Masteronderzoek Radiotherapie - afterMATH

afterMATH: iatrogenic Menopause Awareness, Timely management & Holistic care in gynecological cancer

Background
Treatment for gynecological cancers often leads to iatrogenic menopause, meaning a prompt menopause caused by ovarian failure as a consequence of removal and/or irradiation of the ovaries, and chemotherapy. This could lead to severe symptoms that impact quality of life and increase long-term health risks. Despite its clinical relevance, evidence on symptom burden and QoL among premenopausal patients undergoing gynecological cancer treatment remains limited. In addition, although international guidelines for menopause management exist, clinical practice in the Netherlands is heterogeneous, leading to variation in patient (e.g. the prescribed hormonal therapy) . This project is embedded in the afterMATH study (iatrogenic Menopause Awareness, Timely management & Holistic care), which aims to improve QoL for gynecological cancer survivors through awareness, prevention, and early intervention for iatrogenic menopause.

Aim of the research project
The aim of this project is to generate new clinical evidence on premenopausal symptoms and multiple dimensions of QoL among cervical cancer survivors previously treated at Erasmus MC. Using retrospectively collected questionnaire data, the study will assess symptom prevalence, severity, and impact on daily functioning and overall well-being. In addition, the project aims to identify demographic, clinical, and treatment-related risk factors associated with increased symptom burden. By analyzing patient-reported outcome measures (PROMs), this research project will provide an overview of symptom experiences and QoL in this population following gynecological cancer treatment.

Type of research / research activities for the student
The student will be involved in a retrospective study using (PROMs) collected from patients previously treated for cervical cancer, with a focus on:

• Symptom burden after iatrogenic menopause and association with QoL
• Risk factors contributing to more severe symptoms

The student will be responsible for processing and analyzing the existing PROM, clinical, and demographic data. Activities include data management, statistical analyses, interpretation of results, and reporting of findings. The outcomes of this work will contribute to a better understanding of symptom burden after iatrogenic menopause and the identification of patients at increased risk of experiencing severe symptoms.

Wat do we offer?

• A pleasant and dynamic work environment within a team of physician-researchers;
• Guidance and mentorship from experienced professionals;
• Opportunities to observe and participate in consultations, patient discussions, and research meetings;
• Potential for co-authorship on research publications/

Starting moment: September/October

Contact details for the student / daily supervisor
Dr. S. (Sofia) Spampinato
Research scientist
Department of Radiotherapy
Erasmus MC, University Medical Center Rotterdam
s.spampinato@erasmusmc.nl

Formal supervisor
Dr. G.H. Westerveld, MD, PhD
Radiation Oncologist
Department of Radiotherapy
Erasmus MC, University Medical Center Rotterdam 

References
Del Carmen MG, Rice LW. Management of menopausal symptoms in women with gynecologic cancers. Gynecol Oncol. 2017 Aug;146(2):427-435. doi: 10.1016/j.ygyno.2017.06.013. Epub 2017 Jun 16. PMID: 28625396.

Rees M, Angioli R, Coleman RL, Glasspool R, Plotti F, Simoncini T, Terranova C. European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis. Maturitas. 2020 Apr;134:56-61. doi: 10.1016/j.maturitas.2020.01.005. Epub 2020 Feb 11. PMID: 32059825.

Pepin A, Chesnokova A, Pishko A, Gysler S, Martin C, Smith E, Kassick M, Taunk NK. Hormone Replacement Therapy in Patients with Gynecologic Cancer and Radiation-Induced Premature Ovarian Insufficiency. Int J Radiat Oncol Biol Phys. 2025 Mar 15;121(4):1042-1052. doi: 10.1016/j.ijrobp.2024.10.023. Epub 2024 Oct 23. PMID: 39448037.