CTOS OP ED: Questions, Comments & Counterpoint

Suzie Siegel, who wrote an article for ESUN, Options and Follow-up Care for Women with Uterine Sarcoma, sent the following note to Ian Judson in response to his February 2007 editorial.

"I wish Dr. Judson would comment on gynecologic sarcomas. In the United States, women often see a gynecologist or gynecologic oncologist. The latter often thinks he is the specialist that a woman with sarcoma should see. If he refers her for a second opinion, he may send her to another gyn oncologist, not to a sarcoma center.  Women with gyn sarcomas fall through the cracks of the medical system. Very few gyn oncologists study gyn sarcomas. Meanwhile, doctors in sarcoma centers include us in clinical trials and research but rarely, if ever, mention our situation."

Here is Dr. Judson's reply:

"Dear Suzie,

You raise a very important point. Until a few years ago we saw very few gynaecological sarcomas on my unit but now they represent a significant part of our work. They are frequently only diagnosed after hysterectomy and there is no doubt that the fact that they are so often mistaken for benign fibroids is the main reason for their late diagnosis. There remains a great deal of ignorance about their appropriate management in terms of adjuvant radiotherapy, subsequent surveillance and the potential adverse effect of hormone replacement therapy in a proportion of cases. I agree that patients with gynae sarcomas deserve to be managed by sarcoma multidisciplinary teams just as much as any other type of sarcoma, since the same principles apply, i.e. patients with rare tumours benefit from being treated by an experienced team. Thank you for raising awareness of this issue.

With best wishes,

Ian Judson"

V4N2 ESUN Copyright © 2007 Liddy Shriver Sarcoma Initiative.