LEXINGTON, Ky. — While most oncologists say they would prescribe hormone therapy to cervical cancer patients experiencing early menopause from radiation treatment, significant barriers are keeping many from doing so in practice, according to a new University of Kentucky Markey Cancer Center study published in JAMA Network Open.

The study found that 99.3% of gynecologic oncologists and 73.8% of radiation oncologists surveyed said they would consider prescribing hormone therapy after chemoradiotherapy — a combination of chemotherapy and radiation given simultaneously. Yet both groups reported significant obstacles in implementing the treatment, including difficulty managing patient care long-term and insufficient awareness of clinical guidelines supporting the therapy.

Premenopausal patients treated for cervical cancer with chemoradiotherapy often experience menopause as an unavoidable side effect of ovarian radiation, bringing symptoms like hot flashes, sleep disruption and vaginal dryness that can seriously impact quality of life. Research has demonstrated that hormone replacement therapy does not appear to harm cervical cancer survivors and may even improve survival outcomes.

The research team, led by Markey Cancer Center radiation oncologist Denise Fabian, M.D., surveyed 178 gynecologic and radiation oncology clinicians nationally through the Society for Gynecologic Oncology and the American Brachytherapy Society about their attitudes and prescribing habits around hormonal therapy for cervical cancer patients.

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

The University of Kentucky's Markey Cancer Center is Kentucky's only National Cancer Institute-designated Comprehensive Cancer Center, serving patients across the Commonwealth and the region.

Researchers say future work will focus on increasing awareness of existing clinical guidelines and finding ways to make prescribing more manageable for clinicians, with the goal of improving access to a treatment that evidence shows is both safe and effective for cervical cancer survivors managing iatrogenic menopause.