Whitney Goldsberry, MD, gynecologic oncologist at UofL Health – Brown Cancer Center, uses the latest surgical and medical innovations to improve the lives of women with reproductive cancers.
LOUISVILLE In the field of gynecologic oncology, advancements in testing, medical treatments, and surgical techniques are leading to earlier diagnosis and less invasive operations, resulting in longer and richer lives for patients with reproductive cancers. Whitney Goldsberry, MD, at UofL Health – Brown Cancer Center is at the forefront as a gynecologic oncologist.
Within the broader medical profession, however, many may have a vague understanding of the many facets that are involved in this subspecialty, especially around training and scope of practice. According to Goldsberry, “Gynecologic oncology is so niche. It’s such a small subspecialty that only focuses on women’s reproductive cancers. This allows us to specialize in all those components. So, it’s very different from other specialties.” In addition to performing surgery, she provides chemotherapies, immunotherapies, and targeted therapies.
The Meaning of Mentorship
After completing her undergraduate studies in biochemistry, achieving her medical degree, and then receiving residency training in obstetrics and gynecology from the University of Louisville School of Medicine, Goldsberry did a fellowship in gynecologic oncology at the University of Alabama at Birmingham. Then, as she had always anticipated, she returned to UofL.
Goldsberry states, “When I was a resident, I had dreams of coming back to Louisville and practicing here after I completed my fellowship, so that was always my plan. I wanted to come back because I felt like so many people at the University of Louisville had invested in me and motivated me to become a gynecologic oncologist. I felt like I needed to come back and pay that forward and help future students go in that direction too.”
One of the physicians who made an investment was a former gynecologic oncology faculty member at UofL who exposed Goldsberry to the specialty and all its aspects. According to Goldsberry, “I remember going to the clinic with her at UofL Health, and realizing the impact that she had on her patients and how delicate this relationship was between them. I absolutely fell in love with the field and realized that it was what I wanted to do for the rest of my life.”
Next, during her fellowship, she found another influential mentor in Michael Straughn, MD, professor and the J. Max Austin Jr. Endowed Chair in the University of Alabama and Birmingham Department of Obstetrics and Gynecology’s Division of Gynecologic Oncology.
Goldsberry has now moved into the mentor role herself by serving as an assistant professor and is an instructor in the OB-GYN residency program: “One thing that I also really love about being at UofL is working with young physicians and getting to teach surgery, gynecology, and oncology. It’s very rewarding to have that role as well.”
A Day in the Life
When not teaching, Goldsberry has an incredibly full schedule treating a range of reproductive cancers. She spends Mondays and Tuesdays at an outpatient clinic and operates on Wednesdays, Thursdays, and Fridays, as well as the weekends, if on call. She practices at both the UofL Health – Center for Women’s Health and UofL Health –Mary & Elizabeth Hospital. The main types of cancers that Goldsberry treats are cervical, uterine/ endometrial, ovarian, vaginal, and vulvar.
Goldsberry notes the rate of cervical cancer has been reduced by half since the 1970s when Pap smears were introduced as a routine screening tool. The HPV vaccine has also been useful in lowering these numbers. However, many women harbor the misinformation that HPV is a disease for “girls” in their twenties and that the vaccine is only available for that population. In reality, a woman is at an 85% risk of contracting HPV at some point in her lifetime and should receive the vaccine as a preventative measure up to age 45 if they are engaging in intercourse. Goldsberry advises every patient in this age range on the importance of getting vaccinated.
Endometrial cancers are growing more prevalent, in part due to the obesity epidemic. Not only are more women being diagnosed
with endometrial cancer, but they are also being diagnosed earlier. Meanwhile, the incidence of ovarian cancer has remained relatively the same, though new treatment options now allow certain patients to go into remission and live longer, healthier lives after the diagnosis, a welcome shift in the specialty. As with all cancers, there is a link between systemic diseases—heart disease, lung disease, diabetes, high blood pressure—and reproductive cancers. But, perhaps, the biggest contributing factor is smoking, especially with cervical and vulvar cancer. Subsequently, “smoking cessation is a very important component when I’m counseling these patients,” says Goldsberry.
Building Long-Lasting Relationships with Patients
Since gynecologic oncology is such a small subspecialty, Goldsberry’s relationship with her patients goes far beyond the operating room and encompasses providing additional treatments, counseling on genetics and lifestyle, and postoperative surveillance, which can last a lifetime. Therefore, she forms longterm relationships with her patients. “You really get to know your patients very well, and also, it’s such an honor to be by a woman’s side as she’s going through this journey. I just feel so privileged to have that ability,” Goldsberry states.
Though each of her patient’s hold a special place for Goldsberry, she remembers one woman, in particular, who made a lasting impression. She was asked to consult on a female in her mid-40s who was in the intensive care unit for a serious and complicated condition. During her work-up, doctors detected a pelvic mass and elevated tumor markers indicative of ovarian cancer.
A difficult surgery yielded excellent results; Goldsberry and her team were able to achieve a residual disease of zero, with no disease present at the end of the surgical case. However, when chemotherapy was suggested, the patient balked. Despite Goldberry’s recommendation, after enduring so much, the patient was hesitant to embark on another invasive treatment.
Goldsberry recalls, “I told her that this was her life, and that she was the one who got to make all the decisions. I told her, as her gynecologic oncologist, my role was to support her in that journey, no matter what decisions she made. She was so incredibly grateful.”
After talking it over with her family, the patient opted to proceed with chemotherapy and has been disease free now for over a year.
Robotic Surgery Leads to Better Outcomes
Robotic surgery has been a game changer for surgeons across all specialties, and gynecologic oncology is no exception. Providers at UofL Health can boast performing more than 10,000 successful robotic procedures, many of which are for gynecologic diseases and conditions. Due to the enhanced visualization and the ability to navigate very tight spaces that robotic surgery offers, Goldsberry chooses to perform most procedures using this technology. “The reason I choose robotic surgery is because it is great for my patient outcomes. They have shorter hospital stays; the majority of my patients go home the same day. Blood loss is minimal, healing is better, pain control is better—overall, patient care is better.”
Inspired to Improve Quality of Life
In closing, Goldberry says, “What keeps me motivated, intrigued, and inspired is just wanting to make my patients’ lives better. I want to help women live their best lives, and the way I can do that is through gynecologic oncology.”