Survival rates for cervical and uterine cancer have stagnated for years, although cancer deaths in the United States have generally declined,media outlet The Verge reported. This week, the American Cancer Society announced the largest one-year decline in cancer deaths on record, dropping 2.2 percent between 2016 and 2017. However, while many forms of cancer treatment have improved significantly, these particular cancers, such as cervical and uterine cancer, have been left behind. Reasons may include gaps in treatment and limited funding for research on diseases.
Sarah Temkin, a gynaecologist at Anne Arundel Medical Center, said: “I hope these data show that more attention needs to be paid to these diseases. At all levels, the attention of gynecological malignancies has decreased. Hopefully this will raise some alarm that women with these diseases should be valued and studied just like any other cancer patient. “
New treatments for lung cancer and melanoma, such as immunotherapy, have helped drive the overall decline in cancer deaths. There has been no similar progress in the treatment of cervical and uterine cancers (also known as endometrial cancer), especially for relapse and metastatic forms of disease.
With about 66,000 new cases of endometrial cancer diagnosed in the United States each year, the need for available treatments is growing. The incidence of invasive endometrial cancer without good treatment options is on the rise. The increase in these types of cancer is likely due to an ageing population, rather than other forms of cancer.
These cancer patients sometimes have difficulty in obtaining appropriate treatment. “For endometrial and cervical cancer, we all know that access to treatment is a huge problem,” says Temkin. For example, these diseases are particularly racially diverse in treatment and survival. Black women were less likely than white women to be assessed for vaginal bleeding, which led to a later diagnosis of endometrial cancer with a much lower survival rate.
These differences only get worse when new treatments, such as immunotherapy, are involved, which is often expensive and may not be available in many places. “Even in some cases, immunotherapy is not really used effectively in most endometrial cancers and many cervical cancers,” says Temkin. “
Even as the need to treat these cancers increases, systemic problems are troubling research funding. “These diseases are really underfunded compared to other diseases with similar mortality rates,” Temkin said. In 2014, the National Cancer Institute established the National Clinical Trials Network to coordinate clinical trials for all cancer studies. This restructures federal funding for all cancer research. Gynaecological Oncology credits are for radiation, breast and colon cancer studies. “The cooperative group is getting bigger. Overall funding hasn’t really changed much,” said Matt Carlson, an associate professor in the Department of Gynecology Oncology at UT Southwestern Medical Center.
Temkin said that while there are good reasons to make such a change and improve the efficiency of clinical trials, it has also led to a sharp decline in the number of clinical trials for gynecological cancers. “The number of trials is open and the number of available stousans is plummeting,” she said. We are less affected because our professional scope is so small. “This has increased the reliance on pharmaceutical companies for trials, and their priorities may not be in line with research priorities in the field of gynaecological oncology.”
Despite these challenges, Carlson said he is optimistic that mortality from cervical and endometrial cancer will begin to decline. Carlson and Temkin are both members of the Gynaecological Oncology Society, which has been lobbying lawmakers for more money. “We’ve had gradual success every time,” says Carlson. In September, the U.S. Food and Drug Administration (FDA) also approved new treatments for patients with invasive endometrial cancer or whose cancer recurs after the first round of treatment. “We don’t have a lot of new drugs, and if we had this conversation a year ago, I would have been more pessimistic, ” he says. But it’s an exciting time and we’re still experimenting with other things. “
Temkin says better treatments and barriers to improving survival rates for cervical and endometrial cancer stoushei are not insurmountable. “We have a chance to solve this problem. “