Cancer Today - Winter 2015

Comprehensive Treatment and Surveillance for Gynecologic Oncology
Survivorship Program for Gynecologic Cancer Survivors

Gynecologic cancers affect the reproductive system, including the ovaries, uterus (endometrium), cervix, vulva, vagina, peritoneum and fallopian tubes. Together, these cancers are the fourth most commonly diagnosed in women in the U.S. each year.  

With better detection of early malignancies and improved treatment modalities, thousands of women are surviving gynecologic cancers. And because many women are diagnosed when they’re relatively young, they’re often living for decades after their treatments end.

The Survivorship Program created by the Division of Gynecologic Oncology at Stony Brook University Cancer Center helps survivors cope with the unique physical, psychological, social, sexual, emotional, fertility, financial and quality-of-life issues that these women may have now or in the distant future.

A one-of-a-kind program
What makes this program so unique is its depth and comprehensiveness, and the degree to which it’s personalized for each patient. That’s possible because patients are treated by an interdisciplinary team within the Division of Gynecologic Oncology. From the day of diagnosis to the end of treatment and through often multiple years of follow-up, all important details about a patient and her treatment are documented and shared within the team. This ensures consistent, quality care and reduces potential problems that can result from fragmentation of efforts. 

“We know the patients and they know us. We form tight bonds. Patients know they can trust us to have their best interests at heart. And it’s not just about medical issues related to cancer treatment, though that’s a big part. It’s also about helping a woman take back control of her life and her future.”
-Marlo Dombroff, PA,
Director, Gynecologic Oncology Survivorship Program

Three tiered: information, tools and support
A central element of the program is an all-inclusive, end-of-treatment report, delivered and thoroughly explained to each patient by Ms. Dombroff. The report is an individualized, detailed account of everything related to a woman’s cancer, from the diagnosis to the dates and full descriptions of every treatment and medication received, to ways to reduce the risk of recurrence. Ms. Dombroff goes through the entire report with the patient, line by line, adding explanations where needed and answering questions. 

The report further explains what a woman should watch out for in the years to come, such as possible complications, long-term effects or toxicities resulting from treatment, or side effects that could occur months or even years after treatment has ended.  It provides a schedule of what types of follow-up care and surveillance will be needed, and provides referrals for screening for other types of cancers, if indicated, along with general health guidelines for mammograms, colonoscopies, osteoporosis screening and so forth.

Because fertility and sexuality, as well as general social issues, are frequent areas of concern for patients with gynecologic cancer, referrals may be given for fertility consults, sexual therapy, psychosocial support, genetic counseling or physical therapy. 

Additional resources provided can include access to support groups for cancer survivors, advice on possible lifestyle changes such as nutrition classes, weight loss programs, fitness programs tailored to gynecologic oncology patients, or smoking cessation help.

Valuable information for referring physicians
Many times, a woman’s primary care physician or gynecologist receives progress notes but otherwise has limited participation in the treatment a woman receives. The Gynecologic Oncology Survivorship report,which is also provided to the woman’s referring physician, gives that doctor crucial details, offers guidelines on long-term care and follow-up, and alerts the doctor to known medical complications to look out for, such as cardiac events, lymphedema or a secondary malignancy. 

“We want the program to give a woman the tools and support to empower her future as a survivor,“ concludes Ms. Dombroff.

For the full issue: Cancer Today • Winter 2015