Gynecologic Oncology

This chapter introduces key concepts and principals of diagnosis and management of gynecologic malignancies in older adults. It provides overview of the occurrence of different types of gynecologic cancers in older adults, general principals of diagnosis and treatment of these cancers, describes disparities in care for older adults with gynecologic cancers, and provides recommendations to individualize their care. Symptoms at presentation vary by cancer type and stage, and screening is currently available and recommended only for cervical cancer. Treatment of gynecologic cancers also varies by cancer type and stage and can include surgery, radiation, and or systemic treatments such as chemotherapy. Older patients have worse outcomes than their younger counterparts and black and Latino women are less likely to receive standard of care and have worse outcomes compared to white women. The final section reviews available geriatric assessment-based tools to be used during treatment decision-making to identify older women at high risk for adverse effects from cancer treatment.