Seated in Fred Hutch buiding conference room, Dr. Okoth looks surprised to see me. Please come in, he tells me. Dr. Anthony Ndira Okoth is a Gynaecologist and Obstetrician. He is the Programs Director for the Fellowship Programme in Gynecological Oncology. In a one on one Interview he explains the Fellowship Program in Gynecological Oncology.
The fellowship is about gynecological oncology a specialised field of medicine that focuses on cancers of the female reproductive system. Some cancers include ovarian cancer, uterine cancer, varginal cancer, cervical and vulvar cancer. We are therefore aiming at producing Gynecologic oncologists who specialize in the diagnosis and treatment of cancer in female reproductive organs. They're trained in a variety of diagnostic techniques and management procedures, such as surgery on reproductive organs, radiation therapy and chemotherapy.A gynecologic oncologist is a physician who specializes in diagnosing and treating cancers that are located on a woman’s reproductive organs. Gynecologic oncologists have completed obstetrics and gynecology and then pursued subspecialty training through a gynecologic oncology fellowship. Fellowship involves two additional years of intensive training about surgical, chemotherapeutic, radiation, and research techniques that are important to providing the best care for gynecologic cancers.
Why is an integrated approach important?
“For any cancer patient, it’s beneficial to find an integrated model where doctors are treating the whole patient, not just the disease,” says Dr. Okoth. “With so many cancers, body image issues, sexual function issues, menopause symptoms, and even emotional distress can all impact a patient’s quality of life. Women should have a specialist that can address these concerns, with an understanding of the whole patient.”
Who should see a gynecologic oncologist?
Any woman with a gynecologic cancer should see a gynecologic oncologist if at all possible. In fact, women should see a specialist as early in the process as possible, says Dr Okoth Ndira Antony the Programs Director for the Fellowship Programme in Gynecological Oncology.
“Any woman with a known or suspected gynecologic cancer should be seen by a gynecologic oncologist from the start. Patients who have their first procedure by someone other than a gynecologic oncologist may not receive the most optimal surgery for the disease,” says Dr. Okoth. “With cancer you don’t often get a second chance, so you want an optimal treatment plan from the beginning,” he adds.
Why is it important for a woman with gynecologic cancer to see a specialist?
Gynecologic cancers are complex and treatment often involves multiple modalities such as surgery, chemotherapy and radiation. A gynecologic oncologist is specially trained to diagnose and treat these types of cancers, as well as premalignant conditions that lead to gynecologic cancer. They see women with gynecologic cancers every day, and have developed the skills and judgment required to perform procedures on the reproductive system.
“Gynecologic oncologists provide a level of expertise that’s different from other oncologists, who may treat a variety of cancers like breast, colon, pancreatic, liver, and others. The only cancers gynecologic oncologists treat are gynecologic cancers. That narrow focus is beneficial,” says Dr. Okoth.
Research suggests that women with ovarian cancer who are treated by a gynecologic oncologist tend to have better outcomes than those who are not. “At the end of the day, gynecologic cancer patients do better when treated by a specialist they have better outcomes. Gynecologic oncologists are very focused on these particular cancers. Even with an uncommon gynecologic cancer, we know the latest research in those areas,” says Dr. Okoth.
What unique skills can a gynecologic oncologist offer?
Gynecologic oncologists are trained in providing comprehensive, multidisciplinary care. Finding the exact stage of the cancer is vital to planning the most appropriate treatment. Gynecologic oncologists are trained to perform accurate staging surgery and cytoreductive (debulking) surgery to find and remove tumors that have spread in the pelvic and abdominal areas.
Another advantage to seeing a gynecologic oncologist is that one doctor can manage all your treatment. Following surgery, a gynecologic oncologist can administer chemotherapy if needed. “Because a gynecologic oncologist can perform surgery and administer chemotherapy, it allows for continuity of care. We can develop a long-term relationship with the patient. Most doctors either do surgery or provide chemotherapy. We will do both,” says Dr. Okoth.
For example, for patients with ovarian cancer that has spread through the abdomen, there is an option of giving chemotherapy directly in the abdominal cavity. This technique of delivering chemotherapy to the site of cancer may improve survival for patients with ovarian cancer. Unfortunately, many patients with ovarian cancer are not offered this treatment option.
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. They can work with the rest of your cancer team to address all of your needs throughout treatment.
What should gynecologic cancer patients look for when selecting a cancer treatment facility?
“When selecting a cancer treatment facility, gynecologic cancer patients should look for the availability of fellowship-trained gynecologic oncologists. They should also make sure that the facility treats a high volume of women with gynecologic cancer and that the gynecologic oncologists do a lot of procedures,” says Dr. Okoth.
Many gynecologic cancer patients are concerned about how treatment will affect sexual function, and younger patients often have concerns about fertility. Women should make sure the facility they choose addresses the many aspects of the disease. In addition, family members are often a critical part of the gynecologic cancer patient’s care team, so a facility that partners with caregivers is important.