What is a Gynaecologic oncologist?
Gynaecologic oncologist is an obstetrician/gynaecologist who specializes in the diagnosis and treatment of women with cancer of the reproductive organs.
Specifically, the gynaecologic oncologist treats cancer of the ovary, endometrium, uterus, cervix, vagina, vulva and trophoblastic disease. In order to become a gynaecologic oncologist in the United States , a physician must first complete an approved, 4-year residency program in obstetrics and gynaecology. Following this, he/she must complete a 2–4 year clinical fellowship in gynaecologic oncology. Presently, there are 32 fellowship training programs approved by the American Board of Obstetrics and Gynaecology, Inc (ABOG). The additional training during fellowship provides the skills needed for optimal care of women with a gynaecologic cancer.
Surgical skills that are provided during fellowship include: radical pelvic surgery, gastrointestinal surgery, and urologic surgery. Additionally, fellowship provides training in administration of intravenous, intraperitoneal and oral chemotherapy and the placement of brachytherapy devices for radiotherapy. Formal coursework is required in graduate-level statistics and another area of the trainees choosing. After satisfactorily completing the fellowship, the gynaecologic oncologist may practice his/her specialty. This leads to "board certification" by ABOG. This involves a written and an oral examination.
According to the ABOG. "Bulletin for 1994-1995" the formal definition of a gynaecologic oncologist is:
"A gynaecologic oncologist is a specialist in obstetrics and gynaecology who by virtue of education and training is prepared to provide consultation on and comprehensive management of patients with gynaecologic cancer and whose present activity includes the practice of gynaecologic oncology in an institutional setting wherein all the effective forms of cancer therapy are available. Comprehensive management should include those diagnostic and therapeutic procedures necessary for the total care of the patent with gynaecologic cancer or complications resulting there from."
This definition is comprehensive and accurate. It brings out some important points:
- A gynaecologic oncologist is a specialized obstetrician/gynaecologist. Therefore, gynaecologic oncologists have had extensive training in providing care for women with and without cancer.
- Gynecologic oncologists are trained in providing comprehensive, multi-disciplinary care. Gynecologic oncologists are unique among surgical oncologists in this regard. They are skilled surgical oncologists who also are trained in administering chemotherapy. Therefore, gynaecologic oncologist is able to provide an outstanding degree of continuity of care for their patients. For example, if a patient is diagnosed with ovarian cancer, a gynaecologic oncologist can perform a staging laparotomy to surgically remove and determine the extent of the tumour. Following the surgery, he/she can review the pathological diagnosis and determine if additional treatment is required. If chemotherapy is indicated, the same gynaecologic oncologist is capable of administering treatment. This allows the patient to form a long-term, meaningful relationship with her physician.
- The gynaecologic oncologist is prepared to provide important supportive services such as: pain management, management of medical or surgical complications from treatment, complications of the cancer, and hospice referral. Again, this benefits the patient.