Dr Sharon O’Toole
Senior Research Fellow, Trinity College Dublin
Dr Dearbhaile Collins
Consultant Medical Oncologist, Cork University Hospital and President,
Irish Society of Gynaecological Oncology (ISGO)
Endometrial cancer is the most common gynaecological cancer. According to the National Cancer Registry Ireland, 80% of patients have a five-year survival rate. Despite this, people with a uterus should take the necessary prevention measures.
In endometrial cancer, malignant cells form in the tissues of the endometrium. The endometrium is the lining of the uterus — a hollow, muscular organ in a woman’s pelvis.
Endometrial cancer prevention
As a Consultant Medical Oncologist at Cork University Hospital, Dr Dearbhaile Collins encourages people with a uterus to take effective prevention steps. In her experience, she says the disease is both highly preventable and manageable. “Risks of getting it can be minimised by patients improving physical activity, such as being moderately active for 30 minutes, five days a week.”
A good diet is also a huge influence. There is no screening, so the condition is symptom-led. Bleeding, bloating, pelvic abdominal pain and changes in urinary symptoms or bladder control are all signs to look out for. If any of them are a concern, it’s best to consult a GP who can make the appropriate referral.
Positive news on treatments
Dr Collins, who is also Chair of the Cancer Trials Ireland Gynaecological Cancer Trials, says: “It is an exciting time in gynaecological cancer because 10 years ago, we were mainly limited to chemotherapy, but now, we are seeing new drugs targeting the immune system. Also, targeted treatments against cancer mutations and novel combinations of drugs.” All of this leads to better survival rates with advanced or metastatic disease and a higher quality of life as treatments are better tolerated.
“Surviving endometrial cancer has a huge impact mentally and physically. Patients who adopt good lifestyle choices after surviving treatment are much less likely to see a return of cancer and more likely to experience a return to a happier mental state,” she adds.
Surviving endometrial cancer has a
huge impact mentally and physically.
Awareness of all gynaecological cancers
Dr Sharon O’Toole is a scientist who coordinates the Irish Network of Gynaecological Oncology. This includes charity and support groups across Ireland. “As a network, we want to increase awareness that there are five gynaecological cancers. Worryingly, our survey told us that 34% of women in Ireland believe cervical screening covers all gynaecological cancers. However, it only addresses the risk of cervical cancer,” she says. There is no other screening for other gynaecological cancers, which is why symptom awareness is so important.
Ovarian cancer signs are bloating, eating difficulty, abdominal pain and toilet changes. Cervical cancer is characterised by bleeding or discharge. Uterine cancer can cause bleeding and pelvic pain. Vulval cancer can include itching, burning pain and tenderness symptoms while vaginal cancer can be spotted through unusual discharge, bleeding or urgency to go to the toilet.
Dr O’Toole adds: “Four in five women wouldn’t be confident to recognise the symptoms of ovarian cancer, so there’s a huge knowledge gap. People should know their family history and communicate that to their GP because, for example, the BRCA1 and 2 gene mutations increase your risk of developing ovarian cancer.”
Seeking treatment through clinical trials
Launching more gynaecological clinical trials, including with better representation from patients outside of Dublin, is one of Dr Collins’s big hopes over the coming years. “Ireland currently only has two studies open in gynaecological cancers; one in endometrial cancer and a surgical study in ovarian cancer. But there are two new studies opening soon in ovarian cancer, which are testing new treatments and will give more options to patients with these cancers.”
Ultimately, she urges patients affected by gynaecological cancer to always ask their oncologist about available studies because participation can mean access to new and innovative drugs. While treatments are improving for advanced gynaecological cancers, not all are curable and, thus, prevention is all the more important.