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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 at 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 (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 ovaries are two small, oval-shaped organs in the pelvis (the area between the hips in the lower part of the tummy). The fallopian tube, which is about 10 cm long, connects the womb to the ovary. About 1 in every 70 women develops ovarian cancer during her lifetime. The causes of ovarian cancer are not yet completely understood. The risk of developing ovarian cancer is very low in young women and increases as women get older. More than 8 out of 10 (80%) of ovarian cancers occur in women over the age of 50. There are different types of ovarian cancer, but the most common is serous carcinoma. 

    Treatment depends on the type of cancer diagnosed. As the ovary shares the same lining with other abdominal organs, it is not uncommon for the cancer to spread from the ovary to other abdominal organs.

    Ovary cancer is usually asymptomatic, and patients often go to their GP with non-specific symptoms. An abnormal pelvic ultrasound and a positive blood test (known as CA 125) will increase the suspicion of ovary cancer. The diagnosis is made only after taking a sample/biopsy from the tumour.

  • In 70% of cases, ovary cancer presents with distal spread (metastasis) and requires combined treatment with both chemotherapy and surgery.

    • Surgery for ovary cancer is called Debulking, which means removing the visible cancer/tumour. This may also require bowel surgery and stoma formation (for a colostomy or ileostomy) in addition to removal of the ovaries, fallopian tubes and womb.
    • Chemotherapy: Cancer of the ovary is usually sensitive to chemotherapy. Unless the cancer is confined to the ovary, chemotherapy treatment is recommended. Chemotherapy can be given before surgery (neoadjuvant) to shrink the tumor and after the surgery (adjuvant) to destroy any remaining cancer cells. A combination of two drugs is usually given, carboplatin and paclitaxel.

    After treatment, you will be followed up closely. A clinical examination, blood tests and scans may be performed to monitor for disease recurrence.

  • 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

  • Niamh's story; "They arranged for a nurse in my area to come out to me and to look after me with my dressings and stuff like that." In memory of Niamh.