When Denise Fabian, M.D., began asking oncologists across the country about their prescribing habits, she expected to find resistance to hormone therapy for cervical cancer survivors. Instead, she found something far more hopeful: an overwhelming majority of clinicians who already believe in its value.
A new study from the University of Kentucky Markey Cancer Center, published in JAMA Network Open, reveals that 99.3% of gynecologic oncologists and 73.8% of radiation oncologists say they would prescribe hormone therapy to cervical cancer patients experiencing early menopause after chemoradiotherapy. The treatment, which can relieve debilitating symptoms like hot flashes, sleep disruption, and vaginal dryness, is supported by clinical guidelines—but remains chronically underused.
The gap between intention and practice, the researchers found, comes down to two addressable problems: a lack of awareness about existing guidelines and insufficient capacity to manage patients' care over the long term.
"This study highlights a critical opportunity to strengthen survivorship care for cervical cancer patients, both in Kentucky and nationwide," said Fabian, a radiation oncologist at Markey Cancer Center. "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 research team, led by Fabian with Morgan Levy, M.D., as first author, surveyed 178 gynecologic and radiation oncology clinicians through the Society for Gynecologic Oncology and the American Brachytherapy Society. Their findings suggest that improving access doesn't require convincing skeptical doctors—it requires giving them the tools and support to act on what they already believe.
"This work has shown us that oncologists are interested in prescribing hormonal therapy to improve quality of life for our patients," Levy said. "We are excited to continue working with our multidisciplinary team in survivorship and gynecologic oncology to design interventions to improve the standard of care."
The researchers are now turning their attention to closing the gap. Future work will focus on increasing guideline awareness and finding ways to make prescribing more manageable for clinicians. The goal, Fabian said, is straightforward: get more patients the care that evidence shows is safe and effective.
For the roughly 14,000 women diagnosed with cervical cancer in the United States each year—many of them in their 30s and 40s—this isn't just about managing hot flashes. It's about reclaiming years of life disrupted by diagnosis and treatment. And for the doctors who treat them, this study offers a clear signal that they're already aligned on the solution.