Barbara A. Goff, MD
Making a difference in gynecologic oncology
Dr. Barbara Goff was born at the University of Washington Medical Center, back when it was called University Hospital. Growing up, she considered becoming an astronaut before following a medical tract. “Becoming a doctor seemed more practical for family life,” she says.
Despite relocating to California as a child, and receiving an east coast education, studying at Brown University, University of Pennsylvania , and Harvard, Dr. Goff spent summers at her grandparent’s house on Bainbridge Island. After graduating from medical school and marrying her husband, who is also a gynecologic oncologist, she decided to return to the Pacific Northwest to once again make Seattle her home.
Devoted to family
Dr. Goff has two children to whom she devotes much of her time, especially in after-school concerts and recitals. Her young daughter is an active Irish Step and ballet dancer, and her teenage son is an accomplished musician, who has mastered six instruments, including the bagpipes.
“It was very hot the summer of 2003 during my sabbatical in London,” Dr. Goff says. “Our flat didn’t have air conditioning, and like most people from the Northwest, we couldn’t take the heat, so we escaped to Scotland for a few days.”
They happened to arrive in Scotland during a Fringe Festival where bagpipers serenaded passersby on nearly every corner. “My son fell in love,” Dr. Goff recalls. “He bugged me for a year before I gave in and got him bagpipes—they are a very complicated instrument to play. But he loves it and is now part of the Northwest Junior Pipe Band.”
Her artistic children are an anomaly to Dr. Goff, as neither she nor her husband plays any musical instrument.
“I consider myself a partner in my patients’ care,” Dr. Goff explains. “Having a multidisciplinary approach is key. I enjoy it when patients take an active role in their healthcare. My role is to give them options as there is no one right way to do things. Seattle Cancer Care Alliance is a great place because of this multidisciplinary approach.”
Social workers, physical therapists, and nutritionists are a few of the specialists patients work with during their care and treatment at SCCA. “They are all part of a patient’s whole life and are such great people to collaborate with,” Dr. Goff continues. “We’re all into our work and we all bring the best to the table for our patients.”
Oncology then and now
Back in the 1980s when Dr. Goff finished medical school, getting chemotherapy was almost as bad as getting cancer, she says. “We have better support medications now that have nearly eliminated the horrible nausea that comes with treatment. There are also new, novel drugs to treat cancer being introduced. These are precise therapies that target the cancer and are non-toxic to surrounding tissues,” Goff says. “New developments make this an exciting time to be an oncologist.”
The field of oncologic surgery has improved over the last 20 years ago as well. “We have high-tech surgical suites and are performing less invasive surgeries. We’re even beginning to use robotics,” she says. A hysterectomy, which once required a week-long recovery period, now only usually keeps women in the hospital for two to three days.
Probably the most exciting news in cancer treatment of late is the HPV vaccine, which was approved for use by the U.S. Food & Drug Administration in the summer of 2006. “This is very exciting for our daughters, who may see a complete eradication of cervical cancer [in their lifetimes],” says Dr. Goff.
The HPV – human papillomavirus – vaccine targets HPV types 16 and 18, which account for 70 percent of cervical cancers, and HPV types 6 and 11, which cause 90 percent of genital warts. These four HPV types also cause benign cervical changes that result in "abnormal" Pap tests, the commonly used screening test for cervical cancer. Dr. Denise Galloway, head of the Program in Cancer Biology in the Human Biology and Public Health Sciences Divisions at the Fred Hutchinson Cancer Research Center, was one of the lead investigators that developed this important new vaccine.
While cervical cancer may soon be on the way out, Dr. Goff is seeing a rise in the number of women with endometrial cancer, particularly in younger women. “Obesity is the link,” she says. “It’s getting out of hand and becoming a bigger and bigger problem.” A disease that most often affected post-menopausal women is now being diagnosed in women in their 40s.
And ovarian cancer continues to be a huge challenge to diagnose early. Dr. Goff and Dr. Elizabeth Swisher, director of the Breast and Ovarian Cancer Prevention Program at the SCCA, are hard at work researching genetic mutations and prevention tactics. “Until we can screen people effectively, we can at least look at an at-risk woman’s genes and perform profphyilactic surgery if necessary.”
Terri Rider has a history of cancer in her family, and is considered at risk for cancer herself. The results of genetic tests she had helped her decide that prophylactic surgery was a good idea. After a hysterectomy/oophrectomy, pathology revealed that Terri did indeed have very early-stage ovarian cancer.
“Dr. Goff was friendly and informative. She met with my family after the surgery to reassure them that all went well. And when the pathology report came back, she contacted me immediately to let me know and to set up a treatment schedule,” Terri says. “She has followed me for over five years and has shown great care, concern, information and attention regarding my condition, even though I’ve had no recurrence of the cancer. I have complete confidence in her as my gyn oncologist and have a special feeling of gratitude for all that she has done for me.”
There are early warning symptoms of ovarian cancer, according to Dr. Goff. But they often go unnoticed because they are often vague symptoms that people may experience off and on normally. Some of the symptoms include abdominal swelling, pain, bloating, a feeling of fullness even after a light meal, a change in bowel habits, frequent urination and loss of appetite. You may also notice irregular bleeding, or bleeding with intercourse. “If these are new symptoms that persist for at least three weeks, you should talk to your doctor,” Dr. Goff says.
Living with precision
Dr. Goff has researched and written extensively about ovarian cancer, early detection, and treatment. “There is a significant difference in cure rates if ovarian cancer is found early,” she says. As many as 70 to 80 percent of cases may be cured if found early. That figure drops to nearly 30 percent for those cases diagnosed later, which unfortunately make up nearly 80 percent of cases.
Dr. Goff is also active in researching the pattern of care women across the country are receiving for their cancers. There are guidelines in the United States that are not always being followed she says, providing an opportunity for improvement.
When Dr. Goff isn’t providing patient care or conducting research, she is busy teaching. She is the director of the Gynecologic Oncology fellowship program for the University of Washington School of Medicine and teaches surgical skills as well. “I have a passion for surgery and the precision of surgery,” she says.
A woman who lives her life precisely the way she wants to, when she isn’t working toward curing cancer, Dr. Goff can be found skiiing the Canadian Rockies, traveling abroad, or attending her children’s performances.
Read the stories about some patients treated at SCCA for cervical and ovarian cancer: Elizabeth Records, Suzanne Larsen, and Kim Sheldon.
Barbara A. Goff, MDDr. Goff is a gynecologic oncologist who specializes in caring for women with cervical, endometrial, ovarian, and other gynecologic cancers.
Patient Care Philosophy:
A comprehensive and compassionate multidisciplinary approach to treatment of gynecological malignancies.
- Professor, Gynecologic Oncology, University of Washington School of Medicine
Biology of ovarian cancer; clinical trials for gynecological malignancies; gynecologic surgery; hereditary ovarian, tubal and endometrial cancers
Education And Training
- University of Pennsylvania School of Medicine, 1986
- Residency: Brigham and Women's Hospital Obstetrics & Gynecology, 7/87-7/90
- Fellowship: Massachusetts General Hospital Gynecology/Oncology, 7/90- 7/93
- Visit PubMed for a full listing of Dr. Goff's journal articles.
- In this video , Dr. Goff shares prevention tips and screening information for gynecologic cancers.
- In this video , Drs. Goff and Martins discuss the human papillomavirus (HPV) vaccine and their recommendation about when children should be vaccinated.