Gynecological Oncology is a specialized branch of Gynecology and Obstetrics. Especially in our country, it gained an official status in 2011 and was accepted as a minor. In this department, which is accepted as gynecological oncology surgery, doctors who are trained in the diagnosis, treatment and follow-up of precancerous lesions and cancer diseases originating from the female genital system and breast are trained. Gynecologist oncologists work in partnership with medical oncology, radiation oncology, pathology and many other medical disciplines and hold scientific meetings called councils.
When we look at the scope of gynecological oncology, surgical operations are performed especially starting from the vulva, which is the female external genitalia, and covering cancers of the vagina, cervix, uterus, tube, ovary and peritoneum.
Again in this context, many masses, cysts and tumors that develop from the area where the female organs, which we call sarcoma, carcinosarcoma and pelvis, are located, are treated with surgery. When we look at the precancerous lesions, the diagnosis and treatment of the lesions we call vulvar intraepithelial lesions (VIN), Vaginal intraepithelial lesions (VAIN), Cervical intraepithelial lesions (CIN) are performed.
In addition, a comprehensive evaluation of the vulva, vagina and cervix with a microscope called colposcopy to examine some changes caused by the effects of the HPV virus is also an application in the field of gynecological oncology.
Considering the surgical techniques of gynecological oncology, these operations can be performed with the methods we call open, laparoscopy (closed surgery) and vaginal surgery. Which surgery will be performed is a process in which the doctor and the patient will decide together, depending on the patient’s request and the characteristics of the disease.
When we look at the surgeries for pre-cancerous lesions, surgical removal of the problematic area, which we call vulvar/vaginal local excision, LEEP for the cervix, which we call the cervix, and conization can be easily performed vaginally.
Today, there is strong scientific data that some aggressive ovarian cancers develop from the fringed end of the organ we call the tube, which we call the fimbria. In this sense, within the scope of cancer-reducing risk, it is recommended that the tube be completely removed, not tied, especially in women who have completed the number of children and requested sterilization.
On the other hand, gynecological oncology surgeons have an important role in the field of onco-fertility in gynecological cancers. In this case, fertility-preserving surgeries can be performed according to the type and stage of the tumor and the characteristics of the patient, especially in women without children, in the early stages of cancer and pre-cancer.
In some countries abroad (such as Germany), gynecological oncologists are involved in the surgical treatment of breast diseases and cancers. In our country, gynecologist oncologists play an active role in breast cancer screening, diagnosis and follow-up processes.
Within the scope of gynecological oncology, chemotherapy treatment before or after surgery is given by gynecological oncology specialists in some centers.
In addition to the effective diagnosis and treatment of gynecological cancers, follow-up processes are also vital. Cancer has many biological/genetic features that we do not know today. Even in the early stages, recurrences of these cancers are encountered. Early detection and early treatment are life-saving. In this regard, gynecological oncology follow-ups are very important. These follow-up intervals are determined by the gynecologist oncologist according to the characteristics of the disease.
Cancer diagnosis, treatment and follow-up are of vital importance. This field is specific and challenging work. It should be handled by trained and direct experts on the subject.
I wish everyone a healthy day.