午夜剧场

Cancer is currently the leading cause of death among Japanese people. Cancers such as cervical cancer, endometrial cancer, and ovarian cancer also occur in the uterus and ovaries, which are organs unique to women. Among these, advanced cancer has a poor prognosis, but in recent years, the development and clinical application of new drugs such as immune checkpoint inhibitors and PARP inhibitors have progressed, and improvements in treatment outcomes are expected. On the other hand, the five-year survival rate for early-stage gynecologic cancer is very high, with Stage I showing favorable results of over 90 percent for all types, and radical cure is sometimes possible through surgery alone.

Much of cancer research has focused on "improving survival rates" as its primary objective, developing diagnostic and treatment methods and accumulating evidence for standard treatments through clinical trials. For cancers in organs essential for life support, preserving their function has been emphasized because it contributes to improving survival rates. However, the uterus and ovaries are not essential for life support, and because the peak age of incidence was often higher than childbearing age, there was a tendency to neglect functional preservation. Nevertheless, with the recent trend toward later marriage and childbirth, as well as advances in reproductive medicine such as egg freezing, the idea that losing the function of the uterus or ovaries is "unavoidable" is no longer suited to the times.

For example, if the uterus is removed, the possibility of pregnancy is lost, and the removal of ovaries, radiation therapy, or certain drug therapies will stop the secretion of female hormones. Lymphedema caused by lymph node dissection and hair loss caused by chemotherapy are also side effects that cannot be overlooked; these are issues deeply related to quality of life (QOL) that cannot be expressed simply by survival rate figures. That is why we are now seeking a new approach to cancer care that emphasizes maintaining women's QOL, rather than setting "improving survival rates" as the sole goal.

In our department, we are conducting various studies with QOL as the endpoint and verifying their effectiveness. These include fertility-sparing treatment for cervical and endometrial cancer, sentinel lymph node navigation surgery, the establishment of an Ovarian Support Outpatient Clinic to support the ovarian function of cancer survivors, and scalp cooling therapy to prevent hair loss caused by chemotherapy.

"Cancer" does not end when it is cured. How can one live their life in their own way after being cured? We are working on research while looking toward a future of "living with cancer" together with our patients.