Gynaecologic Oncology

Awareness of risk factors, maintaining a healthy lifestyle, genetic counselling, undergoing regular testing, getting vaccinated against HPV, and early identification of potential signs and symptoms can aid in detecting and preventing gynaecologic cancers.

Symptoms might differ depending on the type of gynaecologic cancer and may be vague and not necessarily due to cancer. The symptoms may comprise the following: 

• Unusual vaginal bleeding or discharge is usual for all forms of gynaecologic cancers except vulvar cancer.
• Feeling full promptly or difficulty eating, bloating, and abdominal or back pain are predominant for ovarian cancer.
• Pelvic pain or pressure is expected in the case of ovarian and uterine cancers.
• More frequent urges to urinate and constipation are usually observed in the case of ovarian and vaginal cancers.
• Burning, itching, pain, or tenderness of the vulva, and modifications in vulva colour or skin, such as a rash, sores, or warts, are present only in vulvar cancer.

Healthcare professionals begin by asking about family and personal medical history and symptoms. They then do a complete physical exam, including a pelvic examination, to look for signs of problems in reproductive organs. To confirm a diagnosis, healthcare professionals order one or more tests, including:

• Biopsy: The healthcare professionals take small samples of the suspicious tissue, which are then examined for signs of cancer.
• Colposcopy: Healthcare professionals use a colposcope (illuminating, magnifying instrument) to examine the vulva, vagina, and cervix for abnormal tissue or signs of cancer.
• Diagnostic Imaging:
  • Computed Tomography (CT): These scans utilize special X-ray equipment to produce cross-sectional pictures inside the pelvic area. CT scans can display the tumour size and whether the cancer has metastasized.
  • Magnetic Resonance Imaging (MRI): This method uses radio waves and strong magnets to produce cross-sectional pictures of an individual’s body. It is also used to assess tumours more closely and look for signs that the cancer has spread.
  • Positron Emission Tomography (PET): An individual will be injected with a small quantity of a radioactive substance. A special scanner produces images that display the highlighted portions to offer details about the cancer, especially the location where it has metastasized.
  • Serum Tumour Markers: They help screen, diagnose, and monitor certain gynaecological cancers. Females with suspected ovarian malignancies undergo a CA125 serum test along with the scans to assess the risk of malignancy. Other helpful markers of ovarian cancer are beta-HCG and AFP produced by germ cell tumours.
  • Pap Smear Test: It is a crucial test for checking unusual cells on the cervix that can lead to cervical cancer.

1. Cervical Cancer: It is the fourth most prevalent cancer among women across the globe, which develops in the cervix of the female (the entrance to the womb from the vagina).
2. Ovarian Cancer: It is a cancerous tumor that forms in an ovary’s tissues.
3. Uterine Cancer: It occurs when healthy cells in the womb change and grow out of control, forming a mass known as a tumour. There are two main types of uterine cancer: Endometrial cancer, which is predominant, and uterine sarcoma, which is rare.
4. Gestational Trophoblastic Disease (GTD): It refers to a spectrum of rare ailments wherein abnormal trophoblast cells grow inside the womb after conception.
5. Vaginal Cancer: It occurs when abnormal cells in the vagina start to proliferate in an uncontrolled manner.
6. Vulvar Cancer: It is a rare condition primarily occurring in postmenopausal women.

Gynaecologic cancers are treated in a multitude of ways. It depends on the type of cancer and how far it has advanced. Women with gynaecologic cancer frequently undertake more than one type of treatment. 

Treatment options include:

1. Surgery: Healthcare professionals excise cancer tissue through surgery. Surgical intervention procedures include staging, debulking/cytoreduction, radical hysterectomy, omentectomy (standard component care of gynaecological cancers, particularly for surgical staging and treatment for malignant ovarian neoplasm), and lymph node removal.
2. Cytoreductive Surgery for Ovarian Cancer: This procedure is the benchmark of therapy for advanced epithelial ovarian cancer.
3. Robot-Assisted Hysterectomy: Here, the surgeons remove the uterus with the help of robotic arms.
4. Chemotherapy: In this approach, special medications are used to shrink or kill the cancer. The drugs can be taken orally, intravenously, or both.
5. Hyperthermic (or Heated) Intraperitoneal Chemotherapy [HIPEC]: It is a surgical procedure providing new hope to patients with abdominal cancer.
6. Radiation: It involves using high-energy rays (like X-rays) to destroy the cancer.
7. Video Endoscopic Inguinal Lymphadenectomy (VEIL): It is a minimally invasive technique employed for the treatment of vulvar cancer.

By offering advanced diagnostic techniques and innovative treatment, Fortis Healthcare stands as one of the topmost hospitals for dealing with gynaecologic cancers. Early and accurate screening and treatment of gynaecological cancers helps patients live longer and with better quality of life.