What is the role of an obstetrician/gynecologist in cancer care for young women? When you think about cancer and cancer treatment, most likely you’re thinking of oncology and what line of defense will be taken against the cancer. A new article in Clinical Obstetrics and Gynecology from Oncofertility Consortium members, Betty Kong, BA, Robin Skory, BS, and Teresa K Woodruff, PhD, entitled “Creating a Continuum of Care: Integrating Obstetricians and Gynecologists in the Care of Young Cancer Patients,” argues that in some cases, the OB/GYN is the key component in this game.
Kong and Skory are both Woodruff Lab members pursuing dual MD/PhDs at Northwestern University, meaning they want to be involved in both the clinical and research aspects of oncofertility. Clearly they are invested in the scientific pathways oncofertility has to offer, but from a clinical perspective, they assert that obstetrician gynecologists are the best advocates for their patients to help them make informed decisions about their future fertility. According to the authors, “obstetricians and gynecologists [are] the primary physicians to many women during their reproductive years [thus] are in a unique position to be at the forefront of the oncofertility initiative by ensuring [they receive] the proper counseling, referrals, and continuity of care for their patients before, during, and after cancer treatment.”
For many young women, once they’ve reached the pinnacle of pediatric care (18yrs old), they are no longer regularly immersed in follow-up medical care as parents, schools, etc, require. Often the physician they see the most is their OB/GYN, whether it be for birth control options, pre natal care or their yearly exams. Many young women build long-standing patient/physician relationships with their OB/GYN as they did with their pediatricians. It is with this understanding that the authors claim the responsibility for the continuum of care falls upon the OB/GYN in many cases. Thus, the more informed they are in the field of oncofertility, the less patients will encounter a gap in their comprehensive cancer care, specifically in fertility preservation.
An OB/GYN is also in a key role should a cancer diagnosis present itself during a woman’s pregnancy. More studies need to be done on the long term affects of chemotherapy regimes on fetus development and future fertility, but there are treatments that women can undergo in their second and third trimester of pregnancy to try and eradicate the disease. According to the authors, “although it is an uncommon diagnosis, cancer during pregnancy presents a critical scenario that must be carefully treated by a multidisciplinary team of obstetrician gynecologists, medical oncologists, radiation oncologists, surgeons, pediatricians, genetic counselors, and patient navigators.” Again, as the multidisciplinary field of oncofertility develops, it is imperative that clinicians and scientists from diverse fields collaborate to provide patients with the best care possible and the most options for their future fertility.
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