Mission:
The creation of a Division of Gynecologic Oncology is in line with institutional mission of creating centers of excellence and sub-specialization in order to capitalize on an underserved segment of our specialty. The creation of such a division will be essential for introduction of a fellowship program at a later date.
The Division of Gynecologic Oncology strengthens the following pillars:
Services – It is estimated that the majority of gynecologic cancers in Lebanon and the Middle East is cared for by physicians with no formal training in the field. The gynecologic oncology patients’ load at AUBMC has steadily increased over the last years and the diversity and complexity of the procedures have grown as well. At present’ we offer all variety of diagnostics and treatments related to gynecologic oncology in all its aspects. Over the years we have been able to expand the services provided to include:
- Sentinel lymph sampling in vulvar cancer and more recently in endometrial cancer
- Advanced complex upper abdominal surgery in ovarian cancer: our rates of R0 debulking match the best centers in USA and Europe
- Intra-peritoneal chemotherapy for ovarian cancer
- Sugar-Baker Cyto-Reductive Surgery and Hyperthermic Intra-peritoneal Chemotherathy (CRS and HIPEC) for certain ovarian tumors (one of very few centers in the Middle East).
- High dose Rate Brachytherapy and Intensity Modulated Radiotherapy for cervical cancer in addition to concurrent chemotherapy
- Use of targeted therapy in gynecologic malignancy
- Colposcopy and LEEP procedures for premalignant cervical lesions
- Advanced surgical procedure for the adherent placentas in collaboration with Maternal Fetal Medicine division (one of very centers in the region).
- Minimally invasive surgery (MIS) in gynecologic oncology, including laparoscopic and robotic surgery in cervical, endometrial, and ovarian cancer.
Our collaboration with ancillary services such as the radiotherapy department, the medical oncology department, the children cancer center, and the surgical oncology center has helped us shape the care of our patients in a way that parallels the best centers in the USA.
The collaboration with the gynecologic oncology services at Hotel Dieu de France University Medical Center and the Rafic Hairiri Governmental University Hospital has been crucial in aligning/standardizing the care of such patients in Lebanon. The senior faculty in the division has been instrumental in leading the Lebanese society of obstetrics and gynecology educational programs and the yearly workshops in gynecologic oncology, and in the international Federation of Obstetric and Gynecology-Gynecologic Oncology Committee and the MOH gynecologic oncology management guidelines.
Moreover, the clinical load in our center and its variety provides a valuable opportunity for a rich clinical interaction and a solid platform for the introduction of a postgraduate training program at later stage. The presence of a fellow in a clinically busy program generates momentum in quality improvement of patient services through enhanced patient accessibility to care and availability of physician support.
Physician Teaching and Education – Currently, formal post-graduate medical education in Gynecologic Oncology is inexistent in Lebanon and the Middle East. Opportunities for Gynecologic Oncology fellowship positions in the USA and Europe, like for all other postgraduate positions, are expected to be the lowest ever during the coming decade. Very few formally trained Gynecologic Oncology specialists practice in Lebanon and the Middle East, whereas the greatest majority of practitioners entered the field with limited clinical exposure and the specialty is not recognized in Lebanon by the LOP and the government. The Gynecologic Oncology division within our department is working towards the establishment of such a fellowship-training program and the establishment of such subspecialty in the LOP.
Research– Faculty members within the Gynecologic Oncology division are involved in multiple research projects funded with the necessary grants. We have recently hired a research assistant and she is involved in coordinating our projects and obtaining the necessary IRB approvals and grants. Currently we have 4 residents working in 4 different projects and one medical student as well. The scope of the research spam from the role of advanced surgery in ovarian caner, the genetics of borderline ovarian tumors, the somatic mutations of high grade ovarian cancer, the introduction of HPV vaccination in a private clinic setting, the recent changes and advances in the surgical and non surgical management of Paget’s disease of the vulva and the role of CA 125 in the follow-up of endometriosis.