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DePartMental organisation

The Radiation Oncology Department comprises 8 specialized physicians based in Institut Jules Bordet and participating in multidisciplinary rounds in several hospital sites.

KeY Figures

27 - 16 - 12 are the yearly incidence rates (per 100,000 women) for endometrial, ovarian and cervical cancers in Belgium

240 cases of gynaecological cancers are treated each year at the Institute

GYNAECOLOGICAL CANCERS

introDuction Gynaecological cancers include cervical, endometrial, ovarian and vaginal cancers. Collectively they account for 14% of all solid tumours in women and 11% of deaths from these (ranking fourth in both incidence and mortality of cancer). Worldwide, gynaecological cancers account for an even larger share of cancer mortality in women, since cervical cancer is a major cause of death in developing countries, where screening and vaccination are minimal.

Dr Jean-Marie Nogaret Gynaecological Surgeon

Prof Véronique D’Hondt Medical Oncologist, Head of Unit

Dr Isabelle Merckaert Psychologist

Julie Dewilde Physiotherapist

ovarian cancer Ovarian cancer, the most lethal of gynaeco- logical cancers in developed countries, is an issue because it is not symptomatic until late in the disease process. This cancer cannot yet be reliably detected at an early stage. There- fore, early diagnosis and better treatment of ovarian cancer remain a major challenge.

Treatment choice for ovarian cancer depends upon a variety of factors. Approximately 20% to 25% of patients with invasive epithelial ovarian cancer are diagnosed at an early stage (stages I and II). Prognosis for these patients is good. When the disease is more advanced (stages III and IV), which is unfortunately the most frequent situation, prognosis dete- riorates considerably. Despite aggressive sur- gery and first-line chemotherapy, the majority of patients will relapse and die. The quality of surgery and experience of the surgeon are critical and affect prognosis. For this reason, only highly experienced surgeons specialised in oncological surgery should operate on such tumours.

When relapse does occur, in the large majority of cases the disease becomes incurable, and palliative care and symptom control are essential. Quality of life is then the main goal of treatment.

endometrial cancer The endometrium is the inner mucosal coating of the uterus. Although our understanding of endometrial cancer is limited, we can identify signs (precursor lesions) of the most common type of the disease and can usually diagnose it early enough to treat it successfully. However, there is an aggressive form of endometrial cancer – serous papillary carcinoma – which, like ovarian cancer, is poorly understood. Surgery remains the first form of treatment in most cases (by laparoscopic surgery if possible). After surgery, radiotherapy and chemotherapy are sometimes indicated.

cervical cancer We are best able to understand and therefore control cervical cancer. Precursor lesions exist that can be detected by local clinical and cytology examinations, such as the PAP test. Such screening and the treatment of lesions that have not invaded surrounding tissue have dramatically decreased the incidence of invasive cancer over a number of decades. More recently, it has been shown that infection by the human papillomavirus (HPV) is a necessary condition for the development of most, if not all, cervical cancers. Two vaccines against HPV infection are currently available. Once cervical cancer has become invasive, optimal treatment involves a combination of surgery, radiotherapy and chemotherapy.

treatMent, FolloW uP, rehaBilitation