Gynecologic Oncology

Each specific type of gynaecologic cancer has a unique set of risk factors. The most common include:

• Human Papillomavirus (HPV) infections that do not go away increase the risk of getting several types of gynaecological cancers
• Family history of malignancy in the family
• Increasing age
• Smoking
• Alcohol
• Obesity
• Sedentary lifestyle

The symptoms of gynaecologic cancer are:

• Abnormal vaginal bleeding or discharge
• Feeling full too quickly or difficulty eating
• Pelvic pain or pressure
• Frequent or urgent need to urinate and/or constipation
• Bloating
• Abdominal or back pain
• Itching, burning, pain or tenderness of the vulva
• Changes in vulva colour or skin - such as a rash, sores or warts

Max Institute of Cancer Care (MICC) is one of the leading facilities in India, which offers the latest treatments under surgical oncology, radiation oncology, and medical oncology. It is one of the largest Cancer Centres in North India, with presence in Saket, Patparganj, Shalimar Bagh, Vaishali, Mohali and Bathinda. It offers high-end treatments like IMRT, and IGRT with facilities like Cone-Beam Computerized Tomography Scan (CBCT Scan) and ExacTrac.

The Gynecologic Oncology DMG has a multidisciplinary group of gynecologic oncologists and surgeons, pathologists, medical oncologists, radiation oncologists, radiologists, genetic counsellors, fellows, residents, research nurses, scientists and clinical research associates who plan research studies and manage patient care. The DMG meets weekly to discuss challenging management cases and pathology results, presenting each case in thorough detail, including reviewing surgical procedures, radiologic imaging, and pathology. When it comes to gynaecologic cancer imaging services by the radiology department, the aim is to establish the techniques so that they work as prognostic and predictive biomarkers. The latest technology is followed for the imaging of patients. This enables a more informative and detailed reporting. There are senior radiologists with expertise in women’s oncological imaging who provide high-quality reports which have shown consistent improvement in patient results.

The treatment for all kinds of gynaecologic cancer like ovarian cancer, endometrial cancers, cervical cancer, vulvar and vaginal cancers, sarcomas and others is provided. There is a strong back-up of on-site ICU as well as other speciality services like cardiology, nephrology, neurology, endocrinology, gastroenterology and others. The treatments may include chemotherapy, surgery, targeted therapy, or radiation therapy, or a combination of various treatment modalities, and consideration for clinical trials.

Tumor Board

At Max Institute of Cancer Care (MICC), the Gynaecologic Oncology DMG (Disease Management Group) provides customised treatment to every patient after discussion in great depth. It has been appreciated all over and has won awards at a national level. We also regularly discuss our patients at the National Cancer Grid Virtual Tumor Boards. Genetic and molecular information is routinely incorporated in order to provide personalized and precise treatment.

Our treatment for gynaecologic cancer begins by staging the disease. Cancer staging describes the size and extent of the disease in the body and whether it has spread from its original site to other parts of the body. To find out the stage of gynaecologic cancer, the doctor may perform several tests. The test results will help the doctor develop the best possible treatment plan and can be used to ascertain the likely outcome or course of the disease.

There are things you can do that may help lower your chance of getting them or help to find them early. It is important to detect cancers early when treatment can be most effective.

A) Pay attention to your body and know what is normal for you. If you have any abnormal vaginal bleeding, or if you have any other signs and symptoms raising suspicion of gynaecologic cancer for two weeks or longer, talk to your doctor right away.

B) Make healthy lifestyle choices. For overall good health, eat a diet rich in fruits and vegetables; exercise regularly; maintain a healthy weight; avoid smoking, and practice safe sex.

C) Get the Human papillomavirus (HPV) vaccine if you are at an age when it is recommended. It protects against the types of HPV that most often cause cervical, vaginal, and vulvar cancers. The vaccine is recommended for girls and women aged between 9-25 years. A gynaecologist should be consulted for recommendations of Pap testing. The Pap test does not screen for ovarian, uterine, vaginal, or vulvar cancers.

Max Institute of Cancer Care (MICC) offers different types and combinations of gynecological cancer treatment. These depend on the type and stage at which it is diagnosed. Possible treatments include:

A) Surgery: The extent or possibility of surgery depends on the type of cancer and the patient's overall health.

Following are the surgical treatment options provided at MICC:

• Ovarian cancer – Cytoreductive Surgery and Hyperthermic intraperitoneal chemotherapy (HIPEC)
• Endometrial cancer – Minimally Invasive Surgery - Laparoscopy and Robotic Surgery with sentinel lymph node biopsy (validated and sentinel performing centre)
• Case-Series of Minimally Invasive Surgery on morbidly obese patients
• Cervical cancer – Minimally Invasive Open Radical Hysterectomy
• Vulvar cancer – Radical Vulvectomy with reconstruction with flap surgery, inguinal dissection, radical local excision
• Colposcopy, Loop Electrosurgical Excision Procedure (LEEP), Conization and laser surgery for various pre-invasive lesions of the genital tract