Like any field of medicine, gynecologic oncology has faced its fair share of challenges during the COVID-19 pandemic.
Dr. Noah Goldman
Board-Certified Physician, Gynecologic Oncology and Obstetrics and Gynecology
But it has also seen several advancements as a result of scientists and doctors continuing to innovate and build upon their learnings amid the crisis.
“I think COVID-19 has affected every industry,” says Dr. Noah Goldman, a board-certified physician in Gynecologic Oncology and Obstetrics and Gynecology. “The oncology world initially had a problem in that it was difficult at the time to set up home chemotherapy treatments. It requires monitoring.”
Because several cancers are typically treated with surgery first, oncologists had to strategically schedule patients’ procedures based on the aggressiveness of their cancer. And in cases where treatment efficacy would be unlikely to change, doctors prescribed chemotherapy before surgery, allowing patients to minimize time spent in the hospital.
“The oncology world, especially gynecologic oncology, did a really good job of trying to balance that, and people have now returned to the operating room,” says Goldman, who added that recent studies have shown that chemo administration during the COVID-19 pandemic didn’t increase death or hospitalization rates of cancer patients, allowing business to continue as usual.
Propelling research and treatment
During the pandemic, recruitment for gynecologic oncology clinical trials continued without interruption, Goldman says. That’s thanks, in part, to organizers shifting enrollment from academic centers, which needed to focus on COVID-19 treatment, to community centers. They also recruited patients online. The result: a 50 percent increase in enrollment.
Other recent innovations in the field include a shift toward less invasive surgery such as with robotics, which has helped reduce surgery and recovery time as well as the risk for complications, Goldman explains. Artificial intelligence, or AI, and computer-based learning have also expanded upon how diagnoses are made, such as following colposcopy. In the future, these technologies have the potential to fill care gaps in underserved and underdeveloped parts of the world.
Other treatment strides include growing research around the benefits of immunotherapy, antibody therapy, and biologics for gynecologic oncology patients. These have been “a godsend in terms of how things have changed in the three big cancers: uterine, cervix, and ovary,” Goldman says. He noted that using either immunotherapy or poly-ADP ribose polymerase (PARP) inhibitors, which are a type of biologic or targeted therapy, have increased progression-free survival rates among patients. In the future, these advancements may lead to less usage of cytotoxic chemotherapy and thus fewer side effects for patients.
Encouraging gynecologic cancer screening
As access to in-person care has been restored, Goldman urges the importance of cancer screenings among women, the patient group affected by gynecologic cancers. “Through no fault of their own, women tend to want to take care of everybody else and put themselves on the backburner,” Goldman says. “If something is abnormal, take the time to get it checked out.”