Oncologists Face Barriers in Prescribing Hormone Therapy for Cervical Cancer Patients

A national survey reveals that while most oncologists are willing to prescribe hormone therapy to manage early menopause in cervical cancer survivors, significant practical barriers prevent its widespread use. The study, published in JAMA Network Open by researchers at the University of Kentucky Markey Cancer Center, points to systemic challenges in long-term survivorship care.

The Clinical Challenge

Premenopausal patients undergoing chemoradiotherapy for cervical cancer often experience sudden menopause as a side effect of ovarian radiation. This can lead to disruptive symptoms, including:

• Hot flashes
• Sleep disruption
• Vaginal dryness

Clinical guidelines support the use of hormone therapy to manage these symptoms, yet prior research shows this effective treatment remains underused.

About the Study

The research team, led by radiation oncologist Denise Fabian, M.D., with Morgan Levy, M.D., as first author, surveyed 178 gynecologic and radiation oncologists nationwide. The survey, distributed through major professional societies, assessed attitudes and prescribing habits regarding hormone therapy after chemoradiotherapy.

Key Findings from the Survey

Prescribing Intent:

• 99.3% of gynecologic oncologists reported they would consider prescribing hormone therapy.
• 73.8% of radiation oncologists reported the same.

Reported Barriers:
Both specialist groups consistently identified two primary obstacles:

1. The capacity to manage patients' care over the long term.
2. A lack of awareness of existing clinical guidelines.

Researcher Insights

"This study highlights a critical opportunity to strengthen survivorship care for cervical cancer patients, both in Kentucky and nationwide. Hormone therapy can meaningfully improve not only quality of life, but also long-term health. We need to ensure more patients can access it."
— Denise Fabian, M.D., study lead

"This work has shown us that oncologists are interested in prescribing hormonal therapy to improve quality of life for our patients," said first author Morgan Levy, M.D. "We are excited to continue working with our multidisciplinary team in survivorship and gynecologic oncology to design interventions to improve the standard of care."

Path Forward

The researchers indicate future work will focus on two main areas:

• Increasing awareness of clinical guidelines among oncologists.
• Developing strategies to make the process of prescribing and managing hormone therapy more manageable within clinical practice.

The ultimate goal is to increase patient access to a treatment that evidence indicates is both safe and effective for managing menopausal symptoms in this specific population.