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Dr. Heidi Gray

Dr. Heidi Gray
Dr. Gray specializes in taking care of women with gynecologic malignancies, including ovarian, uterine, endometrial and cervical cancer.  She is inspired by her patients and the strength and grace with which they deal with their difficult situations.   While most oncology specialties split the surgical and medical sides of treatment, GYN oncologists provide both the surgery and manage the follow-up treatments  Through her specialized training, singular focus on GYN cancers, and the ability to establish relationships beyond the surgery, Dr. Gray is able to provide better outcomes to her patients. Dr. Gray and her team at SCCA are set apart from other programs in the area with their weekly multidisciplinary conference.  Each surgical case is reviewed by the combined expertise of her division, pathologists, and radiation oncologists.

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Ovarian Cancer Biology and Facts

Dr. Heidi Gray describes ovarian cancer biology and facts. Ovarian cancer is the 2nd most common gynecologic cancer in the United States, affecting 22,000 - 25,000 women annually. It is less common than other forms of cancer such as breast cancer, but is difficult to treat as it is often diagnosed at a later stage where it has spread outside the ovary. There are not a lot of known risk factors, but approximately 15-20% of ovarian cancer cases are caused by a genetic mutation passed down in families. All women diagnosed with ovarian cancer should undergo genetic counseling and testing for the two most common genetic mutations, BRCA1 and BRCA2 mutations.

Ovarian Cancer Symptoms and Risk Factors

Dr. Heidi Gray describes ovarian cancer symptoms and risk factors. Ovarian cancer is the 2nd most common gynecologic cancer in the United States. Unfortunately the symptoms are nonspecific, such as bloating, mild abdominal pain, or changes with bladder, which are often attributed to other factors before discovering they may have ovarian cancer. As a result most ovarian cancers are diagnosed at a later stage. There is also not a successful screening strategy as few risk factors are known. The most common risk factor is genetics, which causes only 15-20% of ovarian cancer cases. All women diagnosed with ovarian cancer should undergo genetic counseling and testing for known genetic mutations, as they can have a higher risk for other disease such as breast cancer, and to alter family members to be screened.

Ovarian Cancer Treatment

Dr. Heidi Gray describes the best current and promising future treatment options for ovarian cancer. Treatment for the majority of ovarian cancer cases start with surgery. The initial surgery is most important, the goal is to remove all visible tumor. Patients at the end of their first surgery who have no visible disease have the best outcomes, even if it's advance stage cancer. The next step for most patients is chemotherapy. Patients who have had optimal surgery tend to do best when you deliver chemotherapy intravenously into the veins and interperitoneally into the abdominal cavity. Patients who have had suboptimal surgery are offered dose-dense taxol and carboplatin chemotherapy, or potentially a clinical trial. Minimally invasive techniques for ovarian cancer are still in their infancy, most surgeries are open surgeries because they provide the best outcomes. Most patients will experience a recurrence within 1 to 3 years after their initial remission. PARP inhibitors offer potentially a less toxic therapy and a potential for maintenance therapy where patients can go on a treatment for a prolonged period of time that will prevent their recurrence.