Current Society of Gynecologic Oncology guidelines state: “Cervical cancer is not considered a hormonally responsive cancer and estrogen/progesterone receptor positivity has no prognostic significance in this population. Hormone replacement therapy is safe in women with cervical cancer and should be offered to cervical cancer patients with induced menopause.” With this in mind, a survey-based study polled 178 gynecologic oncology and radiation oncology clinicians treating premenopausal patients with locally advanced cervical cancer undergoing chemoradiotherapy—a treatment that reliably induces ovarian failure. Encouragingly, nearly all gyn oncs (99%) and a solid majority of rad oncs (74%) reported willingness to prescribe hormone replacement therapy. Combined estrogen-progesterone regimens were favored, particularly among gyn oncs (91% vs 70%), as would be expected for a non-surgical cohort maintaining a uterus. Yet, despite most polled physicians recognizing that most or all patients develop menopausal symptoms following chemoradiation, conversations about hormone replacement therapy remained inconsistent—landing mostly in the “sometimes” category. Translating enthusiasm into action was hampered by concerns about long-term management capacity, expressed by 21% of gyn oncs and 43% of rad oncs, and perceived lack of guideline clarity, expressed by 13% across the board. | Levy, JAMA Netw Open 2026
