IGCS offers members the opportunity to share their stories with the greater gynecologic oncology community, inspire care givers around the world and strengthen awareness of the profession and society.
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Joel Fokom Domgue
Department of Obstetrics and Gynecology, University Hospital Centre, Yaounde, Cameroon
IGCS Member since 2014
As an African citizen, some of my family members who I cared a lot for have been pulled out of life, sometimes at a young age, due to poorly managed gynecological cancer.
As an African physician and clinical researcher, I quickly noticed the steadily increasing magnitude of gynecological malignancies in my clinical practice. Given the limitations of health systems in Cameroon as in most settings in sub-Saharan Africa, the majority of cancer patients have to be referred to tertiary level hospitals for proper management. However, very few patients can actually afford to visit these referral hospitals, because they are often from rural and remote settings, of low socio-economic level and disadvantaged backgrounds.
Moreover, I realized the little interest of physicians in sub-Sahara Africa for gynecology oncology. In fact, cancer patients often arrive at an advanced stage of the disease, when the management is difficult, costly, long, and multidisciplinary, often resulting in an uncertain outcome. In addition, the lack of chemotherapy, radiotherapy and palliative care services to accompany clinicians in the care of cancer patients in Africa does not arouse their enthusiasm for this specialty. Even those who have an interest in gynecologic oncology barely find locally an academic and clinical structure that offers such training. As far as I know, there is no practicing doctor in Cameroon to date, who is certified in oncology gynecology. Yet, the number of cancer patients in need of adequate care is constantly increasing. All these factors have prompted me to take an interest in this promising specialty, with the goal of making my modest contribution to raising awareness about the burden of gynecologic cancers in Africa, to help in providing comprehensive care to women’s cancer patients in my country while ensuring the promotion of gynecologic oncology among doctors in Africa.
I work in a reference hospital in my country as a gynecologist and colposcopist. In this capacity, I practice my clinical activity in a unit of gynecology oncology where I take care of patients with gynecological cancers. Briefly, the first step of my work is to confirm the diagnosis, then to determine the stage of the disease, to set up a multidisciplinary care plan, to perform surgical treatment when indicated, or to send patients to other specialized departments (chemotherapy, radiotherapy, intensive care unit, etc…). As a colposcopist, I carry out colposcopic examinations especially in patients referred for abnormal cytology or VIA positive. In this way, I participate in the detection and management of precancerous lesions of the uterus cervix. The treatment options for cervical dysplasia available in my department include crotherapy, LEEP and hysterectomy.
My prevention activities are not confined to cervical cancer but include other gynecological cancers. For instance, clinical breast examination is practiced and breast self-examination is taught to women who consult for various reasons in the department of obstetrics and gynecology of the University Hospital Centre of Yaounde, Cameroon. In families considered to be at risk, genetic screening for breast or ovarian cancers is advised.
In addition, in collaboration with the National Cancer Control Committee of Cameroon, I regularly participate in the organization of awareness campaigns and screening and management campaigns for cervical and breast cancers in rural areas. I also participate in the reflection aimed at elaborating the national strategic plan for gynecological cancers control in my country.
As a clinical researcher, I have noticed that cervical cancer control strategies currently being promoted by WHO do not sufficiently take into account local demands and socio-cultural realities of developing countries. This has led me to get actively involved in research projects aimed at designing realistic and cost-effective strategies for cervical cancer screening and management that are suitable for resource-constrained settings, especially African countries. On the other hand, with the advent of vaccination against HPV, I have started collaborating with partner institutions including US National Cancer Institute (NCI) and the Union for International Cancer Control (UICC), to work out how to contextualize vaccination approaches against HPV in Africa, in order to achieve maximum effectiveness while ensuring scale-up and sustainability of immunization programs.
Gynecologic Oncologist University of Pennsylvania
IGCS Member since 2014
Since medical school, I was interested in a career in global health. As I learned more about oncology and my interests in global health developed further, gynecological radiation oncology seemed to be the right fit due to the heavy burden of cervical cancer globally.
Since completing my training in 2014, I have been based full time in Botswana, in southern Africa. My work here entails running the largest public clinical oncology department, and focusing my clinical and academic work on women’s cancers-gynecological and breast. Along with my local colleagues, I developed gynecological multi-disciplinary tumor board that allows us to provide streamlined and evidence based care to women around the country. Through this clinic, we have been able to to minimize delays in care and also develop a follow up care pathway for women with gynecological cancers. We hope to emulate this model for others common cancers in Botswana as well such as head and neck and breast.
Deputy Director, University of Cincinnati
IGCS Member since 2007
I decided to pursue a career in gynecologic oncology because I was attracted to the opportunity to help women when the need is greatest through surgery and adjuvant therapies while helping to unravel the causes and newest treatments of cancers.
I am lucky to be able to wear multiple hats that include the roles of clinician, researcher, clinical trialist, patient advocate, and administrator. Needless to say these disparate roles cause endless scheduling difficulties but keep me rewardingly busy without burnout in any one concentrated area. I feel that the other roles actually make me a better physician as I am able to see the emerging ‘big picture” to the benefit of my patients. Helping lead the IGCS has been extremely rewarding as this responsibility is a mechanism to pay back to our field and move the field forward not only in the USA but throughout the world.
Lagos University Teaching Hospital. Nigeria
IGCS Member since 2014
I decided to pursue a career in gynecologic oncology because endometrial and cervical cancers are amongst the leading cause of mortality and morbidity in Nigeria. My career choice of gynaecologic pathology is to be part of the mercenaries needed to help reduce this disease burden.
I am currently having a 3 month IGCS-sponsored fellowship at the John Radcliffe Hospital, Oxford University Hospitals NHS under the supervison of Dr Sanjiv Manek. I am being trained in the proper handling and pathologic reporting of gynae-oncology specimens. We hold regular multidisciplinary meetings on the oncology cases. The hospital, being one of the largest cervical cancer screening centres in the United Kingdom further affords me a huge learning opportunity in cytology. It’s barely one month into the programme and the experience has been very rewarding. My special thanks to IGCS for making this a reality.