GYNAE ONCOLOGY

It refers to cancer of the female genitalia and reproductive system and require understanding of the complexities involved. Surgical Oncologist are best suited in the surgical management as they have the skills required to carry out radical procedure which at times require multi organ resection and reconstruction. However, the total gamut of Gynaecological oncology surgeries is spread in to four related fields. These can be briefly ascribed as to be divided as

Carcinoma Cervix:

This type of cancer affects the entrance to the uterus. The cervix is the narrow part of the lower uterus, also called as the neck of the womb. Having sex with multiple partners or becoming sexually active at early age come as precautionary alert for this disease. Bleeding between periods and after sex are the preliminary symptoms. Vaginal discharge with odd smells or tinged with blood, feeling discomfort during sexual intercourse are the other symptoms for this type of cancer.

Treatment

Surgery, Radiotherapy, Chemotherapy or a combination of two or all compose preferred treatment options of the best gynae oncologist. However, treatment decision is highly dependent on stage of the disease, patient’s state of health and age too. It is also needless to mention that early stage detection bears high potential for success.

  • Early stage treatment: Surgery is recommended by best Gynecologist for treating the cancer confined to the cervix. Radiotherapy may be implemented after surgery when the cancer doctor finds sufficient reasons to believe about the existence of cancer cells. Radiotherapy is also used to reduce the risk of repetition.
  • Late stage treatment: Advanced or invasive cancer affects various other parts of the body and thus requires extensive treatment options. Such treatment will comprise radiotherapy or a combination of radiotherapy and chemotherapy. Also the administration of palliative therapy is administered to relieve symptoms and improve quality of life.

Carcinoma Endometrium:

This cancer affects the uterus. An early detection would lead to cure through surgery and close follow-up. The choice of treatment invariably depends on the position and extent of cancer affection.

After confirming that the patient has endometrial cancer, the oncologist will require and recommend surgery for removal the uterus, ovaries and even fallopian tubes. The tissues that are removed in surgery are examined to find out the stage and grade of the cancer. Lymph nodes are also subjected to vigorous testing to ascertain if any cancer has spread out of the uterus area.

Several treatment options may be recommended depending on the severity of cancer. Surgery can be followed by Radiation Therapy to block any further growth and Chemotherapy may be opted for killing cancer cells. Identically, there will be series of follow-up checking for the ailing. Such patients may have symptoms like loss of weight, decreased appetite, cough, bleeding from vagina, rectum or bladder or likewise. Retention of any of these symptoms may result in the recurrence of cancer and put the patient to death.

Carcinoma Ovary:

Cancer in ovarian tubule is basically epithelial in nature. They start from the egg-producing cells. Most amazing is that such tumors open up from structural tissues holding ovaries together and produce female hormones like estrogen and progesterone. The most common type of such cancer is epithelial ovarian cancer or Carcinoma Ovary. These types of cancers are diagnosed at advanced stage since the disease produces no early symptoms and signs of such cancer. Curiously, this cancer shows mild symptoms even in most advanced stages.

Surgical Treatment

The best surgical oncologist and best Gynecologist recommend the surgical intervention depending on the diagnosis and its stage of presentation. In such surgeries, oncology surgeon will require to remove fallopian tubes and ovaries, removal of uterus, Omentum removal, removal of the lymph nodes and removal of any other organ involved in the disease. Staging is thus followed by debulking which means removal. Such removal is aimed to leave no stint of tumor.

  • TAH + BSO+ infracolicomentectomy
  • Cytoreductive Surgery (CRS)
  • Interval Cytoreductive surgery
  • HIPEC (Hyperthermicinterperitoneal chemotherapy)

Carcinoma vagina:

Malignant cells grow in the vagina in such cancer. Such a disease may take its inception due to aging. Another hue for this disease may be the exposure to drug diethylstilbestrol before birth. The other symptoms include pain or abnormal vaginal bleeding.

Diagnosis:

The diagnosis part of the disease will conform to two basic types including Physical Exam and consultation followed by Pelvis Examination. The physical tests suggested by the best gynae oncologist will aim to check general signs of health. This includes checking for signs of disease, such as lumps or anything that seem unusual. Past health habits and history of past illness are treated as best additional input.

Clinical test includes test of vagina, cervix, uterus, fallopian tubes, ovaries and rectum. Vagina is tested by inserting a speculum into the vagina. Signs of disease are apparent thus. Pap test of the cervix also help to indicate the severity and stage of the disease.

Surgical Treatment

Surgery is most frequently used in the treatment of vaginal cancer. The cancer doctor will opt for any one of the following, depending on stage of presentation.

  • Surgery is wide local excision along with primary closure or advancement of flap along with lymph node dissection both inguinal and/or with pelvic node dissection. It is advised to go to centers with best Gynecologist and frozen section for more superior and accurate intra operative decision making and management.
  • Advanced stages require Radiation and chemotherapy.

DISCLAIMER
Oncology is an ever evolving field of medicine and is matter of research and development. The author per say does not claim the following to be guidelines of practice in oncology. These are part of patient awareness initiative by Dr. Suvadip Chakrabarti MCh (Surgical Oncology) to educate people at large of various options in Oncology. It should not be taken to be practice guidelines.