Gynaecologic Oncology

Introduction

Gynecologic oncology is the field of medicine that aims at the early screening, diagnosis, and effective treatment of cancers of the female reproductive organs. Gynecologic oncologists are healthcare professionals trained to treat such ailments. 

Risk Factors

The causes of several types of gynecologic cancer are unknown but might comprise: 

• Environmental factors, such as smoking or excessive weight gain 
• Family history of gynecologic cancer 
• Excessive hormone exposure and estrogen replacement therapy 
• Genetic modifications acquired over time 
• Sexually transmitted infections, which may play a role in raising the chances of developing cancer
• Human papillomavirus infection (HPV), which is responsible for nearly all cervical cancers and certain vulvar and vaginal cancers 

How can You Reduce the Risk of Gynecologic Cancers?

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

What are the Symptoms of Gynecologic Cancers?

Symptoms might differ depending on the type of gynecologic 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 gynecologic 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 color or skin, such as a rash, sores, or warts, are present only in vulvar cancer.

Diagnosis of Gynecologic 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:

1. Computed Tomography (CT): These scans utilize special X-ray equipment to produce cross-sectional pictures inside the pelvic area. CT scans can display the tumor size and whether the cancer has metastasized.
2. 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 tumors more closely and look for signs that the cancer has spread.
3. 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.
4. Serum Tumor Markers: They help screen, diagnose, and monitor certain gynecological 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 tumors.
5. Pap Smear Test: It is a crucial test for checking unusual cells on the cervix that can lead to cervical cancer.

Types of Gynecologic Cancers

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 tumor. 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.

Treatment of Gynecologic Cancers 

Gynecologic cancers are treated in a multitude of ways. It depends on the type of cancer and how far it has advanced. Women with gynecologic 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 gynecological 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 gynecologic cancers. Early and accurate screening and treatment of gynecological cancers helps patients live longer and with better quality of life.