January 2002 · Vol. 14, No. 1Gynecologic care of the cancer patient
As more Ob/Gyns provide follow-up care to patients who have survived cancer, there is an increased need for information on how to better care for these women with regard to menopause, risk for subsequent disease, and preventive care.
MERCEDES
CASTIEL,
MD
WILLIAM
HOSKINS,
MDDr. Castiel is head of general gynecology and director of the Barbara White Fishman Women’s Health Center, and Dr. Hoskins is deputy physician-in-chief, disease management teams; chief of the gynecology service in the department of surgery; and holds the Avon Chair for Clinical Research at Memorial Sloan-Kettering Cancer in New York City. He also serves on OBG Management’s board of editors.
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KEY POINTS
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Selective serotonin reuptake inhibitors (SSRIs), clonidine hydrochloride, and megestrol alleviate hot flushes in women who opt not to take hormone replacement therapy (HRT) due to concerns about subsequent disease.
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Local estrogen therapy in the form of an estradiol-releasing vaginal tablet or ring effectively improves vaginal atrophy and has a higher patient acceptability than vaginal cream.
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Because a majority of women who have survived breast cancer have not been screened for BRCA1 and BRCA2 mutations, Ob/Gyns should screen survivors to identify those patients at risk for subsequent disease.
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Approximately half of the women who survive breast or a gynecologic cancer report severe, long-lasting sexual problems.
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As more is discovered about cancer, caring for the cancer patient has become even more complicated. Women who have survived cancer, even nongynecologic diseases, increasingly are being followed by general obstetrician/gynecologists or primary care physicians. To help Ob/Gyns provide better care, this review will summarize cancer patients’ special needs with regard to menopause and premature menopause, genetic screening techniques, and well-woman care.
Only about 15% of postmenopausal women use HRT.
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