gyn onc and chemotherapy

[Medicalgesia]

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as someone interested in cancer biology, oncology, and surgery, i think it's interesting that gynecologic oncologists manage their patients' chemo (so i've heard). how true is this?

i'm guessing the answer may differ between private and academic. how often do academic med onc depts take over this role vs keeping it with the gyn oncologist? i checked md anderson's site for gyn onc vs breast oncology. for gyn, they list 20 surgical gyn oncs and 3 medical oncologists who apparently focus on gyn cancers. on the other hand, for breast cancer, they list 14 surgical breast oncologists, and over 20 medical breast oncologists; this makes me assume that even at top academic hospitals, the gyn onc surgeon runs the whole show. please let me know how if i'm right!

 

[Geekchick921]

I have been told the same thing by a gyn-onc doctor at my school/hospital that has given talks for our Ob/Gyn interest group about the specialty/subspecialties. In most other cases you have the surgical oncologist for surgery, the medical hem/onc doc for chemo, and the rad-onc for radiation. Gyn-onc does both the surgery and the chemo (but still defers to rad-onc for radiation).

 

[fuzzyerin]

I would say (as an attending gyn onc) that the majority of us do our own chemo still, but that in some places in the country, it's shifting to med oncs. At some of the bigger centers (MD Anderson, MSKCC) the med oncs do all the chemo and the fellows rotate through the chemo service but don't truly manage chemo patients. I prefer to do my own chemo for my patients partially because the pelvic exam is important in the diagnosis of progression/recurrence/response and med oncs aren't interested in doing a pelvic - nor are they trained to.

Some of the shift has to do with reimbursment - chemo used to be a big money maker and it's not so much anymore.