The New York Times recently reported that only 37% of women receive proper treatment for ovarian cancer, mostly because gynecologists do not follow guidelines set out by ACOG (American Congress of Obstetricians and Gynecologists) and the NCCN (National Comprehensive Cancer Network). This information was taken from a study led by Dr. Robert E. Bristow, director of gynecologic oncology at the University of California, Irvine. Sadly, the study revealed that most women with ovarian cancer or a suspicion of ovarian cancer are simply not being directed to surgeons who specialize in treating cancer and specifically, gynecologic cancers.
According to Dr. Bristow, just making sure women get to the people who are trained to take care of them would improve the odds in the fight against ovarian cancer than any new chemotherapy drug or biological agent. Even ACOG agrees that women with pelvic masses indicating a high suspicion for ovarian cancer should be managed by physicians with the training and experience that offers the best chance for a successful outcome. Generally speaking, OBGYN’s lack this type of experience because ovarian cancer is so rare. Shockingly, more than 80% of the women in the study were treated by what the researchers call ‘low volume providers’ – surgeons with 10 or fewer cases a year and hospitals with 20 or fewer.
This story really hit a nerve with me for many reasons, but mainly because the guidelines are being ignored. Most women do not know that they need to be referred to a gynecologist specializing in oncology and it appears most docs are none to keen to tell them. These aren’t the only guidelines gynecologists ignore, by the way. When one considers that only 30% of OB/Gyn clinical practice guidelines have actual evidence behind them, it makes me wonder what the heck is going on with women’s healthcare today.
When I read that only 37% of women with ovarian cancer were receiving the proper care, I immediately thought of how I was subjected to improper clinical care. You can read my full history here.
Briefly, my healthy ovaries were removed during a routine hysterectomy, placing me at a much greater risk for heart disease. The removal of my ovaries and in fact the hysterectomy itself, was against clinical guidelines.
Women with ovarian cancer rarely receive proper treatment while women with no cancer often receive radical over-treatment.
Houston, we have a problem! When it comes to women’s ovaries, gynecologists too often just can’t get it right. Or maybe they just don’t want to… Of the 600,000 hysterectomies performed each year, 73% are estimated to involve ovary removal. Since 90% of all hysterectomies are considered to be medically unnecessary in the first place, this is a huge problem. Even more disturbing is the fact that less than 1% of women whose healthy ovaries are removed have a family history of ovarian cancer. One has to ask why gynecologists are routinely removing healthy ovaries from so many women – especially given the many serious health risks.
There are guidelines in place regarding the indication for hysterectomy and ovary removal. Yet, those guidelines are not followed. A whopping 76% of hysterectomies do not meet ACOG’s own criteria. The most common reasons hysterectomies don’t meet criteria and are considered to be inappropriate are lack of adequate diagnostic evaluation and failure to try alternative treatments before hysterectomy.
Gynecologists routinely rush women into surgery without trying other options first, including doing nothing other than ‘watch and wait’ in some cases. Clearly, women aren’t receiving proper care all the way around regarding ovarian cancer nor are they being properly informed about the alternatives to hysterectomy. Whether we’re talking about birth control, HRT, ovarian cancer or hysterectomy, it pays for women to become educated about their health and their healthcare options. It may save their life.