Mildred Ridgway, MD, is often referred to as a quarterback.

 

More specifically, she's well-respected as the leader for the medical team assisting women with gynecologic cancers.

 

Ridgway, gynecologic-oncologist for the Mississippi Gynecologic Cancer Group at Women's Specialty Center in Jackson, is trained to handle everything from managing chemotherapy, to performing surgery, to taking care of complications for women with gynecologic cancers, who have a higher survival rate and lower complication rate being managed primarily by a gynecologic-oncologist.

 

The only female gynecologic-oncologist in Central Mississippi, Ridgway is one of only four such specialists statewide.

 

After earning undergraduate and medical degrees from Tulane University, Ridgway completed her internship and residency in obstetrics and gynecology, followed by a 3-year fellowship that involved treating the five major gynecologic cancers—cervical, ovarian, uterine, vaginal and vulvar—with intense focus on surgery and chemotherapy at the University of North Carolina at Chapel Hill.

 

When the FDA approved the use of the da Vinci Surgical System, Ridgway was among the first wave of physicians nationwide to use the breakthrough platform for robotically-assisted minimally invasive surgery on gynecologic cancers. With more than 300 robotic surgical cases under her belt, she is frequently called on to proctor other physicians on the da Vinci Surgical System. 

 

Even though gynecologic cancer is not ranked among the top diseases contracted by women annually in the United States, it has a 36 percent mortality rate, according to the Centers for Disease Control and Prevention. In 2006, of 76,515 women diagnosed with a gynecologic cancer, 27,848 died from the disease.

 

"Uterine is by far the most common type of gynecologic cancer we see, accounting for roughly 6 percent of all cancers," said Ridgway. "One of 40 women will likely develop uterine cancer in their lifetime. It's a disease that usually affects women who are older, have been through menopause, have not had any bleeding for a number of years, and suddenly begin bleeding again. Because that symptom is a very troubling one, they usually present early to their local physician. The diagnosis is made by biopsy or D&C, and then patients are triaged to a gynecologic-oncologist for care." 

 

Cervical cancer, the second most common gynecologic cancer in the United States, is the most common gynecologic cancer worldwide. Usually detected early via Pap smear, cervical cancer is often related to an HPV virus exposed by sexual encounter. Of the 100 or so subtypes of HPV, HPV-16 is the most carcinogenic that results in cervical cancer.

 

"Cervical cancer treatments depend on the size and stage of the cancer," said Ridgway. "If it's more advanced, radiation is recommended."

 

The typical protocol for patients in the early stages of gynecologic cancer is a hysterectomy. Those who undergo the robotic procedure benefit from decreased pain, decreased blood loss, and often better specimen counts.

 

"Because the hysterectomy is for cancer, we take some of the lymph nodes from the pelvis to see if there has been microscopic spread," she said. Many times, the procedure requires open surgery, but Ridgway has been able to access the lymph nodes laparoscopically. "Those patients," she noted, "usually do very, very well."

 

Ovarian cancer, which has been linked to breast cancer, is rare. One of 70 women may develop ovarian cancer in their lifetime, yet the 5-year survival rate is grim—less than 50 percent.

 

"By the time ovarian cancer is diagnosed, the cancer can be quite advanced and difficult to treat," she explained. "Its symptoms are vague, and when women realize their abdomen is getting thicker, that they're getting full quicker, or that their pelvic fullness looks like the beginning of pregnancy, ovarian cancer has usually advanced to Stage 3 or 4."
Because there's not a good screening tool for ovarian cancer, a thorough knowledge of family medical history is vital. Risk factors include never having been pregnant, infertility, family history of breast cancer, and genetic predisposition, particularly to the BRCA gene. Recent advances identifying mutations in the gene predisposed for ovarian cancer signal a true paradigm shift in the preventive medicine end of gynecologic-oncology.

 

Treating ovarian cancer typically consists of removing as much of the tumor as possible via surgery.

 

"It's more common for ovarian cancer patients to need chemotherapy in addition to surgery because of the cancer's pattern of spread," said Ridgway. "Any gynecologic cancer could need chemotherapy or radiation, depending on histology and how far it has spread."

 

A leader in her field extending beyond Mississippi, Ridgway has participated in published multiple clinical studies revealing the benefits of laparoscopic and robotic surgery for gynecologic care and also in published instructional surgical videos for robotic surgery. She often travels to hospitals such as M.D. Anderson and Vanderbilt University for consultation and is a member of the Society of Gynecologic Oncologists, American College of Obstetrics and Gynecology, Gynecologic Cancer Foundation, American College of Surgeons, Physicians for Women's Health, and American Association of Gynecological Laparoscopists.

 

Ridgway and her husband, Stennis Wells, reside in Jackson with their daughters, Allison, 7, and Elizabeth, 2.