Background Menopause may cause a constellation of symptoms that affect quality of life. Many women will have menopause induced or exacerbated by treatment for cancer whether that be through surgery, chemotherapy, radiotherapy, or anti-endocrine therapy. As treatments advance, the number of people living with and beyond a cancer diagnosis is set to increase over the coming years meaning more people will be dealing with the after effects of cancer and its treatment. Aims This review aims to summarise available data to guide clinicians treating women with menopausal symptoms after the common cancer diagnoses encountered in Ireland. The use of menopausal hormone therapy is discussed as well as non-hormonal and non-pharmacological options. Conclusions Managing menopausal symptoms is an important consideration for all physicians involved in the care of people living with and beyond a cancer diagnosis. High-quality data may not be available to guide treatment decisions, and, thus, it is essential to take into account the impact of the symptoms on quality of life as well as the likelihood of recurrence in each individual case.

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study compared the surgical outcomes of patients with benign disease who underwent laparoscopic assisted vaginal hysterectomy (LAVH) to determine the association of surgical outcomes with resident participation in the gynecological filed. Methods We performed a single center retrospective study of 683 patients diagnosed with gynecological benign disease from January 2010 to December 2015 who underwent the LAVH procedure. Clinicopathological characteristics and surgical outcomes were compared between the resident involvement group and attending physician alone group. The primary endpoint was 30-day postoperative morbidity. Results In total, 165 patients underwent LAVH with resident involvement and 518 patients underwent surgery without resident involvement. The mean age of the patients was 49 years and 48 years in the resident involvement group and attending alone groups, respectively. There was 30-day postoperative morbidity in 8 (3.5%) and 18 (4.8%) patients in the resident involvement group and attending alone group (P=0.422), respectively. Operative time was significantly different between the two groups, 131 minutes in resident involvement group and 101 minutes in attending alone groups (P<0.001). On multivariate analysis, Charlson comorbidity index > 2 (OR 8.0, 95% Cl 2.7-24.0, P<0.001), operation time (OR: 1.018, 95% Cl: 1.008-1.028; P<0.001) and EBL (OR: 1.002, 95% Cl: 1.001-1.003; P<0.001) were significantly associated with 30-day morbidity, but resident involvement was not statistically significant. Conclusions The operation time was longer when the resident involvement in LAVH, but was no significant difference in morbidity at 30 days. Therefore, resident involvement in LAVH is a reasonable way to meet both resident training and patient safety.

Introduction/Background* Cancer and its treatments can result in physical, psychological, and cognitive impairments. The Healthy Eating Active Lifestyle (HEAL) -GYN "rehabilitation" cancer program was developed to provide intensive group lifestyle training on exercise, nutrition, sleep, social integration, and stress management via a telemedicine platform. The aim of this study was to determine the impact of such an intervention on short-term quality of life for gynecologic cancer patients. Methodology Gynecologic cancer patients underwent experiential instruction and personalized goal setting through an entirely virtual platform. A multidisciplinary team led by a gynecologic oncologist addressed diet, physical activity, strategies for sleep and stress management, sexual health, smoking cessation and alcohol intake. The intervention was aimed to address unmet psychosocial, emotional, physical, sexual, and spiritual needs common to cancer survivors. Self-administered questionnaires with Likert scales (1-5) were utilized in a preand post-fashion to assess improvements in physical activity, dietary and sleep habits, and a general medical symptom questionnaire (MSQ). Result(s)* We report outcomes on the first 22 participants. The mean age was 58.8 years; 22 were Caucasian, and 7 patients were on maintenance therapy during their enrollment. There was a significant decrease in the average number of general symptoms reported by a comprehensive medical symptom questionnaire (MSQ) (36.39 vs 24.77, p<0.05). Trends towards improvement were demonstrated in eating patterns (4.59 vs 3.74 p=0.06), perceived stress (11.32 vs 10.73, p=0.28), levels of anxiety and depression (10.76 vs 7.68, p=0.07) and weight management (17.55 vs 16.79, p=0.23). Patients also reported feeling an increased sense of purpose and connection as a result of their enrollment in the program (35.57 vs 37.26, p=0.07). Effect sizes (d) within the program were mild to moderate for all evaluated dimensions. 100% of participants would "highly recommend" the program and none complained of stress or altered mood associated with online instruction. Conclusion* A telemedicine-based peri-habilitation program is feasible and well tolerated. Based on preliminary data, there are trends towards improvement in overall general medical symptoms, eating patterns, perceived stress, levels of anxiety and depression, and physical activity. These findings support continued investigation of a telemedicine-based healthy lifestyle peri-habilitative program.