At times, they are found during the reproductive years and some women develop these conditions as part of hereditary syndromes. Advances in prevention, detection, surgery and medical therapy are allowing improved outcomes and less impact on quality of life.
Here are five commonly discussed topics impacting gynecologic oncology.
1. HPV vaccine and its expanded use
The Federal Drug Administration’s recent approval of the human papillomavirus (HPV) vaccine for adults ages 27-45 has the promise to reduce the amount of cervical cancer cases. This broadens the indication of vaccination beyond the previous range from nine to 26 years. Initial efforts have already led to decreases in HPV infection and its sequelae — genital warts and dysplasia. The impact on cancer incidence will take more time to be evident. However, the vaccine’s growing use and expanded indications represent a vital public health effort toward preventing the spectrum of HPV-related cancers and their precursors among both women and men.
2. Robotic surgery
Robotics have revolutionized surgery. Through its precision and minimally invasive approach, the robotic platform has allowed patients to recover faster and with less adverse impact to their daily lives. In the field of gynecologic oncology, robotic-assisted surgery has been invaluable in managing endometrial cancers, performing fertility-preserving procedures, and caring for patients with complex surgical histories.
3. Personalized medicine
Like most of medicine, cancer treatments have transitioned from a single standard approach to one individualized to each patient, where specific characteristics of a patient’s condition and tumor may affect their treatment planning and strategy. An increasing understanding of and ability to detect genetic changes within tumors (mutations) provide an opportunity to consider and use targeted therapy in ever-increasing ways. By personalizing medicine, we can learn about a person’s risk of developing cancer and potentially optimal methods of treatment in ways not previously possible.
4. Enhancing survivorship
The Foundation for Women’s Cancer estimates that more than 110,000 women will be diagnosed with some form of gynecologic cancer in 2018. Though some will eventually succumb to their illness, the notion of living with cancer and living with having had cancer are key concepts in modern oncologic care. Helping patients accommodate to and manage their cancer in the context of the rest of their lives is a critical focus for the entire care team.
5. Promoting wellness and prevention
Wellness encompasses many domains of health — physical, emotional, and spiritual. All are interconnected in the holistic care of patients who have had cancer and those who have not. Throughout Northwell Health, programs exist to facilitate wellness among individual patients and their families. These programs include nutrition assessment and planning, integrative medicine, fitness and emotional support. Recognizing the import and need for these aspects of care is how our team enhances the lives of all of our patients.
Andrew Menzin, MD, is chief of gynecologic oncology for Northwell Health’s Central Region, vice chair for academic affairs for Obstetrics and Gynecology at North Shore University Hospital and Long Island Jewish Medical Center. He’s also a professor of ob/gyn at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.