- Clinical gynaecological oncology
- Contact us
- Coping with cancer
- Familial gynaecological cancer
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- Medical gynaecological oncology
- Surgical gynaecological oncology
TypeServices - Services
Our Gynaecological Oncology department is an internationally renowned centre of clinical and research excellence.
We serve a population of around 2.5 million in North East London and Essex.
Our department is based on the eighth floor of The Royal London Hospital, situated at the heart of the East End of London. We are a tertiary cancer centre and part of the London Cancer Integrated Cancer System (ICS). We treat patients with gynaecological cancer in North East London, from the following hospitals:
- The Royal London Hospital
- St Bartholomew’s Hospital
- Newham University Hospital
- Whipps Cross University Hospital
- Queen’s Hospital (Romford)
- Homerton University Hospital
Our holistic, patient centred cancer care is delivered by an internationally renowned multidisciplinary team consisting of gynaecological oncology surgeons, medical and clinical oncologists, radiologists, pathologists, clinical nurse specialists, clinical trials, nursing and administrative staff.
We offer diagnosis and treatment for all types of gynaecological cancers: uterine, endometrium, cervix, tube/ ovary, vulva and vagina. This includes surgical treatments, chemotherapy, radiotherapy and palliative care. We undertake translational research and participate in a large number of national and international clinical trials.
We offer a rapid access diagnostic service for women with suspected gynaecological cancer as well as colposcopy services. We have a specialist high risk familial gynaecological cancer service for women at increased risk of gynaecological cancer.
In our service we treated 468 women with a new diagnosis of gynaecological cancer between June 2015 and May 2016.
- Gynaecological Oncology Clinic—These clinics are for women with suspected gynaecological cancer who are seen within 2 weeks of being referred by their GP or whom have been referred to us from one of our local referring hospitals and for women who have had gynaecological cancer who are being followed up after treatment.
- Pre-anaesthetic Assessment Clinic (PAC)—The pre-admission clinics are held on Tuesday afternoons and Wednesday to Friday mornings for women scheduled for surgery. They enable a full assessment of a woman’s medical and social history, routine pre-operative tests and fitness for an anaesthesia.
- Outpatient hysteroscopy clinic—Women with postmenopausal or abnormal bleeding are often seen in these clinics. A small camera is inserted through the cervix to visualise the lining of the womb and at the same time a biopsy of the lining of the womb can be obtained.
- Familial Gynaecological cancer clinic —This is a highly specialist service dedicated to assessing risk and managing women at high risk of ovarian, breast and endometrial cancers.
- Colposcopy clinic —Women with abnormal smears are referred to our colposcopy clinic where the cervix is visualised with the aid of a highly powered microscope to identify changes. Biopsies or treatment can be offered if abnormalities are identified.
We have an excellent team of dedicated gynaecological oncology pathologists. The team includes Dr Naveena Singh, Dr Asma Faruqi, Dr Sarah Lam Shang, Dr Giorgia Trevisan.
We provide the full range of diagnostic molecular, pathology and cytology services for women with gynaecological cancer. Find out more about our pathology department.
Barts Health operates one of the largest imaging centres in the country, providing medical imaging and diagnostic services, ranging from routine x-rays and ultrasound to specialist scans such as. CT, MRI and PET scans. We also undertake a range of interventional procedures such as directed biopsies, and insertion of drains and stents.
Based at our hospitals across London,our team of leading specialists offer a personalised service using some of the latest scanning technology. We provide one of the most comprehensive medical imaging services in England.
We aim to deliver excellent imaging services which have high quality standards that provide an excellent patient experience and are developed and responsive to our local patient needs.
Clinical gynaecological oncology
Our Clinical Oncology clinic cares for women who have received or require radiotherapy and/or chemotherapy to treat cervix, womb, vaginal and vulval cancer.
Clinical Oncology Clinic
- The Clinical oncology clinic is located in the West Wing of the Breast Care Centre at St Bartholomew’s Hospital.
- The clinical oncology clinics are held within this department on a Tuesday morning and are led by a Consultant Clinical Oncologist and Specialist Registrars.
- The clinic cares for women who have received or require radiotherapy and/or chemotherapy to treat cervix, womb, vaginal and vulval cancer.
- Once women are actually receiving treatment they will be reviewed on a Tuesday afternoon treatment review clinic every week in the Radiotherapy Department (Basement of King George V, St Bartholomew’s Hospital).
- When treatment has completed they will attend the Thursday afternoon clinic once again for all future follow up appointments.
Our comprehensive radiotherapy service offers state-of-the-art treatments for patients with gynaecological cancer. We have five modern linear accelerators (linacs), a CyberKnife unit that can deliver high dose radiation where required, and an Orthovoltage unit that provides palliation for secondary lesions.
We also provide:
- External beam radiotherapy - this uses radiation beams directed at the cancer from a machine outside the body.
The majority of patients requiring radiotherapy at Barts Cancer Centre will receive treatment in our radiotherapy department situated in the basement of the new King George V building.
Our patients from Queens Hospital receive their radiotherapy locally at Queens Hosptial itself.
If you are registered with a GP and aged between 25-64, you will automatically receive an invitation to attend for a cervical smear. This occurs every 3 years between the ages of 25-49 and every 5 years between the ages of 50-64.
Women with abnormal smears are often referred to our colposcopy clinic. The cervix is visualised with the aid of a highly powered microscope to identify changes. Biopsies or treatment can be offered if abnormalities are identified.
Services we provide
This involves taking a small sample of tissue from your cervix and sending it off to the laboratory for further analysis. Depending on the results, we may recommend treatment or follow-up.
LLETZ (large loop excision of the transformation zone)
This is a form of treatment which involves using a hot looped wire to remove a portion of the neck of the womb under local anaesthetic, which is then sent off to the laboratory for analysis. Follow up after the procedure depends on the results of the tissue sent to the lab.
This is a form of treatment which is performed under general anaesthesia, and it involves using a surgical knife (scalpel) to remove a cone shaped piece of tissue form the neck of the womb. The tissue removed is sent off to the laboratory for analysis and follow up depends on the results.
This is another form of treatment which involves using liquid carbon dioxide to freeze the abnormal cervical cells.
Follow up after DES (diethylstilboestrol) exposure
DES is a manmade form of oestrogen which can result in a very rare form of cancer called clear cell adenocarcinoma of the lower genital tract. DES was prescribed to pregnant women from 1940-1971 to prevent miscarriage and premature labour. Both the women who received it and their unborn babies are at an increased risk. We are part of a minority of specialist centres that offer follow up for this.
Follow up after trachelectomies
For women with early stage cervical cancer who have not completed their family, we offer isolated removal of the cervix. We are one of the few specialist centres in the UK that offer follow up after this.
Research trials in colposcopy
We are involved in a number of cutting edge clinical trials which aim to improve the care of patients. You may be approached to take part in our trials. You have the right to decide whether you would like to take part or not. Your wish will be respected and will not affect the quality of your care.
Self-sampling for vaginal HPV trial
This trial is investigating whether different ways of taking and transporting self-collected vaginal samples are as reliable as each other.
If you would like further information on any of our trials or believe that you may be eligible and would like to take part please contact the following member of our research team.
Louise Cadman (Research Nurse Colposcopist)
Telephone: 0203 594 1605
Frequently asked questions
Can I have colposcopy if I am having a period?—This depends on a number of factors and our recommendation is always individualised to your particular situation. Please call our colposcopy clinic for advice.
Can I still travel after having had treatment to my cervix?—We advise to avoid travel outside the country for 4 weeks after treatment.
Can I exercise after treatment?—We advise gentle exercise for the first 2 weeks after treatment and to then to build up to your normal exercise level by 4 weeks.
Can I have sex or use tampons after treatment?—We advise to avoid having sex or using tampons for a few days after a cervical biopsy and for 4 weeks after treatment.
For further information on colposcopy and treatments please visit the links below.
Telephone: 0203 5941605
Fax: 0203 5942792
Paula Marriott (Colposcopy co-ordinator) – appointment queries
Telephone: 0203 594 1605
Telephone: 0203 594 2053
Fax: 0203 594 2792
Sue Applewhaite Wallace
Telephone: 0203 594 2754
Fax: 0203 594 2792
Should you have queries, please use the appropriate contact details below.
Gynaecology surgical oncology ward at the Royal London Hospital (8C)
Telephone: 0203 594 1561/ 020 3594 1562
Gynaecology oncology surgical team queries
Sharon Bath (Secretary to the Surgical Gynaecological Oncology team)
Telephone: 0203 594 2053
Fax: 0203 594 2792
Sue Applewhaite Wallace (Secretary to the Surgical Gynaecological Oncology team)
Telephone:0203 594 2754
Fax: 0203 594 2792
Khadijat Ajagbe (Secretary to the Familial Gynaecological Oncology team)
Catharine Page (Service Manager)
Telephone:0203 594 6032
2WW Central Appointments Office (to cancel/reschedule an appointment):
Telephone: 0207 767 3200
Telephone: 0203 5941605
Fax: 0203 5942792
Anna Parberry (nurse colposcopist) – clinical queries
Telephone: 0203 594 1605
Paula Marriott (colposcopy co-ordinator) – appointment queries
Telephone: 0203 594 1605
Sharon Bath (secretary to the Gynaecological Oncology team)
Telephone: 0203 594 2053
Fax: 0203 594 2792
Sue Applewhaite Wallace (secretary to the Gynaecology Oncology team)
Telephone: 0203 594 2754
Fax: 0203 594 2792
Suneeta Devi (Patient Pathway Co-ordinator)
Tel: 020 346 56049
Nina Backman (Secretary/Administrator/Patient Pathway Co-ordinator)
Telephone: 0203 465 5131 / 0203 465 5123
Fax: 0203 465 6834
Rebecca Joy (Superintendent Radiographer)
Telephone: 0203 594 0966
Naveena Singh/Asma Faruqi: 0203 24 6 0217
Fax 0203 246 0202
Faith Dzumbunu (Clinical Trials Nurse): 07920 817255
Sarah Aswat (Clinical Trials Practitioner): 07444 298830
Louise Cadman (Research Nurse Colposcopist): 0203 594 1605
Coping with cancer
Some women may experience uncomfortable physical symptoms caused by their cancer such as pain, nausea, bleeding, leg swelling and fatigue. Some also experience temporary or longer lasting side effects from oncology treatment such as hair loss (from chemotherapy) or bowel upset (from radiotherapy). There is a lot of advice and support available both for women experiencing symptoms from their actual cancer or side effects of treatment.
Your clinician and clinical nurse specialist is always available to help advise in how to reduce any symptoms you may be experiencing and can arrange further assessment, a prescription or direct you to community resources closer to home.
In addition Macmillan Cancer Support have useful advice on how to manage symptoms during cancer treatment.
Find out more about cancer support we offer
Life after cancer treatment
Most patients feel a sense of relief after their cancer treatment has ended and are able to move forward, getting back to their normal lives. There are however some women who have difficulty in moving forward due to physical, emotional, social or sexual concerns relating to the impact of cancer or its treatment. If you feel you have any of these issues, there is help and support available, so please do discuss this with your oncologist or specialist nurse.
In relation to emotional and social concerns, support can be in the form of wellbeing programmes, welfare advice, telephone networks, support groups/organisations, complementary therapies and specialist psychological support. Sharing your experiences and talking about how you feel is known to be beneficial to your wellbeing. You can read our publication ‘Support and support groups for women with gynaecological cancers” or visit your local Macmillan information centre for local information on what support you are able to access. If you feel you need specialist counselling, please do ask your GP, Oncologist or Specialist Nurse to refer you.
A small number of women may be bothered in the longer term by physical symptoms such as menopausal symptoms, lymphoedema (lower body swelling), sexual issues, bowel and bladder symptoms or other symptoms such as fatigue, pain and nausea. Please do talk to your Doctor or specialist nurse for advice. They can arrange further assessment, prescriptions and direct you to more detailed information and community resources closer to home or specialist clinics if required.
Generally after cancer we recommend a healthy lifestyle to speed recovery and improve wellbeing. This includes eating a balanced diet and engaging in regular exercise. In addition we recommend alcohol in moderation, giving up smoking and being safe in the sun. Many of the advertised wellbeing or cancer recovery programmes give advice on these areas in detail. Macmillan also has two free publications called ‘life after cancer treatment’ and ‘what to do after cancer treatment:10 top tips’.
Cancer recovery programmes
Cancer transitions programme – living with and beyond cancer
6 week programme (2.5 hrs per week) running at St Bartholomew’s hospital open to those that have completed cancer treatment at Barts Health. Patients are able to self refer. Tel 020 3465 7445 or email firstname.lastname@example.org
Health and wellbeing events (advertised regularly)
Regular health and wellbeing open events at St Bartholomew’s Hospital or other locations. Usually a one day workshop covering emotional, welfare rights and healthy living.
Living with illness wellbeing course: St Joseph’s Hospice
Six week self-management programme for patients of St Joseph’s hospice living with advanced disease. Tel 020 85253140.
Familial gynaecological cancer
Our Familial Gynaecological Cancer clinic is dedicated to assessing risk and managing women at high risk of ovarian, breast and endometrial cancers
Each year 7,300 new cases of ovarian cancer and 9,022 new cases of cancer of the lining of the womb are diagnosed in the UK. Of these new cases, it is estimated that 5-10% may be due to an underlying genetic cause that is passed on through the family. Women may be detected to be at high risk on the basis of their family or personal history or due to the presence of a cancer causing genetic alteration (mutation).
Our Familial Gynaecological Cancer clinic is a tertiary specialist service dedicated to assessing risk and managing women at high risk of ovarian, breast and endometrial cancers. Our clinic is based at Barts Hospital (Second floor, Kenton & Lucas Wing, Centre for Reproductive Medicine).
We offer a comprehensive service for managing gynaecological cancer risk. This includes risk assessment, screening, lifestyle & reproductive advice, pre-implantation genetic diagnosis, psychosocial support, HRT use and menopause advice as well as the options of screening and prophylactic surgery (surgical prevention) as needed.
We have a dedicated team with a special interest in this area to deliver this service. We have close links with the high risk breast team at Barts Hospital, Colorectal team at The Royal London Hosptial and North East Thames Regional genetics service at Great Ormond Street Hospital. We host a joint monthly Multidisciplinary Disciplinary Team meeting for managing high risk women within London Cancer ICS (integrated cancer system) with colleagues at the Familial Gynaecological Cancer Clinic at UCLH.
High risk families can generally be separated as belonging to one of the groups below.
BRCA1/BRCA2, gene mutation carriers—These families have a strong history of breast, breast and ovarian or just ovarian cancer alone.
RAD51C, RAD51D, BRIP1 gene mutation carriers—These families have a strong family history of just ovarian cancer alone.
Lynch Syndrome or MLH1, MSH2, MSH6, PMS2 mutation carriers— families have a strong history of cancer of the lining of the womb (endometrial), ovarian, colorectal, small bowel, ureteric and kidney cancers all of which can be suggestive of Lynch Syndrome or hereditary non-polyposis colorectal cancer (HNPCC).
Cowdens’ syndrome or PTEN mutation carriers—These families have a strong history of endometrial, breast, thyroid, colorectal and renal cell carcinomas and melanoma.
Peutz Jeghers Syndrome—Those with a strong family history of cancer but without a known gene mutation
If you are visiting The Royal London or St Bartholomew’s Hospital for an outpatient appointment, this information lets you know what to expect.
Visiting our outpatient clinic
Make sure to check your appointment letter to find out which department to come to - you're welcome to bring a family member or friend with you. If you don’t speak English well, please bring someone with you who can. If we are aware that a patient attending their first appointment does not speak English, we will try to book an advocate to assist, please still bring a family member of friend with you for support.
How to find us
- Our outpatient department is located on the eighth floor of The Royal London Hospital and is open between 9.00am-5.00pm, Monday to Friday excluding bank holidays. Access is via lift bank 9.
- The surgical gynaecological cancer clinics are held within our department, led by a team of consultant gynaecological cancer surgeons and our Senior Sister. The clinics are held on a Monday afternoon, Tuesday morning and Wednesday afternoon.
What happens during your appointment?
During your appointment you will be seen by one or more of the Consultant, Subspecialty Fellow, Registrar or Senior House Officer. You may also be seen by a Clinical Nurse Specialist at this time.
We are a research active department and a member of our trials or research team may speak to you to inform you about ongoing research studies. We also run additional specialist clinics at Women's Outpatients including two week wait/rapid access, colposcopy and hysteroscopy clinics. Furthermore we have a specialist familial cancer service for women at increased risk of gynaecological cancer.
What should I expect?
When you arrive in the department, please report to the reception area where a member of staff will confirm your details, book you in and ask you to take a seat in the waiting area. Please use this opportunity to check and update your personal and GP details. We collect ethnicity information as well for statistical purposes. You don’t have to give this if you do not wish to.
The clinic nurses will let you know when the doctor is ready to see you. The outpatient clinic is often busy and we try our best to see patients within thirty minutes of appointment time. The receptionist and nurses are able to keep you informed of any delay to your appointment time.
During your appointment you are likely to be seen by a variety of members of the team including doctors and specialist nurses. Our hospitals are involved in teaching both medical and nursing students and therefore students may be present during your clinic appointment. You will be introduced to all staff involved in your care and we will ask your permission for students to be present.
Please also bring details of medications you are taking, community services you are receiving and any allergies. During your consultation with the doctor you may require an internal examination. If this is requested a nurse chaperone will be present with you throughout the examination.
If you are coming into hospital for an operation it is important for you to attend a pre-admission appointment (PAC).
The pre-admission clinics are held on Tuesday afternoons and Wednesday to Friday mornings and enable a full assessment of your medical and social history, routine pre-operative tests and fitness for an anaesthesia.
Please keep the morning of your pre-admission appointment free as you will normally be required to undertake various pre-operative investigations following your appointment. You must also bring a list of medications you are taking and any details of community services that you are receiving.
For further information regarding your pre-admission appointment please contact Women’s Outpatients on 020 346 56695. Please click here for the information leaflet about this. Insert link to PAC leaflet.
You may be referred to see the anaesthetic team in the High Risk Anaesthetic Clinic that is held every day at pre-admission clinic 6 on level one. This appointment is to ensure that we optimise your fitness for surgery and can plan the best place to look after you immediately after your operation.
ACAD at The Royal London Hospital is on the third floor. This is the place where you need to come for admission if this you are asked to come on the morning of your operation. If you are having major surgery or an operation that requires an overnight stay, you will then be transferred to ward after surgery to recover.
Ward 8C at The Royal London Hospital is a 20 bed female gynaecology ward specialising in gynaecological oncology surgery.
HDU (High Dependency Unit) is on the fourth floor. Some patients undergoing an operation may need to be transferred to a HDU for closer monitoring immediately after their operation. A member of our team will inform you if this is likely to be the case.
How do I change my appointment?
- If you need to cancel or alter your appointment please call the central appointments office on 0207 767 3200.
- If you need hospital transport, please let them know if your appointment date has changed on 020 3465 5121.
What should I bring to hospital?
Medicines—Please ensure you bring with you all medication prescribed by your GP in their original packets. If you are taking any over the counter medications or herbal remedies please bring these also.
Toiletries and clothes—If it is likely that you will be staying overnight with us, please bring with you essential toiletries (e.g. toothbrush, toothpaste, shampoo) and nightclothes.
Money and valuables—Please do not bring large amounts of money or very expensive items to hospital. Any money or valuables can be stored safely by the nursing team so please inform them if this is something you require.
How to differentiate between members of staff—Every member of staff will be wearing a name badge which will tell you their name and role. Please be aware that we are a teaching hospital and you may come across students and they may be present during your consultation. You have the right to decide whether you would like them to be present or not. Your wish will be respected and will not affect the quality of care you receive.
Community care—Please inform the nursing team of any special arrangements that have been in place prior to your admission for example if you have carers coming to your home, district nurses, Macmillan nurses or social services. This is so that we can facilitate the continuation of this care once you are discharged from hospital. Likewise, if you feel that you may require more help at home, please inform the nurse caring for you on admission to ward 8C.
Our waiting times for clinic appointments
- Colposcopy—Urgent, suspicious of cancer or high grade dyskaryosis on cytology – within 2 weeks of receiving the referral. Routine, non-urgent clinical indications or low grade dyskaryosis on cytology with high risk HPV or borderline nuclear changes on cytology with high risk HPV or persistent inadequate cytology – within six weeks.
- Outpatient hysteroscopy clinic—Urgent, postmenopausal bleeding – within two weeks.
- Gynaecology oncology clinic—Any referral suspicious of cancer – within two weeks.
Medical gynaecological oncology
Our Medical Oncology Clinics are for for women who have received or require chemotherapy to treat ovarian cancer.
Medical Oncology clinics
We hold our Medical Oncology clinics in the West Wing at St. Bartholomew’s Hospital.
- Our medical oncology clinics are held on the first floor of this department on a Tuesday and Thursday afternoon and are led by a team of gynaecological cancer consultants and specialist registrars.
- Your clinical nurse specialist also attends these clinics.
- The clinic is for women who have received or require chemotherapy to treat ovarian cancer.
Chemotherapy is the use of drugs to treat the whole body and to kill cancer cells wherever they might have spread or to reduce the risk of cancer coming back. Most typically, these are given as an intravenous infusion via a drip, although some chemotherapy drugs can be given in tablet form. Chemotherapy drugs can be given on their own, but are frequently given in combination. Treatment is usually given every few weeks for a variable duration, but typically lasting several months. The drugs given and their frequency will depend on the type and stage of cancer.
All side effects will be carefully explained and ways to avoid/treat them will be discussed by the teams involved in your care. The majority of side effects are temporary and will go away once treatment has finished. Your clinical nurse specialist and doctors will explain the particular side effects of the drugs you are receiving and provide support for you while on treatment.
The majority of patients requiring chemotherapy at our hospitals will receive their treatment as an outpatient. These facilities are provided in the following locations:
- Barts Cancer Centre – ward 7A of the new King George V building. This ward has been located for the best views of the city of London, and patient treatment areas are light, spacious with comfortable chairs.
- Queens Hospital – Sunflower Suite on the ground floor of Queens Hospital.
- Cedar Centre at King George’s Hospital, Ilford.
Some patients may require overnight stays in hospital, but this will be discussed with you prior to treatment.
- Macmillan Cancer Support offer additional information on chemotherapy.
Our research is based at the Barts Cancer Institute, Queen Mary University of London. Barts Cancer Institute is one of the top five cancer research centres in the UK and is one of 17 Cancer Research UK Centres of Excellence.
Research undertaken at BCI aims to prevent cancer and develop better diagnostic techniques and treatments. Ultimately we aim to reduce incidence of cancer, improve survival for people with cancer and enhance the quality of life for those with long-term disease.
Barts Cancer Institute, as part of the Barts and The London School of Medicine and Dentistry, is in the top 10 multi-faculty research institutions (Research Excellence Framework 2014).
Our clinical trials are hosted at the Centre for Experimental Cancer Medicine. The Centre provides design and management support for all trials in cancer patients including national, pharmaceutical and investigator-led studies. There are over 120 trials open at any one time.
Our core research interests include risk prediction, screening and prevention of ovarian & endometrial cancer, population based approaches to genetic testing, targeted surgical prevention strategies as well as management of familial gynaecological cancer. We also collaborate with other researchers on a number of national / international studies and trials.
At Barts Health we are involved in a number of cutting edge clinical trials which aim to improve the care of patients with gynaecological cancer. Depending on your medical history or type of cancer you may be approached to take part in one of our trials. You have the right to decide whether you would like to take part or not. Your wish will be respected and will not affect the care you receive.
ICON8B—A phase III randomised trial investigating the combination of dose-fractionated chemotherapy and bevacizumab compared to either strategy alone for the first-line treatment of woman with newly diagnosed high-risk stage III-IV epithelial ovarian, fallopian tube or primary peritoneal cancer.
LOGS—A randomized phase II/III study to assess the efficacy of trametinib in patients with recurrent or progressive low-grade serous ovarian cancer or peritoneal cancer.
BriTROC-1—Sample collection study to investigate the role of homologous recombination deficiency in platinum sensitivity in recurrent high grade serous ovarian cancer.
ROCkeTS—A diagnostic test accuracy study that aims to identify, refine and validate tests and clinical risk scores that estimate the probability of having ovarian cancer in pre and postmenopausal women with symptoms.
Metro-BIBF—Phase II, randomised, placebo controlled, multicentre, feasibility study of low dose (metronomic) cyclophosphamide with and without nintedanib (BIBF 1120) in advanced ovarian cancer.
NiCCC—A randomised phase II study of Nintedanib compared to chemotherapy in patients with recurrent clear cell carcinoma of the ovary or endometrium.
MAPPING—Diagnostic accuracy of MRI, diffusion-Weighted MRI, FDG-PET/CT and fluoro-ethyl-choline PET/CT in the detection of lymph node metastases in surgically staged endometrial and cervical cancer.
INTERLACE—A phase III multicentre trial of weekly induction chemotherapy followed by standard chemoradiation versus standard chemoradiation alone in patients with locally advanced cervical cancer.
SHAPE—A randomised phase III trial comparing radical hysterectomy and pelvic node dissection Vs simple hysterectomy and pelvic node dissection in patients with low-risk early-stage cervical cancer.
An international randomised phase-3 non inferiority trial to determine whether lymphadenectomy, used to restrict adjuvant therapy (other than vaginal brachythereapy) to node positive women, results in a non-inferior survival as compared to adjuvant therapy given to all women with high risk stage 1 endometrial cancer.
Groinss-V II—International study investigating the role of Sentinal Node in localised small vulval cancers. The study assesses whether it is safe to have radiotherapy instead of surgery when vulval cancer has spread to the sentinel lymph nodes
If you would like further information on any of our trials or believe that you may be eligible and would like to take part please contact the following members of our research team.
- Faith Dzumbunu (Clinical Trials Nurse): 07920 817255
- Sarah Aswat (Clinical Trials Practitioner): 07444 298830
FORECEE Study—This is a Multicentre Horizon 2020 collaborative study for Female cancer prediction using cervical omics to individualize screening and prevention for 4 female cancers- breast, cervix, endometrium and ovary.
Our research studies
Being a centre of research as well as clinical excellence, we are involved in a number of research studies and collaborative work. If you would like more information on these, please contact a member of our research team.
PROMISE-FS—This study aims to determine the feasibility of offering women over the age of 18 years the opportunity of determining their individual risk of ovarian cancer and also the impact of providing them with this information. We will also be assessing screening and risk reduction options for women at increased risk. We are also interested in assessing our volunteers interest, acceptability and satisfaction with this process.
PROTECTOR—This is a multicentre UK study evaluating a two step early salpingectomy and delayed oophorectomy strategy for preventing tubo-ovarian cancer in high risk women.
SIGN POST—This study will undertake systematic germline panel and somatic tumour testing for ovarian cancer gene alterations in women with epithelial ovarian/fallopian tube/primary peritoneal cancer. The study will evaluate detection rates of ovarian gene alterations in BRCA1/BRCA2/RAD51C/RAD51D/BRIP1. It will also evaluate the impact of systematic genetic testing on psychological health and quality of life.
RRESDO—This is a study investigating the attitudes of high risk women towards an early salpingectomy with delayed oophorectomy as a way to prevent ovarian cancer.
Research into population based approaches for risk prediction and prevention of ovarian cancer. We are interested in investigating the cost-effectiveness of population testing for ovarian and breast cancer gene mutations.
Research into targeted surgical prevention for ovarian cancer
We are involved in:
- Defining the risk threshold of surgical prevention of ovarian cancer.
- Investigating the feasibility and impact of salpingectomy for prevention of ovarian cancer in low and high risk women.
GCaPPS (Genetic Cancer Prediction through Population Screening)—Randomised controlled trial comparing population and family history based testing for BRCA1/BRCA2 mutations in the Ashkenazi Jewish population.
Research into management of familial gynaecological cancer—We are interested in evaluating decision making, outcomes and all aspects of management of women at increased risk of gynaecological cancer
Research into gynaecological oncology training—We are interested in evaluating experience, work place & training climate, types of training systems and training needs and outcomes for gynaecological oncology trainees both in the UK and internationally. We undertake workshops and are involved in a number of initiatives to improve training in gynaecological oncology.
Research into outcomes of trachelectomy for early cervical cancer—We are interested in evaluating clinical, psychosocial and quality of life outcomes for women undergoing fertility sparing surgery for cervical cancer.
Research into developing Core Outcome Sets for endometrial and cervical cancer—We are part of the CROWN initiative and involved in developing core outcome sets for standardising reporting of trials in endometrial and cervical cancer.
Research into the role of the tube in etiopathogenesis of ovarian cancer.
Pathological assessment of response to chemotherapy in ovarian cancer and its correlation with survival.
Surgical gynaecological oncology
Surgical treatments can vary according to the type of cancer, stage (extent) of the cancer, age and desire to preserve fertility. Your Surgeon, and/or Clinical Nurse Specialist will explain in detail to you what surgery we would advise, how this might effect you, how we would expect you to recover and possible complications. You will sign a consent form for the surgery together with one of the surgical team and be offered a copy of this.
We provide a range of surgical treatments for ovarian cancer, depending on the need of the patient.
- Total abdominal hysterectomy and bilateral salpingo–oophorectomy (removing the womb and neck of the womb, both tubes and ovaries) omentectomy (removal of fat pad that is attached to the bowel) and lymphadenectomy (removal of lymph glands). This operation is usually done by open surgery. For some women we can plan to do this surgery by keyhole.
- Where feasible and appropriate we also offer fertility sparing surgery for ovarian cancer
- Ultra radical debulking surgery—This type of open abdominal surgery is to treat advanced ovarian cancer and involves removing the womb and neck of the womb, both tubes and ovaries, omentum (fat pad that is attached to the bowel) and removing any cancerous tissue that may be present in other parts of the abdomen like the lymph glands, bowel, liver, the stomach, gall bladder, spleen, stripping the lining of the diaphragm and stripping the lining that covers inner organs. We work closely with our colleagues from other surgical divisions if needed for this type of surgery.
- Surgical treatment for recurrent cancer.
- Total hysterectomy and bilateral salpingo-oophorectomy. Certain types of womb cancer may also need removal of lymph glands or omentum. This can be done by open surgery or key-hole surgery or by assisted vaginal surgery (combination of keyhole and vaginal surgery).
- Fertility sparing treatment: For a small number of carefully selected women, fertility sparing treatment may be feasible. We are one of the small number of centres in the UK that offers this.
We offer a range of treatment options for cervical cancer depending on stage of the disease, age of the patient and wish to preserve fertility.
- Cone Biopsy —This involves removing a portion of the neck of the womb in women who have early cervical cancer or in women who have abnormal cells that are deep down in the cervix and cannot be seen during colposcopy (examination of the neck of the womb using a microscope).
- Radical Trachelectomy—We are one of the few centres in the UK that offers this specialist fertility sparing surgery which involves removal of the neck of the womb only (with surrounding tissue). It allows women who have not completed their family the option of future pregnancies. Trachelectomies can be done by vaginal, keyhole or open, surgery.
- Simple hysterectomy—The womb, neck of the womb, tubes and ovaries are removed either by keyhole, open or vaginal surgery.
- Radical hysterectomy—This involves removal of the womb, neck of the womb, tubes, ovaries, nearby tissues (called parametrium) and lymph glands form the pelvis. This is undertaken by either by keyhole surgery or open abdominal surgery.
- Wide local excision—This involves removing just the cancer and leaving healthy tissue.
- Radical vulvectomy and reconstructive surgery—For advanced cancer, removal of all of the vulva may be needed. Reconstructive surgery may then be needed. This may be done together with the Plastic surgeons.
- Sentinel lymph gland excision—This means identifying and removing the first lymph gland(s) cancer cells are most likely to spread to. If they do not contain cancer, then it is likely that the other glands will not either. This is possible in selected women. As a result surgery to remove all the lymph glands in the groins is avoided. This technique is also widely used for breast cancer and melanoma skin cancer.
- Inguinal groin gland dissection—Depending on the size and position of the cancer we may advise removing the lymph glands from one or both sides of your groin. This is likely to be done at the same time as the surgery to your vulva.
- Wide local excision—This means taking out just the cancer and leaving healthy tissue.
- Vaginectomy with or without hysterectomy and reconstructive surgery—The vagina is completely removed. For more advanced cancer taking out the womb/neck of the womb/tubes/ovaries may be needed.
- Where appropriate we offer surgical treatment for recurrent gynaecological cancers. This can involve a range of different types of surgery including excision of pelvic side wall disease and ultra-radical procedures such as extenterative surgery.
Anterior/posterior/total pelvic exenteration
- This is when the bladder (anterior) and/or rectum or lower end of large bowel (posterior) or both (total) are removed. This may at times be done together with the womb, neck of the womb, tubes and ovaries.