Gynecologic cancers represent a diverse group of tumors: labial, vaginal, cervical, endometrial and ovarian cancers. The treatment of recurrent disease has been built on published series, many of which are anecdotes about responses to therapy. The use of radiation has lagged behind in the treatment of recurrence. Now comes a new approach from the Odette Cancer Center in Toronto. They used stereotactic ablative radiation therapy to treat one to a few areas of local recurrence for all of these diseases. This form of advanced radiation uses computer derived treatment fields and allows very focused treatment with less damage to surrounding areas. Published in JAMA Oncology in 2024 is a provocative article by Donovan and colleagues. The abstract of the article can be accessed through the link in the previous sentence. If you wish the entire article send Dr. Stark a message through the box on the right of this page. The authors treated over 200 patients, most of whom had endometrial (uterine) cancer. At five years most of the patients had no further evidence of local recurrence. However, about 75% of patients by 5 years had suffered some sort of recurrence, mostly in the form of distant metastases, all of which will eventually lead to death. Dr. Stark comments: this nice article addresses an important problem. Local recurrence from gynecologic cancer can be very painful and debilitating — leading to a bed-ridden existence. Even though the overal survival rate is not that great, the quality of life for patients who will eventually die of their cancer is improved. That is not a trivial issue.