RM Magazine - autumn 2012 - The Royal Marsden

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GynaecoloGical cancer special Leading the way in treatment and research Dr Susana Banerjee Consultant Medical Oncologist Dr Alexandra Taylor Consultant Clinical Oncologist Dr Susan Lalondrelle Consultant Clinical Oncologist Advances in our understanding of gynaecological cancers is resulting in better patient outcomes at The Royal Marsden. We speak to the consultants and surgeons in the Gynaecology Unit about their groundbreaking work
Cancer focus Q&A GynaecoloGical cancer Miss Jane Bridges, Consultant in Gynaecological Oncology, talks about the different forms of gynaecological cancer and their treatment What are gynaecological cancers Cancer can arise from any of the organs in the reproductive tract, but there are four main types of gynaecological malignancies: vulval, cervical, uterine and ovarian. What causes gynaecological cancers Vulval cancer can be associated with a number of inflammatory skin conditions that affect the vulva. a strong link has also been established between the human papilloma virus (HPV) and the development of this disease. Cervical cancer is also associated with HPV, as well as smoking. Uterine cancers usually arise from the endometrium (uterine lining), although rare tumours called sarcomas can also occur on the muscle wall. The strongest risk factor for developing cancer of the ovary is a family history associated with specific gene abnormalities, which lead to about 10 per cent of cases. How are they diagnosed Vulval cancer normally presents as a painful, ulcerated raised skin lesion that is noticed by the patient. it may be associated with skin conditions that by themselves can cause irritation, itching and soreness. The symptoms of cervical cancer usually include abnormal vaginal bleeding and discharge. The diagnosis is made after a biopsy of the abnormality, which may be an ulcer or raised area on the cervix. Ovarian cancer symptoms are more non-specific and can include abdominal bloating, indigestion, bowel disturbance and frequent urination. Diagnosis is made using a combination of ultrasound scanning, blood tests, and, on occasions, a biopsy. Uterine cancer usually presents with abnormal bleeding, and is diagnosed via a combination of ultrasound scan and biopsy. The majority of women with this cancer will present when the disease is at an early stage, and 75 per cent will be cured. Who does it affect Older women are more at risk of vulval cancer – the disease is virtually unknown in women under the age of 25. The majority of women who develop uterine cancer will also be older, aged 50 or over. Ovarian cancer mostly affects women in the 50 or over age group while cervical cancer mostly affects women who are younger than 50. How common are they although vulval cancer appears to be on the increase in the UK, it still remains relatively rare: it accounts for less than one per cent of all cancer cases and approximately eight per cent of all gynaecological malignancies. Cervical cancer used to be the most common gynaecological cancer in england and Wales, but with the introduction of the cervical screening programme, the incidence has fallen – there are now about 3,500 new cases per year. The incidence of uterine cancers, on the other hand, is increasing due to a strong association with obesity, which has increased drastically in the past decade. Cancer of the uterus is now the fourth most common cancer in women and the most common gynaecological cancer. The second most common gynaecological cancer is of the ovary. How are they treated The primary method of treatment for all gynaecological cancers is surgery. in the case of cervical cancer, this is normally a hysterectomy or, in young women who want to conserve fertility options, a less radical operation called trachelectomy. The treatment for uterine cancer is surgical removal of the uterus, Fallopian tubes and ovaries. Some patients may also require chemotherapy and radiotherapy. new drug treatments for women who have a genetic abnormality and develop ovarian cancer are presently under trial and are showing encouraging results. Is there any interesting research being carried out at The Royal Marsden We have a number of research trials looking at new agents to treat ovarian and cervical cancer. Some of this work is performed in parallel with laboratory research undertaken at The institute of Cancer Research. in gynaecological radiology, there are studies examining new imaging techniques for both cervical and vulval cancer, which may allow more conservative surgery for patients with this disease. ➜ RM magazine 13
Page 1 and 2: Life demands excellence A first loo
Page 3 and 4: Executive notes Contents 12 Gynaeco
Page 5 and 6: Hospital news Photography: ASCO/Tod
Page 7 and 8: Hospital news professor johann de B
Page 9 and 10: Hospital news FAMOuS CHeFS COOk uP
Page 11: Hospital news This picture: a ward
Page 15 and 16: Cancer focus above, from left: dr s
Page 17 and 18: Cancer focus Mr thomas Ind, Consult
Page 19 and 20: Ellis Ward From left: Jimmy Thomas;
Page 21 and 22: Staff profile Senior Staff Nurses,
Page 23 and 24: Beads of Courage Play Specialist Cl
Page 25 and 26: Hospital groups pcaG and The Friend
Page 27 and 28: Fundraising royals’ polo support
Page 29 and 30: Foundation news From bench to bedsi
Page 31: in the next issue RM brings you the

RM Magazine - autumn 2012 - The Royal Marsden

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