|LETTER TO EDITOR
|Year : 2018 | Volume
| Issue : 2 | Page : 13-14
Role of Gynecological Oncologist to Provide Quality Care and Improve Outcome of Females With Gynecological Cancers
Additional Professor, Gynecological Oncology, RCC, I.G.I.M.S, Patna, India
|Date of Web Publication||10-Dec-2020|
Additional Professor, Dept. of Gynecological Oncology, IGIMS, Patna
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pankaj S. Role of Gynecological Oncologist to Provide Quality Care and Improve Outcome of Females With Gynecological Cancers. J Indira Gandhi Inst Med Sci 2018;4:13-4
|How to cite this URL:|
Pankaj S. Role of Gynecological Oncologist to Provide Quality Care and Improve Outcome of Females With Gynecological Cancers. J Indira Gandhi Inst Med Sci [serial online] 2018 [cited 2021 Dec 4];4:13-4. Available from: http://www.jigims.co.in/text.asp?2018/4/2/13/302946
The development of gynecologic oncology as a specialty has contributed to the progress of the treatment and management of women with genital cancers. The trend of conservative surgery has led to an improved quality of life in women with gynecologic cancer. Multidisciplinary care is the need of patients with gynecologic cancer. Awareness and educating patients and health care providers is the challenge today in gynecologic oncology. The subspecialty of gynecological oncology has made many advances over the last few decades; there have been several changes to the management of gynecological cancers, which have led to improved outcome and well-being of patients.
It is estimated that over a million of new cases and half million deaths are due to gynecological cancers annually worldwide. The International Agency for Research on Cancer GLOBOCAN project 1 has predicted that India's cancer burden will nearly double in the next 20 years, from slightly over a million new cases in 2012 to more than 1·7 million by 2035. These projections indicate that the absolute number of cancer deaths will also rise from about 680 000 to 1·2 million in the same period.
Gynecological cancer is a challenging, complex, and multidisciplinary disease. A proper collaboration with dedicated pathologists, medical oncologists, radiotherapists, biologists, palliative care specialists can help to avoid unnecessary mismanagements, and therefore, reinforce the holistic conception of patients with gynecological cancer. Moreover, the recent molecular biology, genetic, and immunology discoveries are opening new optimistic frontiers for the future treatment and cure of this disease. A recent meta-analysis demonstrated that women with gynecological malignancies who receive care from a multidisciplinary team by specialized physicians live for a significantly longer period of time.
According to the definition of the American Board of Obstetrics and Gynecologist, gynecologic oncologist is “a specialists in obstetrics and gynecology who is prepared to provide consultation on comprehensive management of patients with gynecologic cancer and who works in an institutional settng wherein all the effective forms of cancer therapy are available”.
A gynecologic oncologists provides a level of expertise that is different from other oncologists, who treat a variety of cancers like breast, colon, pancreatic, liver, and others. Thus the narrow focus of the gynecological oncologist only on female genital cancers is beneficial for the patient.
A gynecological oncologist is specially trained to diagnose and treat these types of cancers, as well as premalignant conditions that lead to cancer. They see women with gynecologic cancers every day, and have developed the skills and judgment required to perform procedures. A gynecologic oncologist also understands the impact of cancer and its treatment on a woman's life, including future childbearing, sexuality, physical and emotional well-being, and family dynamics.
In 1972, the first gynecologic oncologic fellowship-training programs were introduced in the U.S. with two accredited fellowships. Since then, 46 fellowship programs exist with 126 approved positions. Currently, there is a uniform system of training developed by the American Board of Obstetrics and Gynecologist who provide the training resource documents for the development of a curriculum in gynecologic oncology. Australia, Canada, U.K., and recently, the European Union are other examples of renowned gynecologic oncologic fellowship training programs around the world. However, the number of gynecologic oncologists per patient is still very scarce worldwide, and it is expected that the number of fellowship positions will continue to increase through the following years.
Different studies have consistently shown that patients with ovarian cancer treated at higher centers receive better quality of care, which is accomplished by better surgical staging and better optimal cytoreduction rate as well as better chemotherapy administration rate and schemes. If women with gynecological malignancies are treated by a gynecologic oncologists they survive longer and with improved quality of life. Therefore, patients should be ideally referred to higher centers to increase their life expectancy and quality of life.
Gynecological oncologists can play an important role in performing an optimal surgery and they can also provide a better overall quality of care by having a holistic conception of women.
Introducing more fellowship-training programs worldwide and highlighting the existence and importance of gynecologic oncologists in the general population and among physicians is crucial to increase the patient's accessibility to a specialist's care.
| References|| |
Sankaranarayanan R, Ferlay J. Worldwide burden of gynecological cancer. In: Preedy VR, Watson RR, editors. Handbook of Disease Burdens and Quality of Life Measures. New York, NY: Springer (2010). p. 803-23.
Fung-Kee-Fung M, Kennedy EB, Biagi J, Colgan T, D'Souza D, Elit LM, et al. The optimal organization of gynecologic oncology services: a systematic review. Curr Oncol (2015) 22(4):e282-93.
Gultekin M, Dursun P, Vranes B, Laky R, Bossart M, Grabowski JP, et al. Gynecologic oncology training systems in Europe: a report from the European network of young gynaecological oncologists. Int J Gynecol Cancer (2011) 21(8):1500-6.
Cohn DE, Roney JD, O'Malley DM, Valmadre S. Residents' perspectives on surgical training and the resident-fellow relationship: comparing residency programs with and without gynecological oncology fellowships. Int J Gynecol Cancer (2008) 18(1):199- 204.
Du Bois A, Rochon J, Pfisterer J, Hoskins WJ. Variations in institutional infrastructure, physician specialization and experience, and outcome in ovarian cancer: a systematic review. Gynecol Oncol (2009) 112(2):422- 36.