Best Practice & Research Clinical Obstetrics & Gynaecology
10Treatments for gynaecological cancers
Section snippets
Ovarian cancer
The lifetime risk of developing ovarian cancer is about 1in 70 for most parts of the Western World. In the UK, approximately 7000 cases are reported annually, with an associated mortality rate of 5000. The incidence varies worldwide, with the highest in Scandinavian countries at over 20/100,000 women, and lowest in Japan at 3/100,000 (Figure 1). The reasons for this difference are multifactorial including genetic and environmental. The high mortality rates associated with this malignancy are
Cervical carcinoma
Cervical cancer is the most common gynaecological cancer worldwide. Its most marked feature is the fact that the majority of women in the Western regions will present with earlier stage disease than women in developing countries, where the converse is true.
Endometrial cancer
In the main, endometrial cancer presents with postmenopausal bleeding; adenocarcinomas are the predominant histological subtype. Therapeutic options are surgery or radiotherapy. From retrospective analysis, it is considered that surgery probably has the better outcome, but this suggestion is complicated by the nature of the research. Compared to radiotherapy, surgery is quicker and has fewer long-term sequelae. It is important to note that the staging of this disease is both clinical and
Vulval cancer
This is a rare cancer and, by virtue of this alone, the evidence base for treatment is generally not based on RCTs. In the UK there are about 800 reported cases each year. There is a strong clinical impression that there are two types of vulval cancer: that associated with lichen sclerosis et atrophicus (LSA) and postmenopausal women, and that associated with young women and vulval intraepithelial neoplasia (VIN) or those with multifocal, preinvasive disease of the lower genital tract. The
Conclusions
In the main, the management of gynaecological cancers requires multimodal therapies. Generally, the use of cytotoxic agents is based on evidence from clinical trials but other interventions, in particular surgery, have had limited exposure to such studies. The main changes when caring for patients with these conditions are the overall tendency towards more conservative surgery and the increasing use of non-surgical treatments, with a recognition that when multiple therapies are required, the
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Urologic surgery in gynecologic oncology: A large single-institution experience
2014, European Journal of Surgical OncologyCitation Excerpt :In the last decades, the treatment of gynecological tumors has evolved toward a multimodal approach, including different combinations of chemotherapy, radiotherapy and surgery, in order to obtain an improved oncological outcome. Radical surgery, which is a milestone in the treatment of such malignancies, may require tailoring the extension of the intervention to other non-gynecological structures.1–5 In this context, one of the most important districts connected with major gynecologic oncology surgery is the urological one.
Radiation Dose in the Uterine Perforation by Tandem in 3-Dimensional Cervical Cancer Brachytherapy
2019, Medical DosimetryCitation Excerpt :Gynecological (GYN) cancers are common and account for 10% to 15% of all malignancies in females in the world. These malignancies cause a significant amount of morbidity and mortality with varying incidences and outcomes depending on the country.1 Cervical cancer is one of the most frequent GYN malignancies with a standard treatment protocol.
The impact of gynaecological cancer treatment on physical activity levels: a systematic review of observational studies
2019, Brazilian Journal of Physical TherapyCitation Excerpt :Cervical cancer is the most common gynaecological cancer diagnosed, followed by uterine and ovarian cancers.2 Treatment options for gynaecological cancer include surgery, chemotherapy, radiotherapy/brachytherapy, hormonal therapy, and/or targeted therapy.3–5 Although the aim of surgical and medical treatments for gynaecological cancer is to cure and to improve survival rates,6–8 the cancer and treatments themselves may contribute to impaired physical and psychosocial function,9–12 reduced physical activity (PA) levels13 and low health-related quality of life (HRQoL).14
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