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Introduction

Our Gynaecological Cancer Care Centre is the largest provider in the Republic of Ireland of treatment for malignancy of the reproductive organs: cancer of the womb (uterus), cervix, ovary, vagina and vulva.  Our centre provides a regional and national service and is accredited by the NCCP (the HSE’s National Cancer Control Programme) for complex radical gynaecological surgeries. International standards of treatment apply, and the service is supported by research and teaching activities through Trinity College Dublin and the Cancer Trials Research Office in the hospital.

Over 300 women with gynaecological cancer are referred to the centre annually. Cancer of the endometrium (lining of the womb) is the most common cancer, followed by cancer of the ovary/fallopian tube, then cervical cancer. Cancers of the vulva and vagina are less common. Women are referred by their general practitioners or by gynaecologists at their local hospital. A multidisciplinary team of doctors plans and provides the cancer care, and surgery is performed at the hospital. Some of the treatments such as chemotherapy can be given in other local regional hospitals. Radiotherapy treatment is given at St Luke’s Hospital (in St James's Hospital and in Rathgar, Dublin). When treatment is completed, long-term follow-up care is often provided at the patient’s local hospital.  Follow-up visits may go on for five years or longer.

  • The cervix is the lower part of the womb (uterus) and is often called the neck of the womb. Each year, over 300 women are diagnosed with cervical cancer in the Republic of Ireland. It usually occurs in women over the age of 30. The highest rates occur between the ages of 45 and 55, but it can also affect younger and older women.

    Very early-stage cervical cancer may have no symptoms, which means it is important to have regular cervical screening, so that any cell changes can be picked up early. Cervix cancer may be suspected after an abnormal cervical smear test. A biopsy is important to make the diagnosis and is usually performed at a colposcopy clinic under local anesthetic. There are two common types of cervix cancer: squamous carcinoma and adenocarcinoma. Following a diagnosis, you will have general blood tests and specific radiological tests to check whether the cancer has spread beyond the cervix.

  • Cancer of the cervix can be treated with either surgery, radiotherapy, chemotherapy or a combination of these treatments.      

    • Surgery: Early stage cancer can be treated with surgery only.
    • Cone Biopsy, refers to the removal of most of the inner part of the cervix.
    • Trachelectomy refers to the complete removal of the cervix.
    • Radical Hysterectomy refers to the removal of the cervix, womb and ligaments close to the cervix.
    • Chemotherapy may be used to treat larger tumours that are just in the cervix or those that have spread locally (to the surrounding area). It is commonly combined with radiotherapy to make the radiotherapy more effective, a treatment known as chemoradiation. Usually, the chemotherapy is given once a week during the course of radiotherapy.
    • Radiotherapy: Some patients with deep infiltration of cancer will require radiotherapy after surgery. Locally advanced cervix cancer is treated with a combination of radiotherapy and chemotherapy. Radiotherapy for cancer of the cervix can be external or internal and is often given as a combination of the two. Radiotherapy treatment may last for 5 to 8 weeks. Your cancer specialist (clinical oncologist), who plans your treatment, will discuss your treatment in detail with you.
  • We are a multidisciplinary team of surgeons, medical oncologists, radiotherapists and specialist nurses supported by experts in nutrition, physiotherapy, occupational therapy, stoma care, palliative care and pain and pastoral care. Four outpatient clinics are held weekly. Each clinic has one or more lead consultants and team doctors.

    Gynaecological Consultant Surgeons

    • Dr Noreen Gleeson is the lead gynaecology cancer surgeon and trainer. She is an associate professor at Trinity College Dublin. Her major clinical interests are gynaecological cancer and pelvic surgery and reconstruction. Her research is in surgical methods and how cancer cells grow and spread and affect other systems in the body. Her published research profile is on ResearchGate
    • Dr Tom Darcy is a gynaecology cancer surgeon and trainer. He is also a lecturer at Trinity College, Dublin. He is the director of the colposcopy pre-cancer clinic at the Coombe Women’s & Infants’ University Hospital, Dublin.
    • Dr Waseem Kamran is a gynaecology cancer surgeon and trainer. He is also the director of the Cancer Risk Reduction Clinic.
    • Dr Feras Abu Saadeh is a gynaecology cancer surgeon and the director of clinical research. His published research profile is on ResearchGate; 

    Medical Oncology Chemotherapy Consultant

    • Dr Dearbhaile O’Donnell
    • Dr Karen Cadoo

    Radiotherapy Consultant

    Cancer Nurse Specialists

    • Ms Debra McKnight
    • Ms Ciara Donohoe
    • Ms Elaine Gray

    Debra, Ciara and Elaine will coordinate all your care, from your first visit to the clinic through to your blood and X-ray tests, your admission for surgery or your appointments with other doctors.

    Research /Scientific Investigators

    • Dr Lucy Norris
    • Dr Sharon O’Toole

    Sharon and Lucy are scientific doctors who work in the research laboratory and coordinate the studies outlined. They ensure patients are informed about research studies, so you may meet them when you come to the outpatient clinic, when you come for your surgery or at other stages during your treatment. They coordinate the collection of blood and tissue samples and store them for the various studies.

    Further information on research projects is available on our Research page. Published research for Noreen Gleeson, Feras Abu Saadeh, Lucy Norris and Sharon O’Toole is available through ResearchGate.

    If you wish to support our research, please contact Debra McKnight, Gynaecological Coordinator; dmcknight@stjames.ie. You can also specify which type of gynaecological cancer you wish to support. We carry out research on ovarian, womb and cervix and vulval cancer.

  • Other Resources

    The following are websites of organisations offering information relating to the treatment and management of cancer:

    Irish Cancer Society: www.cancer.ie

    Emer Casey Foundation: www.emercaseyfoundation.com

    Ovacare: www.ovacare.com

    Supporting Ovarian Cancer Knowledge: www.sock.ie