Most oncologists say they would prescribe hormone therapy to cervical cancer patients who experience early menopause from radiation treatment, but barriers are keeping many from doing so in practice, according to a new University of Kentucky Markey Cancer Center study published in JAMA Network Open1.
Premenopausal patients treated for cervical cancer with chemoradiotherapy, a combination of chemotherapy and radiation given at the same time, often experience menopause as a side effect of radiation to the ovaries, bringing on symptoms like hot flashes, sleep disruption and vaginal dryness. Clinical guidelines support the use of hormonal therapy to manage menopausal symptoms in this group, but research has shown the treatment remains underused.
The study, led by Markey Cancer Center radiation oncologist Denise Fabian, M.D., with Morgan Levy, M.D., as first author, identifies barriers to prescribing that can inform efforts to improve patient care.
The research team surveyed 178 gynecologic and radiation oncology clinicians nationally through the Society for Gynecologic Oncology and the American Brachytherapy Society about their attitudes and prescribing habits around hormonal therapy for patients with cervical cancer treated with chemotherapy and radiation.
The survey found that 99.3% of gynecologic oncologists and 73.8% of radiation oncologists said they would consider prescribing hormonal therapy after chemoradiotherapy. Despite that willingness, both groups reported barriers: the capacity to manage patients’ care over the long term and a lack of awareness of existing clinical guidelines.
“This study highlights a critical opportunity to strengthen survivorship care for cervical cancer patients, both in Kentucky and nationwide.”Denise Fabian, M.D., Markey Cancer Center Radiation Oncologist
“Hormone therapy can meaningfully improve not only quality of life, but also long-term health. We need to ensure more patients can access it,” said Fabian.
“This work has shown us that oncologists are interested in prescribing hormonal therapy to improve quality of life for our patients,” Levy said. “We are excited to continue working with our multidisciplinary team in survivorship and gynecologic oncology to design interventions to improve the standard of care.”
The researchers say future work will focus on increasing guideline awareness and finding ways to make prescribing more manageable for clinicians, with the goal of getting more patients access to care that evidence shows is safe and effective.
Reference:
1. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847754
(Newswise/HG)