Gynecologic malignancies such as cervical, ovarian, and endometrial cancers found in young adult patients often present with several additional challenges compared to their older cohorts. Peter Frederick, MD, FACOG, Roswell Park's Clinical Chief of Gynecology and Director of Minimally Invasive Surgery in Gynecologic Oncology, discusses treatment options for young adult GYN cancer patients, how those treatments might impact their lifestyle, career and future fertility options, and the potential long-term effects of their cancer and treatment.
Hello, my name is Doctor Peter Frederick and I am a gynecologic oncologist here at the Roswell Park Comprehensive Cancer Center in Buffalo New York. And the topic that I wanted to discuss today uh was young adults with cancer. And in the field of gyne logic oncology, we see several different kinds of cancers that unfortunately affect younger patients, specifically cervical cancer and some forms of both ovarian cancer and endometrial cancer. And I think that this situation requires um a unique skills set to address some of the specific needs and challenges uh that occur in this patient population. And that's what I wanted to discuss today. Young adults with cancer have a lot of different uh concerns. Uh Some of these can include the desire to maintain future fertility. Uh a concern to be there for their young families. Uh They might be getting started in a new career and there are concerns about uh long term effects of their cancer and their cancer treatment. And so when dealing with all of these different considerations, I think it's important to have a high level of both experience and expertise to help navigate these difficult circumstances here at Roswell Park. One of the things that we really pride ourselves in is a multidisciplinary approach to care. We work very closely with pediatric oncologists uh that really have an expertise in some of the psychosocial aspects of dealing with a cancer diagnosis in young adulthood. We also partner with reproductive endocrinologists in the community to talk about various options for fertility conservation with cervical cancer. Uh Our board certified specialists uh have an approach that will help sometimes depending on the stage of the cancer maintain fertility. I did have one patient that comes to my mind that came to us with an early stage cervical cancer. And we were able to do a conization that maintained her uterus and allowed her to go on and have three successful pregnancies after that case. And so, uh certainly that was very important to her and her family and uh is is a nice benefit that we were able to bring to her. I think one of the other things that we also deal with is the long term effects of cancer treatment. One of the things that is unique about Roswell Park is that we have a survivorship clinic. The survivorship clinic here has a team of physicians and advanced practice providers that help uh patients of all ages uh once they are done with their cancer treatment and they have achieved remission. And so this allows us to bring both evidence based approaches to cancer surveillance and also sometimes uh has a higher level of suspicion for any long term effects of both the treatment and perhaps secondary cancers. The other thing that is unique about Roswell Park is our partnership with our certified genetics counselors. Many times when a younger patient is diagnosed with cancer, there could be factors at play that would predispose them to this diagnosis such as genetic factors. So our genetics counselors allow us to uh facilitate and obtain the testing to identify any risk factors that are of a genetic nature and also provide counseling to the patients. What other cancers might they be risk at risk for how to screen for that, how to do risk reduction, uh as well as how to counsel their families um for any uh cancers that they might be at risk for. In addition to cervical cancer, there are other cancers that we deal with in the department of Gynecologic oncology that can affect young adults. And uh one of the things that we pride ourselves in is an expertise at uh fertility sparing treatments such as fertility sparing surgeries. Um just because a patient does have a cancer diagnosis does not mean that the treatment will result in long term infertility. So I think one of the things that's unique about Roswell Park is the fact that as a comprehensive Cancer center, we have all of these experts, genetics experts, psychosocial experts, uh surgical experts all under the same roof. So the fact that we are all working together as a unified team, really helps provide seamless care for our patients. And of course, when it comes to cancer prevention, I think that one of the most important things is to prevent these cancers before they happen. So our specialists at Roswell Park can also offer expert advice and uh partnerships with our physicians in the community about evidence based screening approaches for cervical cancer as well as other conditions. So, if you are a physician uh in the Western New York area or even beyond Western New York, and you have a young patient that you think either has a cancer or may be at risk for a cancer. Please don't hesitate to send them to us at Roswell Park and we'd be happy to provide our expertise for them.