Dr. Anthony Costales, MD

 

Dr. Anthony Costales, MD Gynecologic Oncologist and Cancer Care

Dr. Anthony Costales, MD, is a fellowship-trained gynecologic oncologist who provides medical and surgical care for cancers affecting the female reproductive system. His clinical focus includes ovarian, uterine, cervical, vulvar, and vaginal cancers, along with complex gynecologic conditions that may require advanced surgical treatment.

His work combines cancer diagnosis, minimally invasive surgery, treatment planning, and coordination with medical oncology, radiation oncology, pathology, genetics, and supportive care teams. He also has a particular professional interest in robotic and laparoscopic surgery, fertility-sparing treatment, sentinel lymph node mapping, and hyperthermic intraperitoneal chemotherapy.

About Dr. Anthony Costales

Dr. Costales is an assistant professor in gynecologic oncology at Baylor College of Medicine and provides care through the Dan L Duncan Comprehensive Cancer Center.

A gynecologic oncologist is an obstetrician-gynecologist who has completed additional fellowship training in cancers of the reproductive system. This specialist can evaluate suspicious symptoms, perform complex cancer surgery, recommend nonsurgical treatment, and coordinate long-term cancer monitoring.

Patients may be referred to Dr. Costales after:

• An abnormal pelvic examination
• A concerning ultrasound or CT scan
• An ovarian or pelvic mass
• Abnormal cervical testing
• A biopsy showing cancer or precancerous cells
• Bleeding after menopause
• A new diagnosis of uterine or ovarian cancer
• Cancer returning after earlier treatment
• A recommendation for complex gynecologic surgery
• A family history suggesting inherited cancer risk

Patients reviewing their options can also read about the wider range of oncology and gynecology services available through Doctiplus.

Professional Background and Clinical Focus

Dr. Costales provides both medical and surgical care for patients with gynecologic cancers. His work includes evaluating newly diagnosed disease, determining whether surgery is appropriate, and helping patients understand how an operation may fit with chemotherapy, radiation, or another treatment.

His main professional interests include:

• Ovarian cancer
• Fallopian tube cancer
• Primary peritoneal cancer
• Endometrial and uterine cancer
• Cervical cancer
• Vulvar cancer
• Vaginal cancer
• Uterine sarcomas
• Precancerous gynecologic conditions
• Hereditary breast and ovarian cancer syndromes
• Fertility-sparing cancer care
• Minimally invasive gynecologic surgery
• Robotic and laparoscopic procedures
• Sentinel lymph node mapping
• Hyperthermic intraperitoneal chemotherapy
• Complex pelvic surgery
• Recurrent gynecologic cancer

Cancer care is personalised. Two patients with the same general diagnosis may receive different recommendations because the cancer stage, tumour type, molecular findings, previous treatment, general health, and personal priorities may differ.

Education and Medical Training

Training Area	Institution	Details
Undergraduate education	Missouri State University	Cell and molecular biology with chemistry studies
Medical education	McGovern Medical School at UTHealth	Doctor of Medicine
Residency	McGovern Medical School and Memorial Hermann	Obstetrics and gynecology
Fellowship	Cleveland Clinic Foundation	Gynecologic oncology
Academic role	Baylor College of Medicine	Assistant professor in gynecologic oncology

Dr. Costales completed his medical degree at McGovern Medical School. He remained within the same academic health system for residency training in obstetrics and gynecology.

He then completed a gynecologic oncology fellowship at Cleveland Clinic Foundation. This additional training focused on reproductive-system cancers, complex gynecologic surgery, chemotherapy planning, cancer staging, and multidisciplinary care.

Gynecologic Oncology Care

Gynecologic oncology focuses on cancers and precancerous conditions affecting the reproductive organs.

The main areas include:

• Ovaries
• Fallopian tubes
• Uterus
• Endometrium
• Cervix
• Vagina
• Vulva
• Peritoneum

A gynecologic oncologist may become involved before a cancer diagnosis is confirmed. For example, an ovarian mass may need specialist assessment because imaging alone cannot always determine whether it is benign or malignant.

The specialist may review:

• Symptoms
• Pelvic examination findings
• Ultrasound images
• CT or MRI results
• Tumour marker tests
• Biopsy or pathology reports
• Family cancer history
• Previous operations
• Earlier chemotherapy or radiation
• General health and surgical risk

The goal is to create a treatment plan that addresses the cancer while also considering recovery, fertility, hormonal health, and quality of life.

Ovarian Cancer and Pelvic Mass Evaluation

Ovarian cancer may be difficult to identify during its early stages because symptoms can resemble common digestive, urinary, or menstrual concerns.

Possible symptoms may include:

• Persistent abdominal bloating
• Pelvic pressure or discomfort
• Feeling full quickly
• Reduced appetite
• Increasing abdominal size
• Changes in bowel habits
• Frequent urination
• Unexplained tiredness
• Unexpected weight changes

These symptoms do not automatically mean that ovarian cancer is present. Benign cysts, fibroids, digestive conditions, and other medical problems can cause similar concerns.

Assessment may involve:

• Pelvic ultrasound
• CT or MRI imaging
• Blood testing
• Tumour marker tests
• Review of personal and family history
• Surgical evaluation

When surgery is recommended, the aim may be to remove the mass, obtain an accurate diagnosis, determine the stage, and remove as much visible cancer as safely possible.

Endometrial and Uterine Cancer

Endometrial cancer begins in the lining of the uterus. It commonly causes abnormal bleeding, which may lead to diagnosis at an earlier stage.

Symptoms that may need assessment include:

• Bleeding after menopause
• Bleeding between periods
• Periods that become unusually heavy
• Watery or blood-stained discharge
• Pelvic discomfort
• Unexplained anaemia

Evaluation may involve an endometrial biopsy, ultrasound, hysteroscopy, or another procedure that collects tissue for laboratory examination.

Treatment often includes surgery to remove the uterus, cervix, fallopian tubes, and ovaries. Lymph node assessment may also be recommended depending on the tumour type and risk level.

Some patients may need radiation, chemotherapy, hormone treatment, or additional monitoring after surgery.

Cervical Cancer and Precancerous Changes

Cervical cancer often develops gradually from abnormal cells associated with certain types of human papillomavirus.

Screening can identify abnormal cervical changes before invasive cancer develops. An unusual Pap test or HPV result does not automatically mean that cancer is present.

Further evaluation may include:

• Repeat cervical testing
• Colposcopy
• Cervical biopsy
• Loop excision
• Cone biopsy
• Imaging
• Surgical consultation

Treatment depends on whether the cells are precancerous or cancerous, how deeply abnormal tissue has spread, and whether fertility preservation is important.

Patients with early-stage disease may be eligible for procedures that preserve more reproductive function. Advanced disease may require a combination of radiation, chemotherapy, and surgery.

Vulvar and Vaginal Cancer

Vulvar and vaginal cancers are less common than uterine, ovarian, or cervical cancers.

Symptoms that may need medical assessment include:

• A persistent sore or lump
• Unexplained bleeding
• Continuing itching or burning
• Skin colour or texture changes
• Pelvic discomfort
• Pain during urination
• Unusual discharge

Many noncancerous conditions can cause similar symptoms. Examination and biopsy may be needed to establish the diagnosis.

Treatment depends on the size and location of the abnormal area, lymph node involvement, cancer stage, and previous treatment.

Uterine Sarcomas

Uterine sarcomas are uncommon cancers that develop from the muscle or supporting tissues of the uterus.

Possible symptoms include abnormal bleeding, pelvic pressure, pain, or a rapidly enlarging uterine mass. However, these symptoms may also occur with noncancerous fibroids.

Imaging cannot always distinguish a sarcoma from a benign growth with complete certainty. Tissue examination after surgery may be needed for a final diagnosis.

Treatment planning may include surgery, medical oncology, radiation oncology, and specialised pathology review.

Minimally Invasive Gynecologic Surgery

Dr. Costales has a professional interest in minimally invasive surgery for appropriate patients with gynecologic cancer.

Minimally invasive procedures may be performed through several small openings rather than one larger abdominal incision. The surgeon may use laparoscopic instruments or a robotic surgical system.

Potential advantages for selected patients may include:

• Smaller incisions
• Reduced blood loss
• Shorter hospital stays
• Less postoperative discomfort
• Faster return to normal activity
• Lower risk of certain wound complications

A minimally invasive approach is not suitable for every diagnosis. Tumour size, cancer stage, previous surgery, body anatomy, and the need to remove disease from several areas may affect the surgical method.

Patients should ask why an open, laparoscopic, or robotic approach is being recommended and whether the choice could affect cancer treatment or recovery.

Robotic Gynecologic Surgery

Robotic surgery uses a computer-assisted system controlled by the surgeon. It does not perform the operation independently.

The system may provide:

• Magnified three-dimensional views
• Precise instrument movement
• Improved access to selected pelvic structures
• Support for complex suturing and dissection

Robotic surgery may be considered for selected uterine cancers, early ovarian cancers, lymph node procedures, and other gynecologic operations.

The most important question is not whether a robot is used, but whether the proposed operation is medically appropriate and can be performed safely.

Sentinel Lymph Node Mapping

Lymph nodes are small structures that form part of the immune system. Cancer cells can sometimes move from the original tumour into nearby lymph nodes.

Sentinel lymph node mapping helps identify the first lymph nodes most likely to receive drainage from a tumour.

A tracer is used to help the surgeon find these nodes. The selected nodes can then be removed and examined for cancer cells.

This approach may reduce the need to remove a larger number of lymph nodes in appropriate patients. It is commonly considered during selected uterine, cervical, and vulvar cancer procedures.

The method is not suitable for every patient. The doctor will consider the cancer type, stage, previous treatment, and whether mapping is successful during surgery.

Hyperthermic Intraperitoneal Chemotherapy

Dr. Costales has a particular interest in hyperthermic intraperitoneal chemotherapy, commonly called HIPEC, for selected patients with advanced or recurrent ovarian cancer.

HIPEC is a specialised treatment in which heated chemotherapy is circulated inside the abdominal cavity during surgery.

The procedure may be considered after visible tumour tissue has been surgically removed. The heated medicine is intended to reach small cancer deposits that may remain within the abdominal space.

HIPEC is not a standard option for every patient with ovarian cancer. Eligibility may depend on:

• Cancer type
• Disease stage
• Previous treatment
• Response to chemotherapy
• Location of remaining disease
• General health
• Ability to tolerate major surgery
• Findings during the operation

Patients can read about peritoneal cancer treatment and when HIPEC may be considered before discussing individual suitability with their oncology team.

Fertility-Sparing Cancer Treatment

Cancer treatment can affect the uterus, ovaries, hormones, and ability to become pregnant.

For selected patients with early-stage disease, fertility-sparing treatment may be possible. Options depend heavily on the exact diagnosis and whether treatment can be provided without creating an unacceptable cancer risk.

The care team may consider:

• Cancer type and stage
• Tumour grade
• Molecular findings
• Whether disease appears limited to one area
• Patient age and general health
• Pregnancy goals
• Risk of cancer returning
• Ability to attend close follow-up

Some patients may be referred to a reproductive endocrinologist before treatment. Fertility preservation may involve egg or embryo freezing, ovarian tissue preservation, or a cancer operation designed to preserve selected reproductive organs.

Cancer treatment should not be delayed without agreement from the oncology team.

Hereditary Cancer Risk

Some ovarian, uterine, and related cancers are connected with inherited genetic changes.

A hereditary cancer assessment may be considered when a patient has:

• Ovarian cancer
• Cancer diagnosed at a younger age
• Several relatives with related cancers
• Breast and ovarian cancer within the family
• Colon and uterine cancer within the family
• More than one primary cancer
• A known genetic change in a relative

Genetic testing may affect treatment, future screening, and the health recommendations given to biological relatives.

Testing should be accompanied by clear counselling about what positive, negative, and uncertain results may mean.

Multidisciplinary Cancer Treatment

Gynecologic cancer care often involves several specialists.

The treatment team may include:

• Gynecologic oncologist
• Medical oncologist
• Radiation oncologist
• Pathologist
• Radiologist
• Genetic counsellor
• Oncology nurse
• Fertility specialist
• Dietitian
• Rehabilitation professional
• Supportive or palliative care specialist

Dr. Costales may coordinate surgical care with these professionals. The final treatment plan may include surgery, chemotherapy, radiation, targeted therapy, immunotherapy, hormone therapy, or clinical trial participation.

The sequence of treatment also matters. Some patients have surgery first, while others receive medication before an operation.

Who May Benefit From Seeing Dr. Costales

A consultation may be appropriate for patients who:

• Have been diagnosed with a gynecologic cancer
• Have an ovarian or pelvic mass
• Need evaluation after an abnormal biopsy
• Have bleeding after menopause
• Need surgery for uterine or ovarian cancer
• Want another opinion about a cancer diagnosis
• Have recurrent gynecologic cancer
• Need assessment for minimally invasive surgery
• Want to discuss fertility-sparing treatment
• Have a hereditary cancer concern
• Need information about HIPEC
• Require complex pelvic surgery
• Have a precancerous cervical, vulvar, or uterine condition

Patients comparing specialists can review another minimally invasive gynecologic surgery profile or use the Doctiplus directory to find doctors by specialty.

What Patients Can Expect During an Appointment

The consultation usually begins with a careful review of the diagnosis, symptoms, medical history, imaging, and pathology results.

Dr. Costales may ask about:

• When symptoms began
• Abnormal bleeding
• Pelvic or abdominal discomfort
• Appetite or weight changes
• Previous pregnancies
• Earlier gynecologic surgery
• Family cancer history
• Previous chemotherapy or radiation
• Current medications
• Fertility goals
• Other medical conditions
• How symptoms affect daily life

A physical or pelvic examination may be recommended when appropriate.

The doctor may also review ultrasound, CT, MRI, PET imaging, biopsy reports, surgical notes, tumour marker results, and genetic testing.

Patients should expect a discussion about the likely diagnosis, whether more testing is needed, possible treatment approaches, and the benefits and limitations of each option.

Preparing for the Consultation

Patients can prepare by bringing:

• Imaging discs and written reports
• Biopsy and pathology reports
• Previous surgical records
• Laboratory results
• Tumour marker results
• Genetic testing reports
• Chemotherapy records
• Radiation treatment summaries
• Current medication list
• Allergy information
• Family cancer history
• Insurance and referral documents
• Written questions

The original imaging and pathology materials may be more useful than summaries alone. The oncology team may request that slides, tissue samples, or scans be reviewed again before finalising treatment.

Bringing a trusted family member or support person may also help when a large amount of information must be discussed.

Questions to Ask Dr. Costales

Patients may consider asking:

• What is my exact diagnosis?
• What type and stage of cancer do I have?
• Is more testing needed?
• Is surgery recommended?
• What is the goal of the operation?
• Can minimally invasive surgery be used?
• Which organs or tissues may need to be removed?
• Will lymph nodes be assessed?
• Could treatment affect fertility or hormones?
• Will chemotherapy or radiation be needed?
• Is genetic testing appropriate?
• Could HIPEC be considered?
• What are the main risks?
• How long might recovery take?
• Should I seek another opinion?
• Are clinical trials relevant to my diagnosis?

Patients should ask for unfamiliar medical terms to be explained and request written information about the next steps.

Recovery and Follow-Up Care

Recovery depends on the type of surgery, extent of disease, treatment method, general health, and whether additional cancer therapy is planned.

Follow-up may involve:

• Wound assessment
• Medication review
• Pathology discussion
• Repeat imaging
• Tumour marker testing
• Chemotherapy or radiation referrals
• Monitoring for treatment side effects
• Activity guidance
• Nutrition support
• Emotional health support
• Long-term cancer surveillance

Some patients recover at home after a short hospital stay, while others need more extensive monitoring or rehabilitation.

Patients should ask how treatment may affect work, driving, lifting, physical activity, sexual health, bladder or bowel function, and the timing of additional therapy.

Practice and Appointment Information

Dr. Costales provides care through the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine.

Clinic:
O’Quinn Medical Tower at Baylor St. Luke’s Medical Center McNair Campus
1919 Old Spanish Trail, 7th Floor
Houston, TX 77054

Appointment phone:
832-957-6500

Public professional information associates Dr. Costales with Baylor St. Luke’s Medical Center.

Clinic locations, appointment availability, hospital privileges, and provider schedules may change. Patients should confirm current information with the clinic before travelling.

Insurance and Appointment Planning

Insurance coverage can vary according to the exact policy, treatment, facility, and members of the care team.

Before scheduling, patients should ask:

• Is Dr. Costales in my insurance network?
• Is the cancer centre also in network?
• Is a referral required?
• Does the consultation need prior authorisation?
• Will pathology review be billed separately?
• Are imaging and laboratory services covered?
• Is the planned hospital in network?
• Are chemotherapy and surgery authorised separately?
• Is a second opinion covered?
• Are telehealth consultations available?

Cancer surgery may involve separate bills from the surgeon, hospital, anaesthesia team, pathology department, imaging services, and other specialists.

When Symptoms Need Urgent Care

Patients should not wait for a routine appointment when symptoms are severe or rapidly worsening.

Urgent medical assessment may be needed for:

• Heavy vaginal bleeding
• Severe pelvic or abdominal pain
• Fainting or severe dizziness
• Difficulty breathing
• Chest pain
• Persistent vomiting with inability to drink
• A swollen and painful leg
• Fever during chemotherapy
• Sudden confusion
• Serious bleeding after a procedure
• Severe swelling or pain after surgery
• New symptoms that appear life-threatening

Patients receiving cancer treatment should follow the emergency instructions provided by their oncology team.