Gynecological Cancer


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Gynecological Cancer

Gynecological cancers include cancers of Ovary, Cervix and Uterus. Carcinoma cervix is a global health problem and it is the commonest gynecological malignancy in developing countries like India. Carcinoma cervix occurs due to infection with Human Papilloma Virus (HPV). Infection with HPV is common in sexually active men and women, vaccination against this virus has shown to reduce the incidence of carcinoma cervix. Ovarian cancer ranks second after carcinoma cervix. Family history of breast or ovarian malignancy is the risk factor for ovarian cancer. Uterine or Endometrial cancer occurs due to unopposed action of estrogen hormone. Conditions leading to excess estrogen in body predisposes to uterine tumors. Obesity, nulliparity, estrogen containing OCPills are some of the risk factors. Tamoxifen used for prevention of breast cancer has been associated with uterine carcinomas.

  • Symptoms
  • Treatment

Symptoms of Gynecological malignancies:

Carcinoma cervix presents as foul smelling vaginal discharge or as post coital bleeding. Some advanced cases of carcinoma cervix may present swelling over lower limbs and kidney failure. Carcinoma ovary presents as distention of abdomen with increased frequency of urination and early satiety. Carcinoma endometrium usually presents as post menopausal bleeding as it is common in obese and post menopausal women.

Diagnosis of Gynecological Malignancies:

Cervical and uterine tumors commonly present as per vaginal bleeding, in uterine cancer it could be spontaneous post menopausal and in cervical tumors it could be post coital. Biopsy from the suspicious lesion in cervix lesion seen during colposcopy helps to confirm the diagnosis. Uterine tumor evaluation requires hysteroscopic biopsy of the endometrial tissue. Ovarian malignancy usually presents in advanced stage with abdominal distention and difficulty in passing urine and stool. CT scan of abdomen and pelvis helps in diagnosis by revealing a complex cystic mass arising from the ovary. CA 125 is a tumor marker secreted by ovarian epithelial cells and is raised significantly in ovarian carcinomas.

Treatment:

Radical hysterectomy along with pelvic lymph node dissection is the treatment of cervical and uterine malignancy. Radical hysterectomy can be done either by open or by minimally invasive techniques (Robotics or laparoscopic). Depending upon the stage of the tumor, adjuvant radiation or chemotherapy may be required. Ovarian malignancy presents in advanced stage and usual protocol is chemotherapy ⇒ downstaging of tumor ⇒ cytoreductive surgery ⇒ chemotherapy. Survival in case of ovarian malignancy is poor as most of the cases recur within one or two years.

GENERAL INFORMATION





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