Survivorship in gynecological cancers: addressing psychosocial and physical challenges

INTRODUCTION: Gynecologic cancers represent 16% of cancers in women worldwide. With the advent of novel therapeutics, gynecologic cancer patients are increasingly experiencing longer disease-free intervals or cure. Optimizing survivorship care for patients can improve post-cancer quality of life. AREAS COVERED: We searched PubMed and utilized OpenEvidence to identify citations relevant to gynecologic cancer survivorship. Gynecologic cancer has a distinct impact on sexual health and fertility. We characterize and explore interventions for fertility management, sexual dysfunction, and premature menopause. Physical concerns following systemic therapy, radiation, and surgery can have lasting effects into survivorship. We emphasize the most common post-operative chronic morbidities including ostomies and lymphedema, sequalae of pelvic radiation, and chronic health conditions due to immunotherapy and targeted therapy. Emotional and psychosocial aspects of survivorship both impact and are impacted by the physical and sexual domains of survivorship. We discuss mental health, financial, and interpersonal implications of survivorship and avenues to improve psychosocial outcomes after gynecologic cancer. EXPERT OPINION: Survivorship in gynecologic cancer will continue to gain importance as the field makes gains in therapeutic treatments and early diagnosis and treatment. Subsequent research will need to focus on models of care implementation including virtual components and coordination across health systems.