(upbeat music) - We're now joined by Dr. Ami Vaidya, who is co-vice chair of the Department of Obstetrics and Gynecology at Hackensack University Medical Center.

And also, she's affiliated with John Theurer Cancer Center as co-chief for the gynecological oncology division at the John Theurer Cancer Center.

Good to see you, doctor.

- It's great to be here, Steve.

- Let's get right to this issue of gynecological cancers.

What are we talking about specifically, A, and B, how prevalent are they?

- So, when we talk about gynecologic cancers, we're talking about cancers that essentially affect only women.

We're talking about cancers of the female reproductive tract, which include ovarian cancers, fallopian tube cancers, uterine and cervical cancers, as well as vaginal and vulvar cancers primarily.

Fortunately, these are not very common cancers of the group.

Most common are endometrial or uterine cancers.

And the incidence for women is about, a lifetime risk of about 3%.

- Let me do this, because I work with many of your colleagues.

I teach, to disclose, in the HMH, the Hackensack Meridian Health Physician Leadership Academy, and many of them come out of the OB, if you will, world.

But I'm curious about this as I've talked to them and tried to understand this.

Genetic testing keeps coming up and I've tried to understand what is genetic testing, how does it relate to the work you do, and what is relevant, more importantly, for our audience watching?

- So, genetic testing has really undergone an incredible transformation over the last several years.

What it is, is a means by which we can try to identify individuals who are at risk for certain diseases.

Since we're talking about gynecologic oncology, we're specifically talking about blood work that will allow us to identify those individuals who may have inherited a mutation from either of their parents and are at higher risk of developing some of these gynecologic cancers that we're talking about.

We do have quite a bit of information about certain genetic mutations such as BRCA1 and BRCA2, which- - What does that mean?

Help to understand BRCA1, BRCA2.

- Sure, absolutely.

So, these are two genetic mutations that again, can be inherited from either parent.

An individual carrying this genetic mutation would not feel ill.

They wouldn't know that they have it unless they underwent testing.

But for those that do have this mutation, these are individuals that are at higher risk for developing breast cancer, and risks as high as 60 to 80% in some groups.

Ovarian and fallopian tube cancers, risks as high as 20 to 40%.

And that's really significant.

That's much higher than the general population.

- You know what's so interesting, this genetic testing, I've never said this on air but I'm going through some genetic testing 'cause my dad had vascular issues, I've got some vascular issues.

And the genetic testing, the specialists in the field were telling me, "Steve, it'll tell us certain things.

It won't tell us everything."

Is that the same approach, philosophy, fact is true in the genetic testing involved with the work that you and your colleagues are doing?

It won't tell us everything but it tells us something.

That's important.

- That's absolutely true.

The technology has moved so fast that we have some information that we don't even fully know how to interpret for the genes that we've identified and have established and have linked to certain cancers.

That's just one piece of the puzzle.

There're other variables like the environment, what do we do to our bodies, you know, as we live our lives.

- That's right.

- These are things that also pose risk for developing certain diseases.

So you're right, the genetic piece is not the be-all, end-all answer but for some patients it can provide a really helpful piece of insight into the possible future and allow patients to make decisions about screening for cancers and even, in some cases, decisions about doing things to prevent certain cancers.

- Okay, let's fast forward, because doctor was talking about gynecological cancer, cervical cancer, ovarian cancer, uterine cancer, vaginal and vulvar cancer.

Now, prevention, screening, or testing, all that treatment, relevant and important.

If, big if, if a woman opts for surgery now versus 15, 20 years ago, as we're talking about robotic surgery, what exactly are we talking about and what are the potential benefits to a patient, doctor?

- So, I'm a huge advocate, a huge proponent for robotic surgery because I've seen over the last 15 years just what a big difference this technology has done for our patients.

In a nutshell, we're talking about very advanced, minimally-invasive surgery that allows us to do really complex procedures, cancer cases in many cases, at a way that allows for better cosmetic results, less postoperative pain and thereby less narcotic use, shorter recovery times, shorter hospital stays, often significantly lower rates of infection, and decrease in blood loss.

I mean, these are tremendous wins for the patient because of technology that's allowed us to access the body in a way that sort of old-fashioned, now, laparoscopy just never could.

- So much important information and a couple other questions here.

Preserving fertility.

Where are we now compared to where we were, you say, five, 10, 15 years ago?

Go ahead, please.

- So, fertility preservation is a very big deal as we are identifying women with cancer and especially identifying younger and younger women with cancers.

Or the flip side of that, some women just delaying childbearing based on numerous, you know, personal reasons.

Well, we are seeing women that want to have an opportunity to preserve fertility wherever possible.

We work really closely with our infertility specialists.

Again, technology has helped.

We've been able to harvest eggs, for example, for women who may be undergoing treatment where those eggs could be be compromised and thereby fertility could be compromised.

In addition, we have testing now that can be done for those individuals, we were just talking about genetics.

Individuals who are found to have certain genetic mutations may not wanna pass those on to their offspring and it is now possible to actually test embryos.

So, to have a woman's eggs fertilized by her partner's sperm and actually test those embryos to find out if any carry a genetic mutation.

This really allows individuals, then, to select which embryos would be transferred back and to try to spare their offspring, you know, certain cancer and other disease risks.

It's really quite amazing what we can do, even from a single egg.

- The science, the technology, the innovation, the advancements.

Extraordinary.

Next time when you join us, doctor, I wanna talk about the issues of mental health associated with a lot of the cancers that you're describing and the treatments and the protocols, but more importantly, the impact on the patient and her family.

And also, let me just say that HMH is a supporter of our healthcare programming.

Doctor, I wanna thank you so much for joining us.

We appreciate it, very educational.

- Thank you so much for having me.

- You got it, I'm Steve Adubato.

Stay right with us, we'll be right back.

- [Narrator] One-On-One with Steve Adubato has been a production of the Caucus Educational Corporation.

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