Dr. Singh explains why a woman should have her ovarian cancer surgery performed by a gynecologic oncologist.
So the, really a cornerstone of ovarian cancer treatment is surgery. This is one of the things where I think women being aware of what their options are is really, really important. There’s a lot of studies and a lot of data that says having your surgery done right by somebody who knows how to do it is really important.
I am a gyne-oncologist, obviously like I come to this from a biased perspective, but even bias aside, looking at the literature, it’s very clear in lots of conditions that specialty care matters, so surgery.
When someone has a mass or something on their ovary and are being taken to the operating room because there is a suspicion of cancer, the ability to have an oncologist available, a gynecologic oncologist available, to do the right surgery the first time is really important.
One reason is about stage. So doing all the things we need to do to find out if the cancer has spread, such as checking lymph nodes, doing biopsies all over the abdomen, removing part of the omentum, those things.
Two, we can preserve fertility in certain people with ovarian cancer with certain kinds of ovarian cancers, especially germ cell tumors. So I have seen plenty of women in their 20s and 30s who unfortunately had more surgery than they needed when it came to taking out their uterus and their other ovary, which those are provincially preservable without sacrificing cure rates.
Three, it’s about taking out all the cancer. To somebody who has widespread ovarian cancer, stage 3 ovarian cancer, we know that one of the most important prognosticators or ways for us to know if they can be cured or not cured and one of the most important influences in their response to treatment is getting out as much cancer as possible.
So as you’re reading online, you’ll hear words like "optimal tumor reduction" or "debulking," and those are about taking out as much cancer as possible, and there’s clear-cut data that being trained to do this makes you better at it, one.
Doing things like taking out lymph nodes, even in the setting of cancer that’s spread because that might be a sanctuary site of cancer, has an influence on outcome, there’s clear-cut data about that. Now some people say, “Well, surgeons do that kind of stuff all the time.”
Absolutely, general surgeons do it. The tricky thing is knowing that it’s ovarian cancer, so having the pathologic expertise to get a frozen section that says ovary and then knowing that ovary cancer is different than some other cancers.
With other cancers, it's not as clear-cut that taking out all the cancer that’s visible makes a difference in cure rates and response to treatment. In ovary cancer, it's really quite clear. So someone who sees colon cancer most of the time might say, “Hmm, I am not sure if doing a huge operation is going to help this person, and so I am not going to do it,” that’s very, very different. In ovary cancer, it's very clear-cut that getting out the cancer gives us the best chance.
About Dr. Diljeet K. Singh, M.D., Dr.P.H.:
Dr. Diljeet K. Singh, M.D., Dr.P.H., is a gynecologic oncologist and is Co-Director of the Northwestern Ovarian Cancer Early Detection and Prevention Program. She is part of the Division of Gynecologic Oncology at the Robert H. Lurie Comprehensive Cancer Center of the Feinberg School of Medicine at Northwestern University in Chicago, Illinois.
Dr. Singh attended medical school at the Feinberg School of Medicine at Northwestern University. She completed her residency at Johns Hopkins Hospital in Baltimore, Maryland, and her fellowship at the University of Texas MD Anderson Cancer Center in Houston, Texas.
Dr. Singh specializes in gynecologic, cervical, ovarian, uterine, vaginal, and vulvar cancers.