By Anna Hoekstra, MD MPH
Women with ovarian cancer live longer if they have surgery performed by a gynecologic oncologist. That has been shown in a variety of cities across the country. Recently, several students from WMed and I showed this is also true in Kalamazoo, when we studied women with ovarian cancer from southwest Michigan. Before 2009, there was no full time gynecologic oncologist in the southwest Michigan community, and many patients traveled to Grand Rapids, Ann Arbor or Detroit for surgery. Other women with ovarian cancer chose instead to undergo surgery locally with a general surgeon or OB/GYN. That changed in 2009, when a full time gynecologic oncologist came to Kalamazoo to practice, and patients in the community no longer had to travel out of the region for surgery. We now know exactly how much women in Kalamazoo and surrounding communities have benefited from having this specialty surgery available locally. Women in the Kalamazoo area with ovarian cancer live, on average, almost two years longer when there is a gynecologic oncologist available locally.
The likelihood that a woman would live five years or more with her ovarian cancer also increased from 34% to 50% after gynecologic oncologists arrived in Kalamazoo. Most gynecologic oncologists live in large cities and practice with big medical groups at academic hospital systems, like the University of Michigan. While this is convenient for women who live in these larger cities, it is not convenient for women who live far away from big hospitals. We know that women in small cities and rural towns often choose not to travel to big cities to have surgery performed by a gynecologic oncologist even if they know they could live longer. We estimate that about half of all women with ovarian cancer have their surgery performed by a general surgeon or OB/GYN surgeon, who are not specifically trained in ovarian cancer surgery.
It is important to share this research with gynecologic oncologists around the country, who strive to help women fighting ovarian cancer live as long as possible with their disease. We now understand that having ovarian cancer surgery locally available is very important for this group of women. Our hope is that more gynecologic oncology groups become established in mid-size cities like Kalamazoo.