As knowledge grows and o h experience is tabulated and analyzed, there must occur modifications in our management of d i d s e aad in the principles and policies that direct our decisions. In gynecologic oncology, some degree of change ih perspective has t a k h place in almost every aspect, in prevention, screening, detection, diagnostics, and therapeutics, as well as in the attention devoted to the sociologic, emotional, and political implications of cancer in women. The specialty is now 50 years old and was established and fbstered by physicians who thought in surgical terms and who were willing and competent to extend their technical arena as far and as fast as continuous improvements in anesthesia and other support measures permitted. The textbooks and journal publications of that era clearly mirror this emphasis. A new generation of gynecologic oncologists has assumed leadership. Their training is broad, and their knowledge and competence extends far beyond technical surgery. This is well illustrated by the program of this conference. And comparison of this program with that of the last session five years ago clearly demonstrates how far we have come from a time of preoccupation with morphology and technique.
Cancer 48425-428, 1981.
OTHING BETTER CHARACTERIZES the enthusiasm N and ferment in iherapeutics during the middle decades of this century than our efforts in gynecology to cure malignant disease. It was well understood tl-iat cancers of the corpus, cervix, and vulva were slowgrowing, accessible tumors that spread in a predictable manner and metastasized relatively late in their course, often long after the primary tumor had become grossly apparent. What better reason was needed to encourage expansion of the volume of tissue treated as fast as supportive measures could be designed to maintain the patient and keep the risks and morbidity down to acceptable levels. Although it may not be entirely accurate to state that we were determined to cure cancer at almost any cost, the surgical effort in barticular occasionally included very extensive resections and rearrangements of function. These were made possible by great improvements in anesthesia and in the prevention of shock, by