Gynae Research
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Groin Surveillance by Serial Ultrasonography Rather Than Sentinel Node Biopsy or Inguinofemoral Lymphadenectomy for Patients with Vulvar Cancer: A Pilot Study
This paper reports a pilot study which we undertook at the Royal Hospital for Women in Sydney on selected patients with vulvar cancer. The major long term complications of the treatment of vulvar cancer are the psychosexual concerns related to the vulvar resection, and the lower limb lymphoedema associated with the groin dissection. Since the 1980s, wide excision rather than radical vulvectomy has been used for the primary cancer. This has significantly improved, though not completely eliminated, the psychosexual issues, without compromising survival. The majority of patients with vulvar cancer do not have spread to the lymph nodes, but at the present time, virtually all patients get some type of groin dissection. This study aimed to see if serial ultrasonic examinations of the groins could identify those patients who had lymph nodes metastases. These patients could then be treated by groin dissection, while the majority of patients could be spared groin dissection and the associated risk of lower limb lymphoedema.
We studied 3 groups of patients: (i) those with a cancer 2 cm or less in diameter on one side; (ii) those with a large cancer on one side that extended to the midline. These patients had a groin dissection on the side of the cancer and the other side was followed by ultrasound; (iii) patients with small, superficially invasive, multifocal cancers. The groin ultrasound was performed every 3 months for 12 months.
There were 32 patients in the study, and we followed 43 groins with ultrasound. We identified positive lymph nodes in 3 patients (9.4%), and 39 groins (90.7%) were spared from any surgery. Two of the patients with positive lymph nodes were cured with further treatment. Both of these patients had very small nodes that could not be felt clinically. One patient died in spite of further treatment. This patient had an enlarged node in the groin that could be easily felt at the time of her follow-up ultrasound. This strongly suggested that the ultrasounds should be performed every 2 months, rather than every 3 months, so that the positive node could be detected before it became palpable. The overall mortality in the study was 3.1%.
The results of this pilot study were very promising. They would justify a larger randomized trial to determine whether lower limb lymphoedema could be prevented in the majority of selected patients by following the groins with ultrasound, and only operating when a positive node was detected. The ultrasounds should be performed every 2 months for 12 months.
Read the article here…
Fast-tracked cervical cancer screening saving lives in remote West Australian communities
A new cervical cancer screening project in Western Australia’s remote areas is reducing waiting times for testing from weeks to a matter of minutes using new technology.
It’s hoped the method will be one day expanded across the nation.
WA’s Country Health Service Obstetrics and Gynaecology head Jared Watts said early detection was crucial.
“Women can do their own test and it takes away that embarrassment, takes away the pain and discomfort,” he said. “If we do detect the changes in the cervix early it is very preventable.”
Cancer Research Visit
AGCF Prof Neville Hacker and former CEO Kim Downes meet with Dr Caroline Ford and her team at the Lowy Cancer Research Centre to discuss ovarian cancer and endometrial cancer research. AGCF with the assistance of the Mazda Foundation provided funding for Dr Ford’s teams endo cancer research.
Cervical Cancer
Self-Screening
From 1 July 2022, all women due for their 5-yearly cervical screening test (CST) were eligible for self-collection. The specimen is collected by introducing a small soft swab similar to the swabs used for COVID testing into the vagina.
Participation in the National Cervical Screening Program has fallen in Australia over the past 20 years and was severely impacted by the COVID pandemic. Over a million Australian women eligible for cervical screening are either under-screened or have never been screened. Only around five in 10 women participate in the National Cervical Screening Program (NCSP) at the recommended interval.
READ MORE…
Rural Women’s Health
It may be surprising to know there are eight Gynae cancers, and that every two hours an Australian woman is diagnosed with a gynae cancer.
Women with gynae cancer in rural areas often have a great deal of trouble accessing an accurate early diagnosis and treatment. In particular, women living in outer regional, remote or very remote areas may have difficulties accessing gynae health care due to distance and the limited availability of health services, and they often lack practical and emotional support. Much is being done to extend access to tele health cancer support services and practitioners, including oncology nurses, however many services are fragmented or in major city centres.
Who we are
We are the Australian Gynaecological Cancer Foundation. The only organisation that focuses on funding laboratory research into all eight gynae cancers.
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