Gynecologic Cancers: Where Are We Now?

By Dr. Neha Kumar, Sr. Consultant, Gynae. Oncology, BLK Super Speciality Hospital

Gynecologic cancers are among the most common cancers affecting women. Cervical and ovarian cancers are the most common gynecologic cancers in India. Although, cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer. Due to the lack of awareness and formal screening programs in our country, diseases are diagnosed only when they reach advanced stages. The incidence of ovarian cancer has been increasing in the past decade and it ranks as the third most common cancer in Indian women. Other gynecologic cancers include endometrial (uterine) cancer, vulvar cancer (cancer of the female external genitalia) and vaginal cancer.

Over the years, there have been several advances in the field of gynecologic oncology, be it surgery, chemotherapy or radiotherapy. These have changed the outcomes of women suffering from gynecologic cancers dramatically. From diagnosis to decision making, minimal access surgeries to highly complex surgeries, postoperative management to long term follow up, the role of gynecologic oncologist is becoming paramount.

The field of Gynecologic Oncology has come a long way.

On one hand, minimal access surgery including laparoscopic and robotic hysterectomies and lymphadenectomies are increasingly being used in the surgical staging of gynecological cancers. On the other hand, with the right expertise and perioperative care, many complex and radical surgeries are being done, for instance for advanced ovarian cancers. HIPEC (Hyperthermic intraperitoneal chemotherapy) is a recent advancement in the treatment of ovarian cancers which involves instillation of heated chemotherapy drugs inside the abdomen after the removal of tumor during surgery.

During robot-assisted surgeries, surgeons operate from a console equipped with two master controllers that maneuver four robotic arms. It provides a magnified, 3-D view of the surgical site and helps the surgeon operate with precise movements, flexibility and control. The intraoperative blood loss is less as compared to open surgery, the postoperative recovery is faster and with the much smaller incisions, the chances of wound infection are reduced.

Timely and appropriate treatment is the key to successful management of cancer.

It is rightly said that cancer is a word, not a sentence. Many cancers, including gynecologic cancers, are curable if detected early. With recent advances and multimodality treatment, the outcomes of patients – even those with advanced stages, have improved considerably over the years.  Being diagnosed with cancer can be extremely traumatic and stressful, but the reassurance received from healthcare professionals, family members, friends, and even support groups, goes a long way in helping the cancer patients in their battle against this disease. In addition, the supportive care provided at dedicated cancer centers is an essential part of cancer management, and helps in taking care of other concerns of these patients including pain control, improving quality of life and psychological and logistic issues during therapy.