CANCER

CANCER DETECTION

Ultrasound can be done a few ways depending on the patient, the reason for the ultrasound, and the request from the referring doctor or healthcare provider:

Cancer of the gynecologic organs is possible in anyone assigned female at birth, though not common. The main gynecologic structures that can possess cancer are the uterus, cervix, and ovaries. While the investigation for and diagnosis of cervical cancer is not usually based on imaging tests, uterine and ovarian cancer investigation will usually involve an ultrasound.

Uterine / Endometrial Cancer

Excluding the cervix, the uterus is essentially made up of two areas - the endometrium and the myometrium. Endometrial cancer is more common than cancers of the myometrium (usually called sarcomas). Endometrial cancer is more common in postmenopausal people.

A person is considered to be menopausal when a year has passed since their last period. Any bleeding after this time is always considered to be potentially abnormal - and this raises the concern for potential cancer or pre-cancerous changes of the endometrium. However, there are many more common benign causes of postmenopausal bleeding and only a small proportion of people who bleed after menopause have anything significantly wrong.

When postmenopausal bleeding occurs, ultrasound can be used to evaluate the uterus and specifically, the endometrium. The endometrial lining can be measured using ultrasound. There are many studies that show that if the lining of the uterus is thin (< 5mm), then it is very unlikely that there is anything significantly wrong.

In this way ultrasound can be used to reduce the need for unnecessary and more invasive investigation. If the endometrial thickness is increased, then Saline Infusion Sonohysterography (SIS) can be performed to assess for intra-cavitary focal lesions such as endometrial polyps. Though not done at the same time as ultrasound in most settings, an endometrial biopsy may be done to collect a sample of the tissue for a pathologist to evaluate under a microscope for cancer or pre-cancerous cell changes.

Ovarian Cancer

Some details about ovarian cysts in general and the approach we take at SUGO can be found here. Ovarian cancer is rare, but a diagnosis is of the utmost importance so that therapy can be faciliated as soon as possible. Besides benign ovarian cysts, ovarian cysts can be borderline or cancerous, both of which are considered in the “cancer” umbrella. Borderline cysts are sometimes referred to as “tumors of low malignant potential” or “atypical proliferative tumors”. Borderline cysts usually need to be removed as they have a dangerous potential. Patients with borderline cysts could have fertility-preserving surgery if desired.

In most cases, ovarian cancer can be differentiated from benign cysts and from borderline cysts using ultrasound. The key is that ultrasound examination and interpretation, like any diagnostic imaging test, is dependent on the skill and experience of the examiner as well as the quality of the ultrasound equipment. At SUGO, we are able to differentiate between benign, borderline and cancerous ovarian cysts in most cases by performing a systematic and detailed analysis of the cyst appearance using the IOTA group approach and predictive models such as ADNEX. In some cases, the diagnosis can be augmented by a blood test like CA125. The information gained from a high quality ultrasound can enable expeditious care to the right doctor, whether that is a gynecologic oncologist or general gynecologist.

Halie Wilcox

03:50 17 Feb 23

I had the absolute pleasure of attending this clinic recently. I was referred to this clinic by an OB-GYN in St. Catharines and drove to Hamilton in order to have what was explained to me as “endometriosis mapping”.I would first like to describe myself as being an extremely anxious person when it comes to anything medically related.Now with that being addressed, upon entering this clinic, the atmosphere was spectacular. I could immediately tell that the owner took great pride in the way that this clinic was presented. Both the waiting room and the bathroom were beautiful and empowering. I found this clinic aesthetically pleasing and calming.As for my procedure, it truly exceeded all of my expectations. Dr. Leonardi and the sonographer were amazing. I received more information in 30 minutes than I ever have about my reproductive system.I am extremely grateful that I had the opportunity to speak with Dr. Leonardi. I truly believe that what he has established with his clinic is ground breaking for women with endometriosis.I witnessed my mother struggle for years with this disease. Seeking out medical help and almost always being ignored. Thank you Dr. Leonardi for being so informed and accessible.

Mikaela Frankovich-Ross

19:08 22 Jan 23

My experience at SUGO was informative and efficient. The staff were kind and I was seen on time.My experience with Dr. Leonardi was by far the most valuable care I have received in relation to Endometriosis. Dr. Leonardi was straight forward and thorough when answering my questions. I highly recommend Dr. Leonardi and SUGO for concerns related to Endometriosis. Thank you for your dedication and hard work.

Wei Deng

17:45 24 Nov 22

My OB referred me to SUGO for a third trimester growth scan. The check-in process was smooth. My sonographer Lee was welcoming and friendly, keeping me informed throughout the scan. I also appreciated them accommodating my mother in for a quick viewing at the end, which I know can be difficult elsewhere during COVID. I also noticed how modern and well-kept their equipments are. Overall very satisfied with my experience at SUGO!

Angela Commisso

19:07 20 Aug 22

I was referred to SUGO from my OBGYN, and was immediately impressed with the overall cleanliness of the office, and kindness of all the staff at the office. Dr. Leonardi immediately made me feel comfortable as his patient. He is considerate, trustworthy, kind, and kept me informed throughout the process. As women we go through so much and it can be stressful, but I felt very reassured with him as my Dr. You are in good hands with Dr Leonardi and all the staff at SUGO!