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Ovarian cancer study reveals most women don't get adequate treatment from the start

March 21, 2013

While many surgeons may operate on a pelvic mass, a certain type of surgeon – a gynecologic oncologist - is specially trained to handle what may be found to be ovarian cancer. A study recently presented at the Society of Gynecologic Oncology (SGO) conference in Los Angeles showed that most women do not get appropriate care when found to have an ovarian mass, and this can lessen their chance of survival.

Not all ovarian cysts are ovarian cancer, but when an ovarian cancer is found, a gynecologic oncologist is particularly suited to perform the operation. This study found that most women around the country with a new diagnosis of ovarian cancer are treated incorrectly or incompletely up front by physicians that don't specialize in ovarian cancer. This leads to delays in care, additional surgery, and lower survival rates.

The study, reported in the New York Times, showed that only a third of patients received the best possible care. The type of surgery and treatment necessary to combat ovarian cancer involves meticulous, extensive surgery and aggressive chemotherapy. Since ovarian cancer often spreads inside the abdomen, survival rates are improved when women have surgery called debulking, which may involve removing the spleen, parts of the intestine, stomach as well as the reproductive system. Gynecologic oncologists are particularly skilled in recognizing the signs of cancer surrounding other organs and removing it, and perform this procedure on a regular basis.

There are many reasons a woman may opt to undergo surgical removal of an ovarian mass under a general surgeon or gynecologist; they may think there isn't enough time to find a specialist, or maybe they aren't aware their condition requires a surgeon specializing in gynecologic oncology. Gynecologic oncologists are trained to better identify and remove all visible traces of the disease in surgery, whereas a surgeon inexperienced with debulking may discover the cancer but be unsuccessful in removing all of it. Seeking surgical treatment from a gynecologic oncologist optimizes a woman’s chance for successful treatment with chemotherapy and/or radiation in the future.

Ovarian cancer affects 22,000 women each year. It is a disease that arises suddenly and has very few, if any early symptoms. The symptoms that women do feel area often vague and confused to be normal – such as abdominal bloating, a bit of constipation, or a feeling of fullness in the upper abdomen. Most ovarian cancers are advanced stage by the time of diagnosis and therefore need aggressive treatment with surgery and chemotherapy.

Surgeons who lack expertise in ovarian cancer should refer women to a gynecologic oncologist for pelvic or ovarian masses that are suspicious. Awareness is key; if a loved one is seeking surgical treatment of an ovarian mass, let them know about this study and urge them to see a specialist. Here at UF Health Cancer Center at Orlando Health's Gynecologic Oncology Center, we have four gynecologic oncologists that are able to provide this meticulous surgery and fine-tuned chemotherapy. Women getting their care at such a center of excellence stand a better chance of doing well over the long term.

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