SGO Issues June 29, 2017
SGO releases review on post-treatment surveillance and diagnosis of recurrence
Carol Brown joins Biden Cancer Initiative Board
Four new educational brochures available for patients
HVO, SGO unite to launch gyn onc project in Nepal, Ghana, Uganda, Honduras
FWC launches new website for National Race to End Women’s Cancer
The July 2017 edition of Gynecologic Oncology features an evidenced-based review, “An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations,” by Ritu Salani, MD, MBA; Namita Khanna, MD; Marina Frimer, MD; Robert E. Bristow, MD; and Lee-may Chen, MD.
Noting that there is a “paucity of research regarding the most effective strategies for surveillance after patients have achieved a complete response,” the main findings were that testing beyond symptoms and examination are of limited benefit.
“There is very little evidence that routine cytology or imaging improves the ability to detect gynecologic cancer recurrence that will impact cure or response rates to salvage therapy,” the authors wrote.
“These results are not particularly surprising, but it is important that most data is based on limited or retrospective results,” said lead author Dr. Salani. “Until prospective trials are conducted, surveillance evaluations will continue to have variability.”
The article’s authors pointed out two items from SGO’s Choosing Wisely list of tests and procedures that physicians and patients should question:
- Avoid routine imaging for cancer surveillance in women with gynecologic cancer, specifically ovarian, endometrial, cervical, vulvar and vaginal cancer.
- Don’t perform colposcopy in patients treated for cervical cancer with Pap tests of low-grade squamous intraepithelial lesion (LGSIL) or less.
“Unfortunately, the overuse of imaging in the setting of surveillance continues to occur at high rates despite lack of data demonstrating any benefit,” said Dr. Salani. “I suspect this is a result of resistance or slow adoption of change to current practice, lack of awareness of guidelines/data, and patient requests/demands. Providing patients and other health care providers with the updated SGO guidelines may help set expectations and eliminate unnecessary testing.”
Based on their review, Dr. Salani explained that it was not possible to tell if the use of colposcopy has decreased for cytology less than high grade. “However, there are studies showing that the use of cytology after cancer treatment did decrease,” she said. “Regardless, we agree with the Choosing Wisely campaign and advocate for limited use of cytology and reserving colposcopy for cases with high grade findings when cytology is performed.”
Dr. Salani added that while she is not aware of any clinical trials evaluating surveillance at this time, it would be an ideal opportunity to incorporate surveillance as a part of other clinical trials.
SGO President Elect-I Carol Brown, MD, has been named to the Board of Directors of the Biden Cancer Initiative, which was launched on June 26 by former Vice President Joe Biden and Jill Biden, EdD. The Biden Cancer Initiative will develop and drive implementation of solutions to accelerate progress in cancer prevention, detection, diagnosis, research and care, and to reduce disparities in cancer outcomes.
The Biden Cancer Initiative will be headquartered in Washington, DC, and led by some of the same team who led the White House Cancer Moonshot for then-Vice President Biden. The BCI Board is comprised of world-renowned leaders and experts in the fields of medical research, patient care, information technology, finance, management, patient engagement, patient experience, and public policy.
“I am honored and excited to work with the Bidens and the other Biden Cancer Initiative board members to tackle some of the barriers that are impeding rapid progress against cancer,” said Dr. Brown, who is the Director, Office of Diversity Programs in Clinical Care, Research, and Training, at Memorial Sloan Kettering Cancer Center in New York City. “I hope to focus on three BCI areas that SGO has also identified as crucial for women with GYN cancer: Reducing disparities in outcomes through equitable access to high quality care for underserved populations, improving access to cutting edge clinical trials, and reducing the financial toxicity of cancer treatment that so many of our patients experience.”
SGO members can order updated educational brochures for their offices from the Foundation for Women’s Cancer. The brochures on cervical cancer, ovarian cancer, endometrial cancer and CA 125 levels were recently updated by members of the SGO Communications Committee. The following brochures are available online and as hard copies:
- CA 125 Levels: Your Guide
- Ovarian Cancer: Your Guide
- Cervical Cancer: Your Guide
- Endometrial Cancer: Your Guide
To order these brochures and other available titles, print and send back the FWC brochure order form.
Health Volunteers Overseas (HVO) is seeking volunteers for a new gynecologic oncology project in Nepal, Uganda, Ghana and Honduras. Volunteers for the Nepal project must be board-certified gynecologic oncologists with at least two years of post-fellowship experience. HVO’s new project in Nepal will bring expert volunteers to develop a gynecologic oncology curriculum for both didactic and clinical skills. HVO volunteers will also bring surgical and didactic training to the Nepal gynecologic oncologists, providing the required number of supervised hours to qualify for local certification.
In addition to the volunteer opportunities in Nepal, HVO and SGO are working on solidifying opportunities for sites in Ghana, Uganda and Honduras.
Gynecologic oncology volunteers are needed in Tegucigalpa, Honduras, to provide teaching and training to staff physicians, residents and students at Hospital San Felipe. Volunteers need to have been in active practice for at least five years.
Dates and specialist needs for Honduras in 2017:
- Aug. 6-12: Surgical oncologist and gynecologic oncologist
- Nov. 5-11: Surgical oncologist and breast oncologist
For more information please contact Andrea Moody, firstname.lastname@example.org, at Health Volunteers Overseas.
HVO’s oncology program is supported by the SGO and the American Society of Clinical Oncology. HVO’s obstetrics and gynecology program is supported by the American College of Obstetricians and Gynecologists. To learn more about volunteering for this project, visit hvousa.org, contact HVO at email@example.com, or call 202-296-0928 to schedule a trip and learn more.
This week, SGO’s Foundation for Women’s Cancer launched a new version of the endwomenscancer.org website for the National Race to End Women’s Cancer on Sunday, Nov. 5, in Washington, DC. The new website instructs visitors on how to donate to the cause, register for the race, join a team and sign up for a Survivors Course, and includes inspirational stories from gynecologic cancer survivors.