SGO Issues April 12, 2018
Gynecologic Oncology focuses on healthcare disparities
SGO Annual Meeting tops 2,500 attendees
Three finalist teams win Shark Bait competition
Winner announced for #SGOHAWAII50 contest
SGO, ACOG to hold joint session at ACOG Annual Meeting
As part of a Special Section on Healthcare Disparities in Gynecologic Oncology, this month’s Gynecologic Oncology features, “A contemporary framework of health equity applied to gynecologic cancer care: A Society of Gynecologic Oncology evidenced-based review” by Sarah M. Temkin, MD; B.J. Rimel, MD; Amanda S. Bruegl, MD; Camille C. Gunderson, MD; Anna L. Beavis, MD; and Kemi M. Doll, MD. In the article, the authors provide practical recommendations for practitioners aimed at eliminating cancer-related outcome disparities.
In addition to listing disparities that are specific to particular gynecologic malignancies, such as cervical, endometrial and ovarian cancers, the article’s authors focused on patient populations that are at risk of healthcare disparities due to inherent mismatches in the healthcare system. These groups include: indigenous, patients of black race, low English fluency, trans and gender non-conforming patients, and rural populations.
“Whenever possible, patients should be allowed to self-identify their race and ethnicity,” said lead author Dr. Temkin.
The authors also made several recommendations for attaining health equity, including a patient navigation service for underserved populations.
“Cancer care delivery today involves multiple layers of the healthcare system that interact to affect outcomes for patients,” explained Dr. Temkin. “The scope of cancer care has grown beyond a single oncologist–patient relationship. Not only are physicians, including oncologists, increasingly specialized, but treatment of cancer today frequently includes multiple additional practitioners that the patient is in direct contact with, such as physical therapists, nutritionists, or wound care nurses.
“Negotiating treatment, multiple office visits, health insurance and pharmacy benefits are overwhelming to even the most organized and educated patients. Oncologic outcomes can be negatively impacted by the stress of navigating the complex structures of the health care system.”
Dr. Temkin added that special populations such as the poor and minority women are at increased risk of getting lost within the system. Patient navigators are now routinely employed within large cancer centers to work with patients and families to help with many different needs associated with the health care system and since 2016 have been a requirement for Commission on Cancer (CoC) accreditation.
“This may include finding doctors, explaining treatment and care options, communicating with their health care team, supporting caregivers, and managing medical paperwork,” she said. “Not every patient navigator does all of these things, and there is no single list of services but patient navigation should be tailored to a hospital and a population’s unique needs such that gaps in care can be bridged and barriers to care can be recognized and solutions identified.”
Dr. Temkin noted that healthcare providers can mitigate health care disparities amongst patients in their own practices by doing something as simple as keeping a list of resources available to patients or directing patients and families towards local and regional resources.
“Provide patient-centered care whenever possible. Use language that is free of stigma,” she said. “And advocate for systems within your practice, hospital or region that improve patient care particularly for those who are disadvantaged. Improving health equity requires a community commitment to improved health for all members of our society.”
The journal’s special section on disparities also includes articles on differences in medical comorbidities and race, disparities in genetics assessment, biological origins of sexual orientation and gender identity, and other aspects of the impact of income and race on survival.
The 2018 SGO Annual Meeting on Women’s Cancer in New Orleans marked the fourth year in a row with record attendance with 2,526 total attendees, including 408 international attendees from 47 countries. A total of 545 total abstracts (Including 16 international and 4 late-breaking abstracts) were presented at this year’s meeting. Abstracts will be published in Gynecologic Oncology in early June. Media coverage of the meeting included stories in Time, Newsweek, Men’s Health, Cosmopolitan, ABC’s Good Morning America and NBC’s Today.
All three finalist teams were awarded $5,000 each from the GOG Foundation as part of SGO’s Shark Bait competition during the 2018 SGO Annual Meeting on Women’s Cancer last month. A total of 14 teams submitted their ideas to serve SGO membership to the Shark Bait Task Force, which narrowed down the submissions to three finalists. The following teams are the winners of the 2018 Shark Bait competition:
Honey Badgers Don’t Care: SGO Policy Leadership Forum
Team Leader: Ryan Spencer, MD, University of Wisconsin School of Medicine and Public Health, Madison, WI;
Team Members: Shitanshu Uppal, MD, University of Michigan, Ann Arbor, MI; Stephen Rose, MD, University of Wisconsin-Madison (UWM); Sandy Niemi, MD, UWM
The goal of the SGO Policy Leadership Forum is to increase the mentorship surrounding policy and economics for gynecologic cancer care by creating a program to train young gynecologic oncologists in these substantive and nuanced arenas. This program would provide training to a select group of interested and motivated early career gynecologic oncologists to prepare them for the complex regulatory and funding landscapes for cancer care.
Mind Over Matter
Team Leader: Monica Hagan Vetter, MD, The Ohio State University, Columbus, OH
The Mind Over Matter proposal involves a “Resilience Masterclass” where SGO members learn about three dimensions of positive psychology—resilience, strength, and mindfulness—with the ultimate goal of equipping participants with the ability to create their own wellness program. This masterclass would be taught by subject experts and would include practical interventions that one can apply to their daily life.
synAPPtic Oncology App
Team leader: Juliet Wolford, MD, University of California-Irvine, Orange, CA (UCI)
Team members: Diana Pearre, MD, UCI; Ramez Eskander, MD, University of California San Diego Moores Cancer Center, La Jolla, CA
The proposed SynAPPtic application synthesizes chemotherapeutic information into an easy-to-search database. The app will be specific to the field of gynecologic oncology and will include sections on chemotherapeutic regimens by disease type, toxicity/treatment, dosing, treatment algorithms, references to appropriate landmark trials, and current clinical trials. SynAPPtic will work to help ensure appropriate drug dosing, increase patient safety, while simultaneously encouraging exploration of appropriate clinical trials.
In addition to the $5,000 award to be put towards making each proposal areality, all of the winning team members will receive a free registration to the 2019 SGO Annual Meeting in Honolulu, HI.
Congratulations to Allison M. Saiz, MD, (pictured in center) a resident at UC Davis Medical Center in Sacramento, CA, for winning a free registration to SGO’s 50th Annual Meeting on Women’s Cancer in Honolulu, HI, March 16-19, 2019. Contest participants took selfie photos at the SGO/FWC booth in the Exhibit Hall during the 2018 meeting in New Orleans and posted them to Twitter or Facebook with the hashtag #SGOHAWAII50 and the winner was randomly selected.
SGO and the American College of Obstetricians and Gynecologists (ACOG) will host a joint session on “Gynecologic Surgery: Tips, Tricks and Oops!” during ACOG’s 2018 Annual Clinical and Scientific Meeting in Austin, TX, on April 27. The three-hour course will be moderated by Farr Nezhat, MD, FACOG, FACS, and Fidel Valea, MD. This session is geared towards the general Ob/Gyn community and gynecologic surgeons doing open or endoscopic surgery.
The course includes sessions on “Navigating the difficult pelvis” (MIS and open surgery) and “Complications in gynecological surgery” (MIS and open surgery) with Dr. Nezhat; “ERAS: Maximizing the desired outcomes” (mostly open surgery) and “Energy use in gynecologic surgery” (MIS and open surgery) with Dr. Valea; and “Surgical tools, toys and tips” (mostly MIS) and “Surgical decision making in the obese patients” (open surgery) with Melissa Frey, MD.
“Gynecologic Surgery: Tips, Tricks and Oops!” is one of 11 subspecialty collaborative sessions that will review hot topics, current trends and identify what practicing ob-gyns need to know.