UPDATE on GYNECOLOGIC CANCER

New Developments that are Changing Patient Care

• Breast self-exam: Helpful or not?
• HPV vaccine promises cost-effective benefits
Ovarian cancer:
• HRT increases risk
• Consolidation therapy extends disease-free interval

Dr. Horowitz is the Willaford Ransom Leach Professor and vice chairman, department of gynecology and obstetrics, and director, division of gynecologic oncology, Emory University School of Medicine, Atlanta, Ga.

Gynecologic oncology is a dynamic subspecialty—one with several important recent developments. For example, closer scrutiny of breast self-examination has changed its status from “required” to optional, and greater understanding of cervical carcinoma and its causes is leading to a vaccine for human papillomavirus (HPV) 16/18 in the near future—an achievement likely to be highly cost-effective.

On the ovarian cancer front, data from the Women’s Health Initiative suggest an increase in cancer rates in women who take hormone replacement therapy (HRT). In fact, ovarian cancer remains our greatest challenge, since 70% of patients are not diagnosed until they reach advanced stages III and IV, when 5-year survival ranges from 5% to 40%. Fortunately, recent findings suggest consolidation therapy may help extend survival and disease-free intervals.