Psychological Stress, glucocorticoids and gynaecological cancers

The incidence of endometrial cancer (EC) is increasing worldwide with approximately 400,000 women diagnosed every year. The role of stress in cancer progression is well established but very few studies have asked how stress can make EC worse.

To understand EC, we need to understand which molecules can promote EC. Additionally, studies must also consider the quality of life (QOL) implications of the disease. The project aim is to measure stress levels in patients with EC and how this varies over time. We also aim to examine if the stress response differs between patients with early vs advanced disease and assess how stress may worsen EC.

We will recruit patients diagnosed with endometrial cancer from University Hospitals Sussex (UHS) NHS Trust and East Sussex Hospitals NHS Trust where there are usually around 110 endometrial cancers diagnosed every year.

We will assess how well we can recruit patients to the study and if they stay participating throughout the whole study. Each patient will undergo surgery and during this time will extract a piece of tissue to develop organoids (mini patient tumours cultured outside the body). The patients will be consulted at 3 monthly intervals in year 1 and 4 monthly year 2 where they will be asked to fill out questionnaires on stress.

We will also assess hyperinsulinism and hyperestrogenism by a blood test. We can correlate stress levels with how the disease progresses and responds to treatment. Additionally, where possible, we will monitor the clinical outcomes e.g., local, and spread by a scan. Our goal at this stage is to identify whether stress can be correlated with cancer aggressiveness. The findings of this research will be disseminated through local (BSMS work-in-progress meetings), National (NCRI) and International conferences (ESMO).