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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…
Mother’s Day Lunch at The Golden Century
A big thank you to the President of the Way In Network, Annie Tang JP, and the Board, for their continued support of AGCF.
At the Mother’s Day Lunch in May, The Way In Network ladies donated $20,000 to AGCF.
Thank you to the owner of the Golden Century, Eric and his wife Linda Wong, for hosting the day and all guests who attended a wonderful lunch.
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.
National Cervical Cancer Week
National Cervical Cancer Week launch at Parliament House, November 2022. Attended by AGCF Board Member Leonie Young.
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.
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.
Painted in acrylic on stretched canvas (167 x 167 x 3.5cm) and inspired by the lush beauty of nature which is a recurring theme of Diana’s art.
I don’t have a strict style. My work hovers between impressionist and abstract, stylised versions of similar themes. I enjoy both. Botanicals and landscapes dominate with occasional bird cameos.
It’s difficult to explain the joy I get from painting. It starts with constant ideas and yearning, fearlessly splashing paint around (because you can always over paint if it doesn’t work out). Then surprise at what appears on the canvas (not always what I planned) and happiness when I reach a finish point. Happiness again when others connect with what I have created.
September is Gynaecological Cancer awareness month and I am donating 25% of the sale price of ‘Mystic Garden’ to AGCF so, if you connect with it, message your interest and together we can do our bit to help fund Gynaecological Cancer research.
‘Mystic Garden’ – $1200
Email: [email protected]
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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Get in touch
Where to find us:
1/1 Jamison Street, Sydney NSW 2001
For general enquiries:
telephone: +61 2 8235 2606
email: [email protected]
Together, we’re giving women hope.
Donations of $2 or more are tax deductable in Australia.
ABN: 17 152 685 295