For women diagnosed with a reproductive system or gynecologic cancer, a gynecologic oncologist is a crucial member of the care team. These doctors are highly trained in both surgical and medical oncology and are experienced in treating the complexities that often come with female reproductive and gynecologic cancers, including:
A gynecologic oncologist’s practice is dedicated to taking care of women with gynecologic cancers, so they have a wealth of specialized knowledge and experience.
“One of the very unique aspects of being a gynecologic oncologist is that we are the only specialists trained to be both surgical oncologists as well as medical oncologists,” says Nnamdi Gwacham, DO, a gynecologic oncologist at City of Hope® Cancer Care Tatum Ridge.
Dr. Gwacham performs complex surgical procedures for malignant as well as benign gynecologic conditions and is trained to perform minimally invasive robotic surgeries and radical cytoreductive surgeries. Because of his comprehensive training, he has a wholistic appreciation for the complicated nature of female reproductive cancers, including scenarios requiring fertility preservation.
“Compared to other oncology specialties, gynecologic oncologists utilize both their surgical and medical skill sets in their integrated approach to the diagnosis and treatment of cancer,” Dr. Gwacham says, adding “and that’s why patients do better when you have a gynecologic oncologist taking care of you.”
In this article we’ll explore:
- What is gynecologic oncology?
- The benefits of gynecologic oncologists
- Finding a gynecologic oncologist
If you’ve been diagnosed with a gynecologic cancer and want to get a second opinion of your diagnosis or treatment plan, call us or chat online with a member of our team.
What is gynecologic oncology?
Gynecologic oncologists use their training and experience to manage all or most of their patients’ treatment, including diagnosing and staging the disease and performing surgery to remove the cancer.
To determine the proper treatment, gynecologic oncologists and pathologists often work together to perform a comprehensive diagnostic evaluation to determine the type and stage of the cancer. Diagnostic procedures may include:
Gynecologic oncologists may also use leading-edge robotic and minimally invasive surgery to find and remove tumors that have spread in the pelvic and abdominal regions—and conduct sentinel lymph node removals, which are performed to help prevent complications after surgery.
While training programs for this sub-specialty have been around since 1972, statistics show there are not enough gynecologic oncologists to treat the roughly 100,000 women diagnosed with gynecologic cancer each year in the United States. Estimates range from about 1,300 to 1,500 gynecologic oncologists practicing in this country as of 2023.
In 2020, a study presented at the Society of Gynecologic Oncologists Annual Meeting on Women's Cancer found that 98.3 percent of those practicing were located in urban areas with nearly 62 percent of U.S. counties without access to this sub-specialty.
The shortage of gynecologic oncologists may be partly due to the challenging nature of the training required. Landing a coveted fellowship spot is highly competitive and training requires an additional three to five years beyond residency, according to Dr. Gwacham, who already was in his ObGyn residency when he became aware of this sub-specialty, and it piqued his interest.
“That sort of lit the fire, at least for me,” he says. “I gained curiosity about the field.”
The usual route to becoming a gynecologic oncologist requires four years of medical school, completion of a four-year obstetrics and gynecology residency, followed by a three- to five-year fellowship in gynecologic oncology. This extensive training results in:
- Thorough knowledge and understanding of the biology and pathology of gynecological cancers
- Surgical techniques, including state-of-the-art robotic and minimally invasive technologies to help preserve fertility
- Using the latest and most appropriate chemotherapy, immunotherapy and targeted therapy to treat the cancer
- Harnessing precision medicine including using genomic testing to offer patients biomarker-informed treatments and clinical trial access
- Partnering with radiation oncologists to coordinate access for patients who could benefit from combined modality therapy
Over the past few years, as the benefits of having a gynecologic oncologist as part of a woman’s cancer treatment team have become more apparent through research studies, more training opportunities have opened up and the number of gynecologic oncologists has slowly edged upward.
“Certainly, in the last five, six years or so, we have sought to train more gynecologic oncologists,” Dr. Gwacham says. “There are more fellowship training programs, more fellowship training spots, that ultimately will be good for women, especially if we can place gynecologic oncologists in underserved areas.”
A study in Frontiers in Oncology noted the crucial role gynecologic oncologists play in women’s care, saying “gynecologic oncologists not only play an important role in performing an optimal surgery, but they can also provide a better overall quality of care by having a holistic conception of women.”
| Cancer type | Estimated new cases in 2024 | Estimated deaths 2024 | Five-year survival rate |
|---|---|---|---|
| Cervical cancer | 13,820 | 4,360 | 67% |
| Ovarian cancer | 19,680 | 12,740 | 51% |
| Uterine cancer | 67,880 | 13,250 | 81% |
| Vulvar cancer | 6,900 | 1,630 | 70% |
The benefits of gynecologic oncologists
What are the benefits of having a gynecologic oncologist on your care team?
“That’s simple,” says Dr. Gwacham. “When a gynecologic oncologist is involved in the care of someone diagnosed with gynecologic cancer the outcomes are better.”
Research studies bear this out. According to the Frontiers in Oncology study, “patients operated on by gynecologic oncologists have significantly better oncological outcomes, which resulted in an increased overall survival of 10 months, in comparison with those patients treated by general gynecologists or general surgeons.”
The study also notes that the precise and effective surgical skills these highly trained subspecialists possess not only result in greater survival rates but also may help preserve fertility in women of reproductive age.
Another study published in the Journal of Clinical Oncology looked specifically at women with endometrial cancer and concluded “care provided by gynecologic oncologists improved the survival of those with high-risk cancers.”
Specifically, the study found that women with advanced-stage disease had a five-year disease-specific survival rate of 72 percent when treated by a gynecologic oncologist versus a 64 percent survival rate when treated by other types of specialties.
Dr. Gwacham believes “the reason the outcomes are so good is because of the specialty training that gynecologic oncologists receive. We tackle disease from two different sides—medically and surgically. It’s important to have a gynecologic oncologist who is thinking from both sides on your side when you are battling gynecologic cancer.
“Anyone who is diagnosed with a gynecologic cancer should always have a gynecologic oncologist on their team,” he says. “We have proven data that demonstrates that outcomes are better whenever a gynecologic oncologist is spearheading the treatment course.”
Finding a gynecologic oncologist
With these highly trained sub-specialists at a premium, City of Hope is fortunate to have gynecologic oncologists on staff across its national system, with three serving the Phoenix area.
“That’s paramount because that’s where the great majority of patients are—in the community,” Dr. Gwacham says. “People don’t have the resources or the means to drive many, many miles. It’s nice to have the community impact with the gynecologic oncologists we have here at City of Hope.”
Increased training opportunities for the sub-specialty also has led to more gynecologic oncologists. Research published in 2021 in the journal Gynecologic Oncology shows that “since 2015, gynecologic oncologists are working at more clinics and hospitals and covering a greater geographic area, thus providing greater access to specialized gynecologic cancer care. Our findings suggest that rural disparities related to access to gynecologic cancer care may be addressed by having doctors travel to their patients, rather than the other way around.”
City of Hope prioritizes having gynecologic oncologists immediately take the lead and direct care for gynecologic cancer patients, from diagnosis through survivorship.
As Dr. Gwacham advises: “Certainly anytime a patient has a diagnosis of a gyn cancer, I’d encourage that patient to seek out and at least have a meeting or consultation with a gynecologic oncologist when navigating their cancer journey.”
If you’ve been diagnosed with a gynecologic cancer and want to get a second opinion of your diagnosis or treatment plan, call us or chat online with a member of our team.
