Gynecologic Cancer: What Every Woman Should Know
When Should a Woman See a Gynecologic Oncologist?
Updated on: June 20, 2003
Patricia Goldman, President, Ovarian Cancer National Alliance
I consider myself a lucky woman! I am a ten-year survivor of ovarian cancer. The fact that I can say this is, in large part, due to the fact that the physicians I saw with my acute symptoms referred me to the correct specialists for diagnosis, surgery and treatment.
In 1993, I didn't know that the increasing indigestion, considerable bloating and other symptoms I was experiencing could be indicative of ovarian cancer but as my symptoms worsened, I was lucky that my internist referred me to my gynecologist. I was lucky that my gynecologist, in turn, referred me to a gynecologic oncologist when she suspected I had ovarian cancer. Despite being raised in a medical family, I had never known there was such a specialty as gynecologic oncology. Recent studies, however, have shown that women with ovarian cancer whose initial surgeries were performed by gynecologic oncologists have enhanced survival rates.
At the time of my diagnosis, I was, indeed, lucky in many ways. Women should not, however, have to depend on luck to survive a diagnosis of ovarian cancer or any other gynecologic malignancy. That is why I am anxious that more women become knowledgeable, not only about the symptoms and risk factors of gynecologic cancers but about gynecologic oncologists, the doctors specially trained to treat these cancers.
In the following article, Kenneth Hatch, M.D., president of the Society of Gynecologic Oncologists(SGO) and chair of the Department of OB/GYN, University Medical Center, Tucson, Ariz. and James Orr, Jr. M.D., president elect of SGO and director, Gynecologic Cancer and Research, Florida Gynecologic Oncology, Ft. Myers, Fla., answer questions about gynecologic oncologists and the roles they can play in a woman's gynecologic health care both prior to and following a diagnosis of cancer.
Q. Dr. Hatch, what specialized training do gynecologic oncologists receive to prepare for their careers?
A. Following the completion of medical school and a 4-year residency in obstetrics and gynecology, gynecologic oncologists complete an additional three years of sub-specialty fellowship training in an American Board of Ob/Gyn-approved program. That subspecialty program provides training in the biology and pathology of gynecologic cancers as well as in all forms of medical treatment for these cancers including surgery, radiation, chemotherapy, and experimental treatments.
Q. I was first referred to a gynecologic oncologist after the transvaginal ultra-sound my gynecologist ordered raised a strong suspicion that the mass seen might be malignant. Is that the only time women should seek the advice of a gynecologic oncologist?
A. Women experiencing symptoms may want to consider making an appointment for a diagnostic assessment. Women with a family history of breast or ovarian cancer or other known risk factors for gynecologic cancer can also consult a gynecologic oncologist to discuss how to reduce their cancer risk. It is also appropriate for women newly diagnosed with a gynecologic cancer to seek the expertise of a gynecologic oncologist.
Most women will remain under the care of their gynecologic oncologist following initial surgery and/or treatment.
Q. Dr. Orr, I was put in contact with a gynecologic oncologist through my gynecologist. Is that common? Is it the only way women can gain access to the expertise of gynecologic oncologists?
A. Obstetrician/gynecologists are the physicians that are most familiar with gynecologic oncologists but other physicians can also refer patients to us. Primary care physicians, general surgeons and medical oncologists, for example, often make referrals. Patients with suspicious symptoms or findings on examination or with abnormal laboratory or radiologic findings can always request a referral to a gynecologic oncologist.
A woman can also contact a gynecologic oncologist's office on her own if she has concerns about a gynecologic cancer. The national database of gynecologic oncologists available at GCF's Web site, www.wcn.org, can help women identify gynecologic oncologists nearest their homes.
However the contact is made, it is critical that women diagnosed with gynecologic cancer or with a strong suspicion of a gynecologic malignancy be evaluated by physicians specially trained in gynecologic oncology. A National Institute of Health consensus panel stated, "Women with ovarian masses who have been identified preoperatively as having a significant risk of ovarian cancer should be given the option of having their surgery performed by a gynecologic oncologist".
A Joint Committee of the American College of Obstetricians and Gynecologists (ACOG) and the SGO recently reinforced that point in an opinion issued regarding the detection and treatment of ovarian cancer.
The joint opinion specifically states that a woman requiring surgery for a gynecologic malignancy should have the procedure performed by a physician trained to appropriately stage and remove ovarian cancer, such as a gynecologic oncologist. I believe that advice applies even if a woman needs to travel to have access to the right physician.
For a free list of gynecologic oncologists in your area or a complete listing of all board-certified gynecologic oncologists in the U.S., log on to www.wcn.org or call the GCF information hotline: 1-800-444-4441.
Find the full text of the ACOG/SGO joint opinion on SGO’s Web site at www.sgo.org/publications/generalist.pdf.
This article by the Gynecologic Cancer Foundation originally appeared in an advertising supplement to the New York Times on Sunday, June 22, 2003.
GCF gratefully acknowledges Aventis Oncology for its generous support of this educational supplement. The content of this supplement is the work of many individuals and does not reflect commercial interests.
Aventis Pharmaceuticals
www.AventisOncology.com
