Evolving Roles in Gynecologic Oncology: Balancing Surgery, Systemic Therapy and Team-Based Care

Dr. Stephanie Blank, a gynecologic oncology leader at Mount Sinai, highlighted how the field has shifted from a primarily surgical specialty to a more complex, multidisciplinary practice. Advances in treatment, including improved drugs and the use of neoadjuvant chemotherapy, have reduced the need for more aggressive procedures. “We’re not just a surgical specialty anymore,” she explained, noting that modern care now requires a broader skill set.

Understanding “Scope Evolution” in practice

As the field expands, there is no longer a single way to practice gynecologic oncology. Some physicians focus more on surgery, while others play a larger role in systemic therapy. Dr. Blank described this as “scope evolution,” emphasizing that not every clinician can do everything. At the same time, all gynecologic oncologists must understand systemic treatments, which have become increasingly complex and require close patient involvement rather than a “cookbook medicine” approach.

The growing complexity of treatment

With newer therapies come new challenges. Treatments now involve more nuanced decision-making and can carry serious side effects, requiring time, expertise and coordination. Physicians must also navigate institutional barriers, as some need to advocate for the ability and resources to provide comprehensive care, including systemic therapy.

The importance of team-based care

Dr. Blank underscored that gynecologic oncology is a team effort. Advanced practice providers play a critical role in patient care, particularly in managing side effects and supporting patients throughout treatment. “They’re critical to the practice,” she said, adding that these providers should be fully integrated into clinical decision-making and even clinical trial development.

What patients should know

For patients, especially those newly diagnosed, Dr. Blank stressed the importance of seeking care from experienced specialists and high-volume centers, where outcomes are often better. She also encouraged patients to feel comfortable with their care team and to seek a second opinion if needed. “It’s never just one person—it’s always a team,” she said.

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