Gynaecological Malignancies: A Battle to Win

Gynaecological malignancy remains a major health concern for women in India. According to GLOBOCAN 2022, it is the second most common cancer among women, accounting for 23% of all female cancers, following breast cancer.

The most prevalent gynaecological cancers include cervical, ovarian, and endometrial cancers. While postmenopausal women are at higher risk, these cancers affects women of all ages. Early detection and timely intervention significantly improve outcomes, making awareness crucial.

Cervical and endometrial cancers often present with vaginal bleeding, unusual discharge, bleeding during intercourse, and persistent back pain. Ovarian cancer may manifest as an abdominal lump, persistent pain, or irregular menstrual cycles. Many women overlook these signs, mistaking them for minor health issues. However, recognising symptoms early and seeking medical advice can improve prognosis.

Diagnosis involves clinical examination, imaging (MRI/CT scans), and biopsy confirmation. Blood-based tumour markers, particularly for ovarian cancer, aid diagnosis. Once confirmed, treatment is personalised based on cancer type and stage.

Cervical cancer in early stages is effectively treated with surgery or radiation therapy, ensuring good prognosis. Locally advanced cases require a combination of radiation, chemotherapy, and brachytherapy, achieving high cure rates. Metastatic cervical cancer patients benefit from chemotherapy or immunotherapy, which offers promising results with fewer side effects.

Ovarian cancer in early stages is treated with surgery, while advanced cases require surgery combined with chemotherapy. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has shown encouraging results in improving outcomes.

Endometrial cancer, if diagnosed early, is often cured with surgery. Intermediate-stage cases require post-surgery radiation, while advanced stages necessitate chemotherapy. In elderly or high-risk patients, if surgery is not feasible, brachytherapy alone offers effective treatment.

Preventing cervical cancer involves maintaining personal hygiene, regular screenings from age 30 via PAP smears or DNA testing, and HPV vaccination (Quadrivalent or Nona-valent). The vaccine is administered in two or three doses over six months and is highly effective in reducing cervical cancer risk.

Oncology advancements have improved treatment efficacy while minimising side effects. Minimally invasive surgery reduces hospital stays and complications. Modern LINAC-based radiation therapy enables precise tumour targeting, reducing side effects and improving control. Molecular markers now allow personalised treatment, enhancing effectiveness while lowering toxicity.

Women should never hesitate to seek medical help. Early diagnosis, expert oncological care, and access to modern treatments make winning the battle against gynaecological malignancy possible. Raising awareness and embracing medical advancements empower women to lead healthier lives post-treatment.

Authored by: Dr Deepak Kumar, MD, Consultant Radiation Oncology, Ranchi Cancer Hospital and Research Centre, Ranchi, Jharkhand