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New Delhi (India), September 29: As we enter Cancer Awareness Month, it is imperative to shed light on two crucial fronts in the battle against this formidable adversary: gynecologic and blood cancers. These top experts share their guidance to unravel the intricacies of these malignancies, exploring the latest insights, prevention strategies, and treatments. From the unique challenges posed by gynecologic cancers to the complexities of blood cancers, we delve into these critical aspects to empower readers with knowledge and understanding during this pivotal month dedicated to cancer awareness.

Dr. Viral Patel, DNB (Gynec), M.Ch.(Gynecologic Oncology), European society of Gynecological oncology certification, Consultant Gynecologic Oncologist and Robotic surgeon, HCG Cancer Centre, Ahmedabad

Gynecologic cancer surgery has witnessed significant advancements over the years, with a focus on improving patient outcomes, minimizing complications, and enhancing post-surgical recovery. Robotic and laparoscopic surgery has revolutionized the field of gynecologic oncology, allowing for sentinel node mapping and early discharge. The sentinel node mapping technique removes only the affected lymph nodes. Sentinel node biopsy has been proven effective in reducing the incidence of lymphedema, a common complication following gynecologic cancer surgery. Lymphedema, characterized by the accumulation of lymphatic fluid in the tissues, is a potential complication following gynecologic cancer surgery. With appropriate patient selection and comprehensive postoperative care plans, many patients can be safely discharged earlier than traditional protocols dictate. Early discharge improves patient satisfaction, reduces the risk of hospital-acquired infections, and facilitates a faster return to normal daily activities. In gynecologic cancer, minimally invasive surgery advances have made it possible for many patients to be discharged on the next day of surgery.

Dr. Anita Malik, MBBS, MD (Past experience: AIIMS New Delhi and Medanta the Medecity Gurugram) Senior Consultant Clinical Oncologist, Venkateshwara Hospital, New Delhi

Gynecological cancer start in the female reproductive organs, including the cervix, ovaries, uterus, fallopian tubes, and vulva. Early detection and timely intervention are crucial for the successful treatment of these cancers. Symptoms depend on the site, type, and stage of cancer. Common symptoms are abnormal. Vaginal bleeding, pelvic pain and pressure, changes in urine and bowel habits, pain during intercourse, vaginal discharge, itching, and burning Accurate diagnosis with imaging (CT/MRI/PET CT), biopsy, and other tests is crucial to determining the type and stage of cancer. Treatment includes surgery, radiation, chemotherapy, targeted immunotherapy, or a combination of these. Regular follow-up and appointments with oncologists are essential to monitoring progress, detecting early recurrence, and managing the side effects of treatments.

Dr. Bharat Ashok Vaswani, MD (General Medicine), DM (Medical Oncololgy), MRCP-UK (Medical Oncology) ECMO, PDCR, Senior Medical Oncologist & Hematologist- Yashoda Hospital, Secunderabad

As per Globocon data, cancers in females are more common than in males in India. Common cancers in females, like breast and cervix, can be diagnosed in asymptomatic individuals by screening for these cancers. This includes doing a mammogram every year after age 40 and a PAP smear every 3 years or combining with HPV testing every 5 years from age 30.

HPV vaccination, preferably nanovalent (2 doses), should be given to all girls starting at age 11 or 3 doses starting at age 15 to prevent cervical cancer. Recent years have seen an emphasis on testing for hereditary causes for all newly diagnosed ovarian and uterine cancers, including BRCA mutation and MSI testing (for ruling out Lynch syndrome). This helps in screening other family members if the test is positive. Management of gynecological cancers has seen recent advances with the use of oral medications, including PARP inhibitors and immunotherapy. However, early diagnosis and prompt treatment is key to long-term survival.

Dr. Gunjesh Kumar Singh, MBBS, MD, DM Medical Oncology (Tata Memorial Hospital –Mumbai), ESMO Certified Medical Oncologist, Consultant & HOD- Bhagwaan Mahavir Medica Super Speciality Hospital, Ranchi

Blood cancer, a group of malignancies affecting the blood, bone marrow, and lymphatic system, comprises leukemia, lymphoma, and myeloma. It disrupts normal blood cell production, posing serious health risks. Symptoms vary but may include fatigue, unexplained weight loss, and frequent infections. Early detection and treatment are vital for improved outcomes. Raise awareness through education, regular screenings, and supporting organizations dedicated to research and patient care. Donations and advocacy bolster research into innovative treatments and therapies, offering hope to those affected. Together, we can enhance understanding and resources to combat blood cancer and enhance patients’ quality of life.

Dr. P Vijay Karan Reddy, MD RT, FUICC(US), FAROI(US), FUICC(UK), ESMO(Med Onc), AMPH consultant Oncologist, Apollo Cancer Institute, Hyderabad

The prevalent challenges posed by gynecological cancers, with a focus on cervical and uterine cancers, which rank as the third most common cancers in India. It emphasizes the significance of awareness, early detection, and comprehensive care in combating these malignancies. Cervical cancer, typically caused by HPV, can affect women of various ages, with symptoms including abnormal bleeding and discomfort. Prevention through HPV vaccination, such as Gardasil 9 or CERVAVAC in India, is highlighted.

Uterine cancer, including endometrial cancer and uterine sarcomas, typically affects women who are approaching menopause, between the ages of 40 and early 50, known as the perimenopausal period. Symptoms involve vaginal bleeding, abdominal pain, and discomfort. While medical advancements are on the rise, there is yet no proven screening test for uterine cancer. Heightened awareness among women and taking professional assistance upfront are vital to prompt investigation and diagnosis. A high rate of successful outcomes has been noticed when the problem is detected early.

Dr. Neha Shivran, MD Radiodiagnosis, Consultant – Manipal Hospital, Jaipur Trustee, Smt. Bhuri DevI Memorial Charitable Trust, Jaipur

Dr Neha Shivran said “the cancer screening movement for women with available resources at small towns and villages is the best and noble way to make empowered women on the country”

The escalating cancer rates among females in low- and middle-income nations result in disproportionately higher mortality compared to developed countries. Limited organized screening, lack of awareness, and inadequate treatment options contribute to this alarming trend. The combined program of integrating a well woman examination with screening for breast & cervical cancer and diagnostic evaluation for Ovarian and Endometrial cancer in symptomatic women can serve as a model to be studied for efficacy.

Breast cancer, constituting 23% of cases and 14% of female cancer deaths, is projected to see 70% of new cases in low- and middle-income countries by 2020. Cervical cancer is responsible for 80% of half a million cases in low-resource areas, with 85% of deaths occurring without screening programs.

The core strategy involves screening asymptomatic women aged 30–59 for breast and cervical cancer and diagnosing symptomatic women for ovarian and endometrial cancer. This methodology would include an annual clinical breast examination [CBE] followed by diagnostic breast sonographic evaluation in screen positive women.

Dr. Rohit Ranade, MS, MCH (Gynecological Oncology), Narayana Health City, Bengaluru

International Gynecological Cancer Awareness Month is a worldwide celebration of gynecologic cancers in the month of September every year. Why Gynecologic Cancer Awareness Month Is Important: It spreads awareness among those who are looking out. It’s informative, provides solutions, and also gives information that aids many women in tracing gynecologic cancers at an early stage in life. It saves lives; due to the awareness, lives are saved as many women end up getting checked. They also keep a lookout for signs of cancer. 

How to Observe Gynecologic Cancer Awareness Month: Get checked: The best way to celebrate the day is to get yourself checked and find out if there is anything that needs immediate attention. Talk about it: Many people are still unaware that these cancers even exist. Wear the ribbon to show solidarity with the patients.

Dr. Rajeshwar Singh, MBBS, MD (Medicine), DM (Med Oncology), General Physician, Hematologic Oncologist, Haryana

Ovarian cancer is the third most common female cancer in India, with an annual incidence of 30,000 new cases. This risk predominantly affects women aged 50 to 65. Approximately 15 percent of cases stem from familial factors, often linked to inherited faulty genes like BRCA1 or BRCA2, significantly elevating the risk of breast and/or ovarian cancer. Other contributing factors include obesity, smoking, and conditions such as PCOD.

Recognizable symptoms may include abdominal enlargement, bloating, stomach pain, early satiety, and changes in urinary habits or bowel movements. Diagnosis typically involves ultrasound or CT scans and CA 125 blood tests. Treatment entails surgical removal of the ovaries, tubes, and uterus, followed by chemotherapy using paclitaxel and carboplatin. It’s essential for individuals facing this diagnosis to remain positive and maintain self-belief, as a normal life can still be achieved with the right care and mindset.

Dr. Sanket Shah, MS, MCh, Director Surgical Oncology, Ved hospital, Mumbai

Gynecological cancers are most common cancers in females and very important for an oncologist as it affects young population. They encompass ovarian, cervical, uterine, vaginal, and vulvar cancers. We place strong emphasis on women gaining a comprehensive understanding of these cancers as early detection holds the key for improved treatment outcomes. It is crucial for women to not only recognize these cancers but also be aware of the various risk factors, which may include a family history of ovarian and breast cancer, HPV infection, obesity, and lifestyle choices. Encouraging women to adopt healthier habits, such as receiving the HPV vaccine, maintaining a healthy weight, and practicing safe sexual behaviors, can substantially mitigate their risk.

Common symptoms are postmenopausal bleeding, vaginal spotting, abdominal distension, vaginal or vulval lesion. Destigmatizing conversations around gynecological health so that women feel comfortable discussing these topics openly and seek medical attention promptly if they experience any concerning symptoms. By improving knowledge about common symptoms, we can empower women to take proactive steps in managing their health, facilitating early detection, and ultimately saving lives in the process.

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