Monica H. Vetter, M.D., board-certified gynecologic oncologist at Norton Cancer Institute in Louisville, brings not only expertise in treating all types of gynecologic malignancies through a variety of techniques, including surgery and chemotherapy, but a deeply rooted passion as well.

Native Kentuckian passionate about serving women in her home state

As a Louisville native, Dr. Vetter is especially fervent about preventing cervical cancer among women in Kentucky. Although cervical cancer is almost entirely preventable, Kentucky has one of the worst rates of the disease in the U.S.

“I want all women to be protected,” Dr. Vetter said. “I want to make sure we’re giving our patients the opportunity to be aware and have a good relationship with a physician so they feel like they can advocate for themselves.”

According to the Centers for Disease Control and Prevention, there are 9.9 cases of cervical cancer per 100,000 women in Kentucky, compared with the national average of just 7 cases per 100,0000.

“Kentucky’s higher rate of cervical cancer — fourth worst in the country — often is driven by low adherence to cervical cancer screening guidelines, especially in the eastern, Appalachian, region of Kentucky,” Dr Vetter said.

Reasons for noncompliance with screenings vary: for example, a lack of access to gynecologic care in rural areas, or an active mom who is simply too busy to schedule an appointment. Sometimes, people may put off the screening because they feel too embarrassed.

“I think there’s a lot of reluctance to talk about cervical cancer and Pap smears, because getting a Pap smear can feel very intimate. It can be something people think is embarrassing, because, as a society, we don’t talk about the female reproductive system a lot,” Dr. Vetter said. “So, I think it’s just a lack of awareness.”

Dr. Vetter hopes to improve adherence to cervical cancer screening through patient education and normalizing talking about sensitive issues involving reproductive health.

Surgery plays a crucial role in treating gynecologic cancers

As one of a relatively small number of gynecologic oncologists in Kentucky, Dr. Vetter has experience with treatment of all gynecologic malignancies, including uterine, ovarian, cervical and vulvovaginal cancers, to name a few. Because often gynecologic oncologists are also surgeons, she also has extensive expertise in the integration of robotic-assisted surgery into the management of gynecologic oncology.

“Gynecologic oncologists have expertise in pelvic surgery and are trained on additional procedures like lymph node dissections as well as bowel and bladder procedures,” Dr. Vetter said. “This high-quality surgery is a critical part of the management of gynecologic malignancies.”

Patients with ovarian cancer have been shown to have a higher rate of appropriate surgical staging, complete surgical resection of their disease and improved survival when they have surgery with a gynecologic oncologist compared with other surgeons. Additionally, because gynecologic oncologists are focused on a very small number of cancers, they have specialized training in the medical management of these disease.

Dr. Vetter is passionate about the incorporation of minimally invasive, robotic-assisted surgery into gynecologic cancer care.

“Robotic surgery has been shown to decrease surgical risk and improve patient recovery and satisfaction,” she says. “I believe that when safe and feasible, robotic surgery is a wonderful tool for our patients.”

A team of subspecialized providers

Dr. Vetter is fortunate to work alongside a specialized team to provide individualized care.

“Management of gynecologic cancer can be complex, frequently involving a multifaceted approach to treatment, including surgery, administration of chemotherapy and management of survivorship issues,” she said.

The team of gynecologic cancer surgeons collaborates with other subspecialty oncology surgeons to coordinate complicated surgeries where multiple types of expertise are needed or when there is more than one cancer type present. They also coordinate with radiation oncology specialists to develop treatment plans that can include specialized types of radiation therapy or image-guided stereotactic radiation.

At Norton Cancer Institute, in addition to these highly-trained specialists, patients have access to navigators to help guide them through their care journey. Adding a layer of depth to the patient’s care team are nutrition and dietary specialists, speech-language pathologists, physical therapists, genetic counselors and others.

“By serving as a ‘one-stop shop,’ Norton Cancer Institute allows for a more holistic approach for the treatment of patients with gynecologic cancers,” Dr. Vetter said.

Clinical trials: the future of gynecologic cancer care

Dr. Vetter has a strong interest in ensuring that cancer patients in Kentucky and Southern Indiana have access to national and international clinical trials to improve outcomes.

Norton Cancer Institute has a wide spectrum of open research trials, including Phase 1 and Phase 2 trials, which not all facilities have. This gives patients access to treatments that would otherwise be unavailable, and gives our researchers unparalleled experience with a therapy once it gains Food and Drug Administration approval.

“Patients are more likely to receive the appropriate chemotherapy and more likely to enroll in a clinical trial when seen by a gynecologic oncologist,” Dr. Vetter said. “We also keep abreast of the most recent research, allowing our patients access to new drugs that may improve their survival.”

Dr. Vetter earned her medical degree from the University of Louisville School of Medicine. She completed her OB/GYN residency and a fellowship in gynecologic oncology at The Ohio State University College of Medicine in Columbus. Dr. Vetter is a member of the Society of Gynecologic Oncology, American Society of Clinical Oncology and the American Medical Association, and she is a fellow of the American College of Obstetricians and Gynecologists.