Gynaecologic Oncology : Its finally here!

Dr Samar Gupte,
Gynaecologic Oncosurgeon
81, Swami Vivekananda Rd,
Near Police Station,
Khar West,
Mumbai – 400052

In the Greek era, the great Plato said, “each man is capable of doing one thing well. If he attempts several, he will fail to achieve distinction in any.”

This fact is true in all aspects of life, more so in the field of medicine. The advent of the industrial age and evolution of science resulted in specialization. In the past, there would be one doctor, hakim or vaid who would treat all human condition. Centuries and decades later, they specialized into physicians, surgeons, obstetricians and gynaecologists.

As knowledge, evidence and science grew, physicians evolved into different specialities like dermatologists (skin specialists), psychiatrsts, pathologists, microbiologists. Later, with advent of imaging (Xrays, sonography etc) doctors also became radiologists. Some surgeons concentrated on bones, joints and fractures and became experts called orthopaedicians. There were enlightened surgeons who concentrated on eye diseases to become opthalmologists and others concentrated on ear, nose and throat to become experts in these areas. Some physicians worked in the field of anaesthesia to become anesthetists.

In the 20th century, physicians became more specialized into cardiologists (heart), nephrologists (kidneys), neurologists (brain), oncologists (cancer medicine) etc while surgeons super specialized into cardiac surgeons, urologists, neurosurgeons. New fields like plastic surgery evolved out of basic surgery. Surgeons dealing only with cancers became oncosurgeons.

With all these changes, it became evident and very clear that patient outcomes and results were far better when their diseases were treated by the respective experts. With time and further increase in scientific knowledge, research, evidence and equipment all fields specialized even further into sub specialities. Gynaecologists became fertility experts dealing only with infertility and some obstetricians became fetal medicine experts.

Cancers of the uterus, cervix, ovaries, fallopian tubes, breast and pregnancy cancers are included in the purview of gynaecologic cancers. In the 1950s, the developed world realized that, treatment outcomes were far better in women when treated by qualified gynaecologists who were further trained in the field of cancer surgery (oncosurgery) and cancer medicine (oncology).

As a result, training programs were initiated for superspeciality training for gynaecologists. The program included training gynaecologic surgeons further into carrying out the difficult and complex surgeries required for these cancers. Training included aspects of preventive oncology, diagnostic methods, surgical and medical management, rehabilitation of these cancer victims and survivors, their mental health, palliative care, end of life care and many such aspects.

There is now absolute irrevocable evidence to the fact that, women with gynaecologic cancers, when treated by gynae-oncologists have a far superior quality of life and live much longer and better.

Such dedicated programmes are in India, only for the last 20 odd years. The tribe of trained Gynae-Oncologists is still small, but growing fast. Moreover, the high end complex surgical skills acquired during this training, makes the gynae oncologist more adept at surgically dealing non cancerous but equally challenging pelvic diseases like difficult endometriosis, tuberculosis, complex fibroids and other non cancerous pelvic tumours. As gynae-oncologists, we offer state of the art medical care, to treat women with gynaecologic cancers, precancerous diseases and other cancer like conditions.

Theodore Roethke, the American thinker and poet said, “What we need is more people who specialize in the impossible.”

The gynae-oncologist essentially is a one stop shop that coordinates a team which offers diagnosis, treatment (complex surgeries, chemotherapy, radiation), rehabilitative and palliative care with the ultimate aim of enhancing and bettering the lives of women with cancer.

 
Dr. Samar Gupte
(Consultant Gynaecologic Oncosurgeon)