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Peter Dottino, MD, in honor of Gynecologic Cancer Awareness Month

September 25, 2023

How has treatment improved for patients with gynecologic cancers, and in your opinion, what is the outlook for gynecologic cancer in the next five years?

There’s been a lot of dramatic changes in outcomes for patients with gynecologic cancers just looking back since I started over 35 to 40 years. Life expectations for some gynecologic cancers was less than two years and now we are curing a small percentage – maybe 15% of these patients, but a good portion will live between five and nine years on new therapies. The longer someone lives, the more options they have for all of these new therapies that come along. And so our ability to continue to treat patients, to continue to offer them surgeries, has had a fairly profound impact on increasing survival. But with these treatments and surgeries, we are always conscious of quality of life for our patients that it as good as it can be.

What are some of the biggest challenges you face in caring for patients with gynecologic cancers? 

One of the biggest challenges is the frustration that we know that with early detection, most of these cancers – with ovarian cancer and endometrial cancer being among the most common gynecologic malignancies – the earlier they are caught, the better, because we know they’re curable if you catch them early. Eighty-five percent of the women diagnosed with ovarian cancer are going to be Stage 3 or Stage 4. While we’ve extended their survival beyond five years, they still will ultimately succumb to drug resistance. But we know if you catch it in Stage 1, the cure rates are going to be well north of 94%. So a bigger emphasis has to be put on driving money toward early detection and awareness. The case where screening has set an example is the development of a Pap test for cervical cancer in the 1930s. Cervical cancer has fallen to the bottom of cancers in the U.S. because the Pap test picks up a precancerous condition on a patient’s cervix. They don’t need to have a hysterectomy and can receive office-based treatments – a freezing treatment, a laser treatment – and you cure the cancer before they even get it. You cure the precancerous state. But we have to make sure that everybody gets the Pap test. They should be made available to every woman, not just those with health insurance.

As we honorGynecologicCancer Awareness Month, what do you want our patients and families to pause and remember?

It’s important that we always keep in mind that it’s just not the patient that we treat. Every patient is a tree with many branches. There’s a husband, a wife, a sister, a brother, there’s children, parents, friends, and neighbors. You realize how cancer affects the lives of everyone around the patient. I think it’s important to realize that we’re all in this together.

Submitted by Eliza Folsom on September 25, 2023