History of GOC
In the 1970's there began within the specialty of Obstetrics and Gynaecology, the identification of the need for certain members to develop experience and expertise in the management of gynaecologic cancer. Such individuals would provide leadership and, where appropriate, responsibility for the management of patients with gynaecologic cancer.
Prior to this time, while most of the initial diagnosis and assessment of gynaecologic cancer was made by gynaecologists, the treatment varied greatly from one area of the country to the other and, if anything more than simple surgery was required, radiotherapy was utilized exclusively.
The need for the development of special expertise in the overall care of the cancer patient from screening to treatment to palliation was greatly needed. The principle that gynaecologic oncology patients would have a single physician until they are cured or undergo palliation was the key to the development of the subspecialty, which was first developed in the United States during the 60's and early 70's. The constant involvement of gynaecologic oncologists through all phases of the patient's cancer treatment was envisaged to provide optimal integration of surgery, radiation and chemotherapy. This continuity of care and reassurance by a single physician in all steps of the cancer process was deemed as highly desirable and was actually the first time such a concept was considered.This concept formed basis for the subspecialty of gynaecological oncology.
In the early 70's in Canada, a few if any obstetrician gynaecologists took an interest in the treatment of gynaecological cancer. There were some notable exceptions who had an a particular interest only in the surgical aspect.
A few of these early 'pioneers' in gynaecologic oncology included Dr. Cosby and Dr. Bean from Toronto; Dr. Turko from Vancouver; Dr. Allen of London; Dr. Blahey from Montreal and Dr. Tupper from Halifax.
The renewed interest in the surgical management of early invasive cancer of the cervix, plus the introduction of effective cytotoxic agents for carcinoma of the ovary offered an opportunity to develop more effective and varied gynaecologic treatment arms, and encouraged a number of gynaecologists to develop a greater interest in this field. Among those who became involved were the late Dr. Peter Vernon of Toronto, Dr. Leigh Brown of Edmonton, Dr. John Carmichael of Kingston and Dr. Bob Seymour of Montreal. As well, the opportunity for further Post Fellowship training in gynaecologic oncology became available in centres in the United States. Canadians began to return with formal training in this subspecialty and a declared interest in devoting most of their energies to this field. Included in this group were Dr. Lou Benedet of Vancouver; Dr. G. Krepart of Winnipeg; Dr. D. DePetrillo of Hamilton; Dr. Michel Roy of Quebec; Dr. Bob Fraser of Halifax, and Dr. David Popkin of Montreal. Two other circumstances at the time encouraged the development of the subspecialty and the subsequent formation of the Society of Gynaecologic Oncologists of Canada.
The first was the development of a Clinical Trials Division of the National Cancer Institute of Canada. Gynaecologic cancer played an early role in the development of this division, particularly the ovarian clinical trials. This allowed gynaecologists interested in oncology to meet with each other at the annual national meetings of the N.C.I.C. As well, because they were usually responsible for the administration of these trials in their own communities, this allowed them to be identified to their fellow gynaecologists within their community as a reference and resource for these particular clinical problems.
In addition, in 1974, the Association of the Professors of Obstetrics and Gynaecology of Canada (APOG) struck a Committee chaired by Dr. David Boyes of Vancouver with Dr. R. Fraser of Halifax and Dr. J. A. Carmichael of Kingston as members. This Committee was given the task of defining the subspecialty of Gynaecologic Oncology, it's role within the gynaecologic community, as well for the training required for gynaecologic oncologists. This was presented to APOG at their annual meeting in 1976 and was unanimously accepted by every academic department in Canada.
In 1979, largely under the enthusiastic leadership of Dr. DePetrillo of Hamilton, a small organizing committee (Drs. Krepart, Anderson, Fraser, Gerulath and Roy) convened to explore the development of a society. A nucleus committee of Drs. DePetrillo, Anderson and Roy were charged with drawing up the by-laws for the society and in January of 1980 the Society of Gynaecologic Oncologists of Canada was incorporated over the signatures.
In June 1980, the first Annual Meeting of the Society of Gynaecologic Oncologists of Canada was held in Jasper, Alberta in association with the annual meeting of the Society of Obstetricians and Gynaecologists of Canada.
In 1986, gynaecologic oncology became a subspecialty of the Royal College of Physicians and Surgeons of Canada and the Society of Gynaecologic Oncologists of Canada became a national subspecialty association. Since then, the society has grown, with the development of five Royal College specialty training programs in gynaecologic oncology in Canada. Gynaecologic oncologists can receive their training within Canada and all major cancer centres in the country now have gynaecologic oncologists. The Society has a number of meetings including an annual meeting occurring in June of each year. In 1998 the Society voted to increase its membership to not only include gynaecologic oncologists but also medical oncologists, radiation oncologists and pathological oncologists who devote a significant amount of their time to the treatment and research of gynaecological cancer.The Society represents the only national forum and gathering point for all specialists trained in treating gynaecological cancer.
What is a gynaecologic oncologist?
A gynaecologic oncologist is a specialist who has had five years of postgraduate training in obstetrics and gynaecology. He/she subsequently does a further two years of cancer training. The principle of longitudinal integrated care is the hallmark of the gynaecologic oncology practice. This means that a single physician has the necessary skills and knowledge to manage a patient from screening and initial diagnosis of gynaecological cancer to its treatment and subsequent therapy in both surgery and chemotherapy and subsequent palliation if necessary. These physicians are highly trained in all aspects of gynaecological cancer and include specialized training in radical surgical procedures, chemotherapy, the use of radiation therapy and other treatments of the disease. The majority of members participate in university and cancer centres and devote a significant portion of their practice to research and education.
S.C. Peter Bryson
GOC Historian
