Women’s History Month 2014 – patient care mission

March 19, 2014 College News - In honor of Women’s History Month, the Medical College of Wisconsin has created a series of video vignettes and stories that will be posted online during the month of March. The vignettes highlight some of our women faculty, staff and students and the contributions they have made. The stories highlight MCW programs that improve women’s health or help develop women students, physicians, researchers, educators and leaders.

The fourth story in the series features MCW patient care programs that address women’s health issues. All of the vignettes and stories will be added to MCW’s Women's History Month 2014 Web page as they are published.

Adolescent Gynecology
Pediatric and adolescent gynecology is an emerging specialty, at the intersection of pediatrics, pediatric endocrinology, gynecology, pediatric surgery, dermatology, psychiatry, public health medicine and genetics. It thus addresses a wide spectrum of diseases from the newborn period to adolescence. The gynecological problems encountered in children and adolescents are often both medically and psychologically complex and thus require a highly skilled and coherent approach. The adolescent, who is no longer a child but not quite an adult, poses a particular management problem to the traditional specialties. The Adolescent Gynecology Clinic, located at Children’s Hospital of Wisconsin in the Clinics Building, focuses on the needs of children and adolescents from infants to teens.

Gynecology Oncology
At the Froedtert & the Medical College of Wisconsin Cancer Center, a multidisciplinary-team approach gives gynecologic cancer patients every advantage possible. State-of-the-art diagnostic and treatment options, including participation in clinical trials, are provided. An entire team of experts follows each patient from screening to diagnosis, treatment and after-care.

The physicians of the Gynecologic Cancer Program are fellowship-trained gynecologic oncologists and radiation oncologists. They have an in-depth understanding of cancers of the female reproductive system, and they devote their practice to treating women with these complex diseases.

Maternal-Fetal Medicine
Maternal-Fetal Medicine, sometimes called perinatology, involves providing specialized care for all types of complications of pregnancy, including women who have serious illnesses. These illnesses may be either in association with, or as the result of pregnancy. Care is also provided for pregnancies in which there is a suspected or established fetal abnormality, and the practice provides diagnostic, therapeutic and counseling services, including genetic consultations. Invasive fetal therapy is also performed, in collaboration with specialists at the Children’s Hospital of Wisconsin and the Fetal Concerns Center of Wisconsin.

The Froedtert & the Medical College of Wisconsin Genetics Program provides genetic counseling and testing to people who may be at risk for certain diseases due to a personal or family history of a genetic condition. Our genetic counselors provide personalized consultation regarding a person’s risk for genetic disease, how genes are linked to disease, how disease is inherited, genetic testing, and options for early disease detection. As an academic medical center, Froedtert & the Medical College have the expertise to offer comprehensive testing, counseling and referrals to appropriate specialists and services. In certain cases, interested people may be able to participate in various genetic research trials throughout the country.

Preventative Medicine for Women’s Health
Physicians and staff in the Department of Obstetrics and Gynecology care for women with a range of concerns by providing services including but not limited to routine prenatal care, well-woman exams, breast and pelvic exams; abnormal menstrual bleeding; benign tumors of the uterus and ovaries such as fibroids and cysts; abnormal PAP smears; and routine contraceptive management. The majority of the physicians from the Department of OB/Gyn have been named to Best Doctors in America.

In addition, many of these health care providers have special areas of interest to provide care for women with more complicated gynecologic problems, some of which are highlighted below.

Caring for Women with Fetal Concerns
The Fetal Concerns Center of Wisconsin is a joint effort between the Froedtert & the Medical College of Wisconsin Birth Center and Children’s Hospital of Wisconsin. The program offers a full range of care when there is a fetal heath concern in pregnancy. Caregivers of the Fetal Concerns Center provide diagnosis of birth defects, medical care for the infant, a specially trained nurse to help coordinate care, and, when appropriate, assistance in creating palliative care plans. Conditions commonly treated for infants in this program include abdominal wall defects, heart defects, genetic disorders, spina bifida, chest lesions, cleft lip and palate, urologic problems, neurologic problems, multiple fetuses and prematurity risk counseling. Consultation and support throughout the pregnancy, delivery and the baby’s first year are provided.

Solving Fertility Issues
The Froedtert & the Medical College of Wisconsin Reproductive Medicine Clinic is one of the only fertility programs in the Midwest offering complete fertility evaluation and treatment services for men and women. The physicians here are subspecialty trained in infertility. As a team, they discuss the best way to treat each couple’s unique situation. This means patients get the opinion of not one, but multiple infertility experts.

Treating Women’s Incontinence and Improving Sexual Health
The Women’s Incontinence and Sexual Health (WISH) Program specializes in diagnosing and treating a wide range of pelvic disorders and sexual health issues. A multidisciplinary team of experienced Medical College physician specialists understands the personal nature of these conditions, and they provide confidential, compassionate and individualized care. The expertise of this program’s staff combined with its scope of services makes it unique in Wisconsin.

Convenient and Comprehensive Care for Women’s Cancers
MCW doctors who are fellowship-trained in gynecologic oncology, surgical oncology, medical oncology and radiation oncology treat women with breast and gynecologic cancers at the Froedtert & the Medical College of Wisconsin Clinical Cancer Center. State-of-the-art diagnostic and treatment options, including participation in clinical trials, are offered.  A team of experts follows each patient from screening to diagnosis, treatment and after-care.

Improving the Cancer-Killing Odds with Pioneers of Radiation Technologies
Radiation has been used in the treatment of gynecologic and breast cancer since the early 1900s. Brachytherapy or implantation of radioactive sources into or near a tumor was one of the first forms of radiation treatment available to these patients.  Currently brachytherapy is used to treat many gynecologic cancers and select breast cancers.

Some of these brachytherapy techniques were pioneered and developed in the Department of Radiation Oncology at Froedtert & The Medical College of Wisconsin, including breast brachytherapy and CT and MR-guided gynecologic brachytherapy.

College physicians have a long history of success in treating women’s cancers, particularly through the use of a combination of external beam irradiation and brachytherapy, which delivers highly tailored doses of radiation to tumors with relative sparing of the nearby healthy organs. This effective approach applies as well to tumors of the bladder, urethra, rectum and anus where radiation is often combined with surgery and chemotherapy to cure disease and preserve function of important adjacent organs. In cancers of the cervix and vagina, for example, radiation has been used to cure advanced disease with preservation of the bladder and rectosigmoid. Surgery for similar stage patients might include the more drastic procedure of removing all organs from the pelvic cavity. In cancers of the breast, cosmetic preservation has been achieved through use of limited surgery and radiation to the breast, and if appropriate, the regional lymph nodes. This has provided an excellent alternative to mastectomy with equivalent survival.

Use of highly sophisticated imaging techniques both for the staging of the cancer as well as for radiation planning and delivery, combined with physician expertise in the field of radiation, have significantly improved outcomes for many women with cancer. At Froedtert & The Medical College of Wisconsin Clinical Cancer Center, there is a priority on interdisciplinary care with input from surgeons, radiation oncologists, medical/gynecologic oncologists, pathologists, and radiologists. All of these strategies are pivotal in curing cancer in women while preserving quality of life.

Controlling Osteoporosis: A Special Concern for Women
The average 50-year-old American woman has a 50% chance of suffering a low trauma fracture in her remaining lifetime, roughly twice the risk for a 50-year-old man.  Low traumas are those caused by a fall from standing height or lesser trauma.  More than two million low trauma fractures occur each year, including 300,000 hip fractures.  Hip fractures are deadlier than heart attacks, strokes, and breast cancer, and about half of those who survive end up losing the ability to live independently. 

MCW's multidisciplinary osteoporosis program addresses the many potential causes of skeletal fragility, including postmenopausal osteoporosis, the most common cause. The majority of the patients seen at the clinics are women, and the clinics have specialists in endocrinology, rheumatology and internal medicine. These specialists have clinical expertise in postmenopausal osteoporosis, osteoporosis related to cancer treatments, and two other forms of osteoporosis more common in women than men—those related to rheumatic and endocrine diseases.

Faculty members in the osteoporosis program hold national leadership posts in physician organizations related to bone health, and have research programs in bone strength, osteoporosis related to breast cancer treatments, and the adverse effects of osteoporosis medications. The availability of on-site testing and treatment facilities, including physical therapy and exercise instruction, are unique features of the program that provide comfort and convenience for osteoporosis patients.

Improving Health of Unborn At-Risk Children and Their Mothers
Pregnant women in Southeast Wisconsin at high risk of poor birth outcomes are being cared for by MCW physicians in the Department of Family and Community Medicine through the Medicaid-sponsored Obstetric Medical Home Pilot Program. The program encompasses MCW employed Pre-Natal Care Coordinators working with more than a dozen partner care organizations that provide healthcare professionals for home visits as well as access to information and services that will reduce the odds of premature birth and infant mortality, and increase healthy birth weights in high-risk pregnant women.

Affordable Care for Teen Girls at Downtown Health Center
Medical College doctors and staff, in collaboration with Children’s Medical Group, provide high quality, affordable health care to teen girls at the Downtown Health Center’s Adolescent Clinic. The clinic offers primary care and a range of reproductive health services. There is also a Teen-Tot Clinic at the Downtown Health Center where Medical College doctors see teen moms along with their babies during the same clinic visit. Care for this group of mothers is provided until their 21st birthday. In addition, adolescent nurse practitioners care for pregnant teens at Custer High School.