytoreduction approach is often minimally invasive using robotic technology, in order to avoid larger incisions.
First of all, what are ovarian cysts, how did they get there and are they all the same kind? If you did not ask these three questions, you may be on the wrong path towards getting rid of the type of ovarian cysts that you have. If someone tried to treat you without explaining the differences, you may be working with the wrong doctor.
You’re not alone in having any of these ovarian cysts, but there are DEFINITELY more than a few different kinds. Literally millions of women have various types of cysts grow on their ovaries during their lifetime, sometimes once and sometime many times. The key to successful treatment and prevention is to realize that there is no “one-size-fits- all” type of “cure”.
It is important to understand that most ovarian cysts can be successfully treated medically and naturally, but ovarian tumors can’t. Tumors can be benign or malignant (cancer), but they NEVER go away on their own and can threaten your life. This is a crucial distinction that you need to find the answer to before wasting time or putting off a surgery that you might really need. In some cases, that surgery can save your life. On the other hand, you need to know enough to avoid a surgery you may NOT need. You are about to learn about all of this and how to find out what else you need to know to make the right choice for YOU!
If you have endometriosis, the chances are very high that it will be growing on your ovaries, forming cystic masses called endometriomas. Endometriosis is a benign (not cancer) condition or disease where cells and tissue of the same type that are normally found inside the uterus (endometrium) start growing outside the uterus and mostly inside your pelvis.....in the area that your ovaries and bladder and rectum are located. The good news is that even though 70% of women with endometriosis have it growing on their ovaries, only 5% actually develop a significant size endometriotic cyst that actually causes problems. Also, a small percentage (<1%) can develop cancer.
So, cysts are largely benign and can go away on their own. Tumors are a subset and usually require surgery. Cancer is even a smaller subset, but it can threaten your life. Find out what is going on in your body with an understandable opinion from a doctor that you connect with.
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