Gynecologic oncology: changing perspectives

As knowledge grows and our experience is tabulated and analyzed, there must occur modifications in our management of disease and in the principles and policies that direct our decisions. In gynecologic oncology, some degree of change in perspective has taken place in almost every aspect, in prevention, screening, detection, diagnostics, and therapeutics, as well as in the attention devoted to the sociologic, emotional, and political implications of cancer in women. The specialty is now 50 years old and was established and fostered by physicians who thought in surgical terms and who were willing and competent to extend their technical arena as far and as fast as continuous improvements in anesthesia and other support measures permitted. The textbooks and journal publications of that era clearly mirror this emphasis. A new generation of gynecologic oncologists has assumed leadership. Their training is broad, and their knowledge and competence extends far beyond technical surgery. This is well illustrated by the program of this conference. And comparison of this program with that of the last session five years ago clearly demonstrates how far we have come from a time of preoccupation with morphology and technique.