Our centre for gynaecologic oncology diagnoses and treats the main cancers that originate in women’s reproductive organs — Cervical, Endometrial, Ovarian, Vulval, Fallopian Tube, and Uterine. Each year, thousands of women are diagnosed with one of these conditions. Fortunately though, many of these cancers are highly treatable and even curable with the comprehensive, and multidisciplinary, preventive treatment approach employed by The McIndoe Centre.
We always tell our patients to try and avoid ‘worst case scenario’ thinking. It is normal to be anxious when diagnosed with cancer, but the reality is, in most situations the outcome is much better than the patient may imagine. Whatever the circumstances, we consider it important to address those anxieties at the outset and discuss the likely outcomes in an open and informative manner.
We understand that for many young women, gynaecological cancer brings their chances of future fertility into question. However, in most cancers it is possible to offer fertility preserving options if the tumour is diagnosed early enough. We do everything in our power to pursue these options.
We believe that the first step in a successful treatment is the accurate diagnosis and staging. Our dedicated multidisciplinary team of doctors specialise in the investigation of gynaecological cancers ensuring diagnosis is swift and effective. .
The best chance to cure a cancer is with the first treatment. Careful planning and decision making is crucial to ensure that the first treatment is the best it can possibly be whilst minimising side effects.
Our surgical team are highly trained experts who have spent many years honing the skills necessary to perform the often complicated procedures required to treat gynaecological cancers — all the while achieving the best possible outcomes.
We also offer radical surgery where appropriate, with aims to cure difficult or recurrent cancers when previous opinion suggested surgery was impossible.
Unfortunately, many women come to The McIndoe Centre having been previously told that their cancers are “inoperable” simply because the surgery required is difficult and involves procedures that are outside the usual range. However, often these women can achieve excellent responses and cures from our more extensive radical surgeries that extend beyond the “normal” range.
Surgery offers the best therapeutic modality for gynaecological tumours where it is applicable and we believe it should always be considered.
Cancer of the cervix is a relatively uncommon cancer in the United Kingdom and has become less common with the introduction of the smear test. Routine smear tests are now available to all women in the UK. Additionally, the recently introduced vaccination programme against HPV may reduce the incidence further.
Conservative treatment is often possible for small cervical tumours. Provided the tumour is completely removed by a cone biopsy, additional treatment may not be required. Pelvic lymph nodes can be treated where necessary, using minimally invasive techniques.
Accuracy of diagnosis of very small cervical cancers has been dramatically improved using an endovaginal MRI coil which gives especially accurate images of the tumour in the cervix.
Robotic surgery is changing the way we are able to surgically treat pelvic tumours, and is available in only a very few centres in the UK. The Da Vinci robot is an ideal platform for undertaking complex pelvic surgery and allows very complex procedures to be done in a minimally invasive manner.
Radical exenterative surgery for recurrent cervical cancer
Occasionally, cervical cancer will recur after radiotherapy treatment. Where possible, the only treatment that will offer the possibility of a cure is exenterative surgery. This is a very big operation and very few centres offer this procedure on a regular basis but the operation can be lifesaving in the correct situation.
Endometrial cancer is usually treated by hysterectomy. This surgery can now be performed using a single keyhole port in the umbilicus which disappears almost completely as it heals. Additionally, recovery from this procedure is remarkably quick.
When the disease is caught early, we can often offer fertility preserving treatment for our younger patients. However, young women rarely develop endometrial cancer or endometrial pre-cancers before they have their family. Recent research has shown that some young women can be treated with hormones to reverse the cancer long enough for them to have their families. We are delighted to say we have had some very notable successes with this approach.
While ovarian cancer is relatively uncommon, it unfortunately still accounts for more than 7,000 new cases in the United Kingdom each year. Often these cases are sporadic, and occur in women with no family history. However, approximately 5% of ovarian cancers are the result of BRCA1 or 2 genetic mutations, which are associated with an increased incidence of breast and ovarian cancer in families.
Here at The McIndoe Centre, we do everything in our power to ensure that the entirety of the tumour is removed. Our surgical team is dedicated to the highest standard of care and the best possible outcome for women whilst minimising complications of surgery. Additionally, our nursing staff is second to none in providing compassionate care following surgery.
Chemotherapy is the usual treatment for women with ovarian cancer that has recurred, but in some women, radical surgery at this stage can make a difference to the outcome of the disease. We are prepared to look at each case individually to assess whether there is a role for further surgery, and to give the best possible advice regarding this option.
Biomarkers are increasingly being used to select treatment options, particularly when first line chemotherapy fail. Through our collaboration with the Queen Anne Street Medical Centre, our patients are able to benefit from this emerging technology.