Objective: This study aimed to assess gynecologic oncologists (GOs)’ perceptions and attitudes toward cancer survivorship to help improve survivor care. Methods: We conducted a web-based questionnaire survey about survivorship issues for the GOs belonging to the Japan Gynecologic Oncology Group. We analyzed the proactiveness of the participants toward addressing 25 survivor issues. In addition, the practice patterns and barriers to care for survivors’ long-term health issues, such as second primary cancer (SPC) and lifestyle-related diseases (LSRD), and return-to-work (RTW) support were assessed. Results: We received 313 responses. The respondents had a mean of 22 years of physician experience. The ratio of men to women was approximately 7:3, and 84.7% worked at facilities for multidisciplinary cancer treatment. The respondents’ proactiveness for addressing psychosocial problems was significantly lower than physical and gynecological issues (p<0.01 by χ2 test). However, most GOs tried to contribute to such issues according to patients’ demands. Women GOs were more proactively involved in some survivorship issues than the men (p<0.05 by logistic regression analysis). The rates of the respondents who proactively discussed SPC, LSRD, and RTW were unexpectedly high (60.7%, 36.1%, and 52.4%, respectively). However, the GOs only provided verbal support for these issues in many cases. Conclusion The Japanese GOs were enthusiastic about survivorship care. However, their tendency to deal with survivors’ problems through their own knowledge and judgments raises concerns about the quality of care. Therefore, creating survivorship care guidelines and enhancing multidisciplinary collaboration should be prioritized.

The patient was a 73-year-old woman. She had been treated for squamous cell carcinoma of the lung (cT3N3M0, Stage IIIC) at our department. The patient had low back pain due to retroperitoneal lymph node metastasis; in June 2022, this was exacerbated as lung cancer progressed. She had difficulty in body movements due to edema in both lower limbs, in addition to the pain. Consequently, she was urgently admitted on July 8 and received radiotherapy (30 Gy/10 fractions) for retroperitoneal lymph node metastasis. She was being given tapentadol at a dose of 200 mg/day for relief of her pain. However, she was switched to fentanyl patch at a dose of 1200 µg/day during her hospitalization, which resulted in relief of low back pain. The underlying disease causing the edema was investigated. Based on physical and laboratory findings and medical history, lymphedema associated with retroperitoneal lymph node metastases was diagnosed. On day 31 of hospitalization, the patient was allowed to be temporarily discharged from the hospital because the edema had improved and the activity of daily living around the bed had increased. Treatment methods for lymphedema associated with lymph node metastasis have not been established, but the efficacy of radiotherapy has been reported. We have herein reported a case of lymphedema that was improved by radiotherapy after it was differentiated from other diagnoses.