MY PRACTICE in Portola Valley in Gynecological Oncology (cancer surgery and complex pelvic surgery) is based at Sequoia Hospital in Redwood City, CA. I welcome new surgical as well as all gynecological cancer patients. I am sub-specialized (see my resume) in the surgical care of pelvic problems from benign to malignant.

WE SEE AND OPERATE on patients from every state, and will make your surgery visit very safe and convenient for you. If you want to come to meet me in one visit, and then return later for surgery, just call the main office number above and schedule your first visit.

However, many patients will want to schedule everything in “One-Stop,” coming to our office for their first visit the day before we plan to operate, with both the office visit and the surgery scheduled well in advance. This takes careful planning ahead of time, but we do it often, safely, and easily. We will need to plan your consultation ahead of time by reviewing the faxed reports of the studies that you have had done, and we may possibly need to order other tests before you arrive so that all is ready on the day of your consultation.

TO BEGIN PLANNING YOUR SURGERY: Download and print the Pre-operative instructions and Recovery Information. This document explains every bit of your surgical preparation and recovery. Read it well before your visit, writing down any questions you may have. Bring this document to every visit and especially to the hospital. It describes your recovery in great detail so that there are no surprises, and it contains your discharge instructions, including what kinds of problems warrant an emergency call. You will need to re-read the “Discharge to home” section before you leave the hospital.

DOCTORS: Come to learn TLH! Register online for the 5th ANNUAL SURGICAL MASTERS’ COURSE on TOTAL LAPAROSCOPIC HYSTERECTOMY AND ADVANCED LAPAROSCOPIC AND ONCOLOGIC PROCEDURES at the fabulous Hotel Nikko San Francisco on April 22-24, 2010. Come with a partner for maximum utilization.

• Pelvic mass, Ca 125, and Ultrasound
• Cancer of the ovary
• Cancer of the uterus, and uterine pre-cancer
• Cancer of the vulva and pre-cancer (PDF)
• Cancer of the cervix, and cervical pre-cancer (dysplasia)
• Treatment of abnormal pap smear / Guidelines for therapy(PDF)
• Total Laparoscopic Hysterectomy +/- oophorectomy
• Laparoscopic radical hysterectomy and catheter care(PDF)
• Radical vulvectomy (PDF)
• Familial ovarian cancer( PDF)
• Pain or bleeding, adenomysosis or fibroids and avoid need for hysterectomy
• Trophoblastic or placental cancer (PDF)

ABOUT GYNECOLOGIC SURGERY: Besides surgery for the above cancer and pre-cancerous reasons, some women may need a hysterectomy (removal of the uterus) for benign reasons such as pressure from large fibroids, pain or bleeding that can't be managed by natural methods, pills or hormones. Some have a leaky bladder when coughing, laughing or sudden motion. Some are Female to Male Transsexuals and need hysterectomies. How do you know you need a hysterectomy or removal of your ovaries? The answer is: If there is no other way to manage the symptoms, and the symptoms bother you. Hysterectomy and removal of the ovaries have gotten a bad reputation ever since some doctors performed them unnecessarily or failed to help their patients feel their best afterwards. Extensive research tells us that 98% of women who have a hysterectomy are actually very satisfied or happier than before and breast, uterine, and ovarian cancers are significantly reduced.

IF YOU NEED A HYSTERECTOMY, have it done by laparoscopy! Recovery is quicker with four tiny incisions. There is less blood loss, less pain, shorter hospital stays and speedier return to work than with large, open-incisional surgeries. Complications are not higher. We perform nearly every hysterectomy by four tiny half-inch incisions, using a camera and long instruments, called Total Laparoscopic Hysterectomy. We do not ever leave the cervix in. I have performed well over 1000 total laparoscopic hysterectomies (TLH) since 1996 and have a very low complication rate. TLH is used for all benign surgeries and most malignant surgeries. Women with masses suspicious for cancer, uterine cancer, massive uteruses from fibroids (size of a 24 week pregnancy), women in their 90s, and women who have very high body mass tolerate this procedure better than the long incisions. I presented my data about laparoscopic surgery for endometrial cancers and ovarian tumors, or taught these procedures at the annual international meeting of the Society for Gynecologic Oncologists yearly for the past five years.

SHOULD THE OVARIES COME OUT? When planning an operation, it is important to think about what else should be done during the surgery that could prevent or reduce the need for future surgeries. (Do you have killer premenstrual mood changes, migraines, or severe menstrual pain? if so, now is your chance for freedom!)

WILL YOU NEED HORMONE THERAPY as you enter your surgical or natural menopause in 2009? What if you are under age 51? What if you've had breast cancer? What if you come from a family with many members with breast or ovarian cancer? You may need genetic testing. If you are BrCa positive, it will be important to consider removal of the uterus, tubes and ovaries as the cancer risk in each of these organs is significant. Fill out this questionnaire about your family history and send to me. We will need your consent if testing will be done. Should women with BrCa mutations have their uterus removed prophylactically along with their tubes and ovaries? What are some proven alternatives to estrogens? Who should use vaginal estrogens? How do I reduce risk factors for heart disease or breast cancer and intepreting their bone density measurements. I believe it is also important for each of us to have some knowledge about the common diseases that lay us women up, including understanding the risk factors, the screening tests and how to reduce risk. It is possible to reduce risk for cancer, osteoporosis and heart attack with good nutrition, smoking cessation, exercise, multivitamins. Are you experiencing a low libido?

TOO LITTLE IS KNOWN ABOUT LESBIANS' HEALTH issues, and, in particular, how homophobia issues may cause gay men and lesbians to avoid seeing the doctor and not get good care, and pose a health hazard. What would really be important would be health policy changes, which I have proposed in my publication in the Journal of Women’s Health (2004) and in our trade journal Obstetrics and Gynecology. See a video lecture about the Health concerns of lesbians, bisexuals, transgendered and intersexual people given by me at Stanford University's McGann Lecture Series.

See a lecture by Dr. O'Hanlan about homosexuality and parenting and marriage with evidence from the academic literature.

WHAT DOES MEDICAL SCIENCE HAVE TO SAY ABOUT HOMOSEXUALITY and civil marriage and parenting? See my article for the American College of Obstetricians and Gynecologists national journal, and read my testimony to the Legislative Committee of the California Assembly on April 10, 2007 that includes the policy statements from national organizations with over 400,000 professional members of this nation's medical and psychological experts.

WHAT ABOUT FEMALE TO MALE TRANSSEXUALS needing hysterectomy and oophorectomy? We welcome TransMen for their surgical care, and assure them that our office and Sequoia Hospital staff are very happy to provide your care. I have performed my surgery for FTM guys together with Dr. Michael Brownstein performing top surgery at Sequoia hospital, and find that he does excellent top surgery.

While I think we should try to avoid surgery as much as possible, by living a very healthy life, it ís also important to get the job done right when you do need surgical care, especially if you have a pre-cancer or cancer in your pelvis. Find a Gynecologic Oncologist (see SGO.org) in your area if you have a pelvic mass, or any pelvic cancer. We gynecologic oncologists can give you all the surgical care you need in one procedure. If you have a health issue you would like to discuss, please call the office to schedule a visit. In the meantime, stay well, and enjoy life!

4370 Alpine Road, Suite 104 Portola Valley, CA 94028-7927 tel (650) 851-6669 fax (650) 851-9747 Directions Kate O'Hanlan, M.D. Gynecologic Oncologist
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