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More often than not, progress in medicine occurs incrementally. The report of an'important'new observation is typically greeted by a mixture of excitement and skepticism. Yet the true value of the discovery may not be known for several years until it is confirmed (or refuted) by independently conducted studies. In some cases, controversy may continue to shroud a topic due to the discordant results generated by different research groups. Since the last Gynecologic Oncology volume in the Cancer Treatment and Research series, a number of new areas have emerged that shed new light on the pathogenesis, diagnosis, and treatment of gynecologic malignancies. In this volume of the Cancer Treatment and Research series, I have attempted to integrate articles that highlight some of these newest developments with chapters that provide an overview of selected areas of controversy. This volume is not meant to be an abbreviated text of gynecologic oncology but rather a collection of selected works that can provide the reader with a better perspective on the areas of change within the field. The application of molecular biology to cervical cancer has allowed us to understand more completely the roles of human papilloma viruses and cellular oncogenes in the development of cancer of the uterine cervix.

At the turn of the century gynecology had achieved independence from surgery in most medical schools; although gynecologists were surgeons, their interests were turning toward nonsurgical aspects of their specialty. In 1900, merely two years after the Curies'discovery, radium was first used as a treatment for carcinoma of the cervix. In that day cervical cancer claimed more women's lives than any other malignancy and was described by Wil­ liam P. Graves, the second professor of gynecology at Harvard as follows:'Cancer of the cervix may rightly be termed of all tumors one of the most deadly and most ghastly. It kills by slow torture, causing in later stages months of agonizing pain and producing a discharge of such a foul and nauseating character as to repel proper medical assistance. Nurses declined to care for these cases, while many public hospitals closed their wards to them as patients.'In late twentieth century parlance the dramatic results of radium therapy would indeed have been called a'breakthrough'? and radium techniques, later combined with external irradiation, were devel­ oped by gynecologists, no longer just surgeons. Pathology was the basic science of gynecology and gynecologists with a special interest in pathology served as pathologist to the departments of gynecology. As late as 1970 six months of the three-year residency program in obstetrics and gynecology at Harvard were devoted to formal training in pathology.