A study of 29 Washington area hospitals found that surgeons and gynecologists treating ovarian cancer patients did not adequately find the extent of the cancer during the initial operation in more than half the cases, according to an article in the Journal of the American College of Obstetrics and Gynecology.
The study covered the cases of 298 women in area hospitals who were told they had cancer of the ovary between August 1978 and June 1981.
The report found that only patients seen by gynecologic cancer specialists had the extent of their cancers evaluated properly.
The main author of the article, a George Washington University Medical Center doctor who is such a specialist, said that the study was conducted by examining surgical notes, patient records, interviews and pathology reports.
The study is the first to analyze the ways that different doctor groups handle ovarian cancers, according to a spokeswoman for the American College of Obstetrics and Gynecology.
The study found that 65 percent of the women seen by general surgeons and 48 percent of the women seen by gynecologists did not have their cancers adequately evaluated.
"They operate on the patient but don't determine the amount of cancer in the patient," said the journal's author, Dr. Larry McGowan. "This is not a local problem. It is a national one that has been related by others."
The results should encourage women with a diagnosis of ovarian cancer to seek out a gynecologic oncologist, as "the skills and knowledge of the general surgeon and obstetrician/gynecologist in relation to ovarian cancer are not as proficient as they should be," McGowan said. The specialist has had another two years of training in cancer of the female reproductive system, he said.
His findings are important, McGowan said, because when the cancer is not fully located during the initial surgery, the treatment will not kill all of the cancerous cells.
"If steps are taken and the patient is pronounced cancer-free and the patient isn't treated, she dies," he said.
The study, which also was researched by health researchers Linda Parent Lesher, Marjorie Barnett and Dr. Henry Norris, did not determine the number of women who died.
The study indicated that doctors' incomplete discovery could be a reason that the five-year survival rates for ovarian cancer have not improved over the past 50 years.
McGowan said that doctors who are not in his subspecialty typically did not sample or observe the amount of fluid in the abdomen -- a major way in which the cancer is spread -- and did not take other tissue samples that are considered necessary for a complete evaluation.
Other local doctors and hospitals have not considered the study self-serving for his specialty, he said, noting that he has spoken at several local seminars that attempt to educate doctors on how best to treat ovarian cancer.
The cancer generally affects women over the age of 54 and often is diagnosed initially during pelvic examinations that find enlarged ovaries.
The names of the local hospitals were not revealed, but it was found that women operated upon in university hospitals had the highest rate -- 66 percent -- of receiving a complete evaluation of their cancer during surgery. Only half of those in community hospitals were found to have been studied adequately.