#Gynecological cancers

[nowhereall]

Dispelling myths and empowering knowledge! Join Dr. Viral Patel as he debunks common misconceptions surrounding gynecological cancers in our latest video. Let's separate fact from fiction and empower women with the truth. Stay informed, stay empowered. Watch now to learn the facts and protect your health.

[drdodulmondal]

Understanding Gynecological Cancer: Detecting, Treating, and Healing

When it comes to women’s health, gynecological cancers stand as a significant concern. Gynecological cancer refers to cancers that specifically affect the female reproductive system. These cancers can occur in various parts of the female reproductive organs, including the cervix, ovaries, uterus, vagina, and vulva. It's crucial for every woman to be aware of the symptoms and treatment options available.

[ijcimr]

 Hereditary breast ovarian cancer syndrome: One case, multiple lessons by Ikram Burney in International Journal of Clinical Images and Medical Reviews 

Abstract

Ovarian cancer is one the most common gynecological cancers, and epithelial ovarian cancer is the commonest sub-type. Between 10 and 15% of all epithelial ovarian cancers occur secondary to a mutation in BRCA1 or BRCA2 gene, and may be associated with breast cancer, known as hereditary breast ovarian cancer syndrome (HBOCS). We report a case of HBOCS, highlight the importance of family history and treatment history and discuss the recent developments in surgery and systemic treatment for patients in relation to the presentation of this case.

Introduction

Ovarian cancer is one the most common gynecological cancers (Bray 2018). Epithelial ovarian cancer is the commonest sub-type (Kurman 2014). Between 10 and 15% of all ovarian cancers occur secondary to a mutation in a cancer susceptibility gene (Zhang 2011). Mutations in BRCA1 and BRCA2 gene are the commonest cause of hereditary ovarian cancer (Mikki 1994; Claus 1996). These mutations also predispose the individuals to other cancers. Patients with epithelial ovarian cancer may also develop breast cancer (Easton 1993; Easton 1997). We report one such case here, and discuss the recent advances in the medical and surgical management of hereditary breast ovarian cancer syndrome (HBOCS).

Case

A 57 year-old lady presented with abnormal vaginal bleeding and abdominal distention. She was diagnosed to have high grade ovarian cancer, underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy, and was found to have stage IIIC serous papillary type of high grade ovarian cancer. The patient was treated with 6 cycles of Carboplatin and Paclitaxel to complete serological and radiological remission, however, she tolerated the chemotherapy with frequent episodes of febrile neutropenia. Three years later, the disease relapsed and the patient was treated with 6 cycles of Liposomal Doxorubicin to state of complete serological remission. One year later, the disease relapsed yet again, and this time, she received Carboplatin as a single agent. The disease entered serological remission after 3 cycles, however, the patient could not continue treatment because of repeated febrile neutropenia and thrombocytopenia

One year later, the disease relapsed a 3rd time. CT scan showed disease only at one site (figure 1a) and the patient was treated with Carboplatin at a reduced dose, once again to a state of complete serological and radiological remission (figure 1b). A surveillance mammogram was reported as BIRADS II and the bone mineral density revealed osteopenia. One year later, the disease relapsed a 4th time, again in a solitary site, and the patient was counseled about treatment with chemotherapy followed by a secondary cyto-reductive surgery, to which the patient agreed. The patient received 6 cycles of chemotherapy at reduced doses, followed by surgery. There was no residual disease and the patient remained in complete remission for more than one year and 3 months.

At this stage the CA-125 was seen to rise again serially, and mammogram showed a 2.2 cm speculated lesion in the left breast. A fine needle aspiration was highly suggestive of breast cancer, and a core biopsy revealed an infiltrating ductal carcinoma, grade II, estrogen and progesterone receptor positive, but negative for HER-2/neu protein  (ER positive; PR positive; HER-2/neu negative). The proliferation fraction measured by Ki-67 was 40%. The morphologic and immunohistochemical patterns were consistent with a diagnosis of a primary in the breast (Table 1). Staging CT scan revealed a metastatic lesion in liver and bilateral pulmonary metastases. An attempt at guided biopsy from the pulmonary lesion was unsuccessful and led to pneumothorax. The patient refused further attempt at biopsy and agreed to be treated with Letrozole, considering that the pattern of metastases was more likely secondary to breast cancer rather than the ovarian cancer. Ten months later, the CT scan showed a marked regression in the size of pulmonary lesions, but a stable liver lesion (Figure 2).

Table 1: Immunohistochemical staining patterns of breast and ovarian cancer. WT-1 (wilm’s Tumor 1); PAX 8 (Paired box gene 8); CA 125 (Cancer antigen 125); ER/PgR (Estrogen receptor / Progesterone receptor); CK 7 (Cytokeratin 7); GCDFP-15 (Gross cystic disease fluid protein-15); TP 53 (Tumor protein 53)

Figure 1: CT scan at the time of the 3rd relapse (Figure 1A) shows a 35 mm x 28 mm mass in the region of omentum, which disappeared completely after 6 cycles of carboplatin AUC 4 (Figure 1B).

Considering that the patient had HBOCS, the patient was referred to the cancer geneticist. A detailed history revealed that her mother had dies of a malignancy of unknown primary site, her sister died at the age of 40 years, of a malignancy with ascites, but the primary site was not known to the patient or the family. The patient underwent counseling followed by assessment with a germline mutational analysis for breast and ovarian cancer panel, which revealed a pathogenic mutation in BRCA2 gene (c.4243G>T), and a variant of unknown significance in the NBN gene (c.425A>G). The BRCA2 mutation was consistent with a diagnosis of HBOCS. One year later, the CA 125 was seen to rise again serially, while the metastatic lesions in the lung and liver were under good remission. The patient was commenced on treatment with Olaparib, and the CA 125 dropped from 324 to 26 in one year (figure 3). The patient continued to receive Letrozole. Twelve years after the diagnosis of ovarian cancer, and while still on treatment for breast and ovarian cancer, the patient passed away of an unrelated cause. During the course of the treatment, patient’s three daughters agreed for mutational analysis; two tested positive for mutation on the BRCA2 gene, and one of those two was screen-detected to have a breast cancer.

Figure 3: Serum CA 125 levels (IU/L) plotted over time. The patient was commenced on treatment with olaparib in Nov 2015. The levels dropped to within the normal limits (<36IU/L) in March 2016 (within 4 months of the treatment).

Discussion

We report the case of a woman diagnosed to have HBOCS, who lived 12 years after the diagnosis of high grade ovarian cancer, received multiple lines of intra-venous chemotherapy, albeit with difficulty, underwent a secondary cyto-reductive surgery, and in the last 4 years of her illness was treated for the two cancers with an oral aromatase inhibitor and a PARP inhibitor. Both breast and ovarian cancers responded to the treatment with the two oral agents. We would like to highlight several aspects of management for the general readership of this journal.

The median survival of patients diagnosed to have high grade ovarian cancer, stage IIIC is dismal at around 3-4 years (Peres 2019). This patient lived for 12 years. Complete response to chemotherapy on five occasions, and a poor tolerance to chemotherapy, even at an age of 57-65 years indicate the tumor is exquisitely sensitive, especially to platinum containing chemotherapy. Platinum derivatives (Cisplatin, Carboplatin and Oxaliplatin) are alkylating agents, which act by disrupting the DNA repair pathways. Usually, PARP (Poly (ADP-ribose) polymerase) enzyme is required for base excision repair (BER). If the enzyme were inhibited, DNA repair would be affected. Also, if one allele is inactivated on the BRCA 1 or 2 gene, such as, because of mutations or methylation, DNA repair will be grossly affected, leading to a process called ‘synthetic lethality’ (Konstantinopoulos 2010; Helleday 2011). In the last few years, three such compounds (Olaparib, Niraparib and Rucaparib) have been developed, tested, and have become the standard of care for patients with either germline BRCA mutations, or even in patients who may have homologous reconstitution deficiency (Ledermann 2014, Mirza 2016; Pujade-Lauraine 2017; Coleman 2017). The first-in-class compound was Olaparib, approved by the FDA in 2014 for use as a single agent in patients who had germline BRCA mutations and had failed three lines of chemotherapy (Ledermann 2012). Our patient was treated and responded to the treatment.

BRCA 1 mutation is more common than mutation in BRCA 2 gene, and it is important to distinguish between the two. Although, response to platinum chemotherapy or PARP inhibitors is the same (Konstantinopoulos 2010), there are phenotypic differences, especially for breast cancer, and the susceptibility to develop other cancers, required for counseling the family members. Patients with BRCA 1 mutation are associated with triple-negative breast cancer (ER negative; PR negative; HER-2/neu negative) in more than 75% of the cases, whereas, patients with BRCA 2 mutations are associated with hormone-receptor positive breast cancer in more than two thirds of the cases (Hartmann 2016). Our patient had BRCA 2 mutation and hormone-receptor positive breast cancer, which was treated with aromatase inhibitor for more than 4 years. Although the life-time risk of developing breast cancer is same (65-70%) in the patients and the first-degree relatives, the life-time risk of ovarian cancer is 40-45% in case of BRCA 1 mutation carrier and 10-15% in case of BRCA 2 mutation career (Antoniou 2003; Hartmann 2016). Our patient had three daughters and they were counseled. Two tested positive for the same mutation. Because of their relatively young age, and the minimal increased risk of ovarian cancer in BRCA 2 mutation carriers, till the age of 45 years, they were advised to consider delaying BSO.

The role of secondary cyto-reductive surgery in ovarian cancer has been contemplated and debated over the last several years. Three major phase III trials have been reported in the past 2 years (Please see table 2). The GOG-0213 trial was the first trial to have been reported (Coleman 2019). The primary end point was overall survival (OS); 485 patients were randomized to receive standard of care chemotherapy with or without secondary cyto-reductive surgery. The patients were selected if the treatment free interval from the last dose of platinum containing chemotherapy was more than 6 months. Although, there was a non-significant prolongation in the progression-free survival (PFS) (18.9 vs 16.2 month; HR 0.82), there was no difference in OS. Actually, the OS was inferior in the group which received secondary cyto-reductive surgery (50.6 vs 64.7 months; HR 1.29). However, a sub-set of patients who achieved R0 resection had a better PFS and OS, compared to those who could not have a R0 resection. The DESKTOP III trial randomized 407 patients to receive standard of care chemotherapy with or without secondary cyto-reductive surgery (du Bois 2017). There was a clinically and statistically significant prolongation in the PFS (19.6 vs 14 months; HR 0.66). Also, the primary end-point was met (du Bois et al 2020). The was a significant 7.6 months prolongation in OS (53.6 vs 46 months; 0.75 (0.58-0.96; P = 0.02). In addition to the criteria of treatment free interval of more than 6 months, the investigators also used the AGO criteria. The AGO criteria was developed after the DESKTOP I trial, and women with no gross residual disease after primary surgery, ECOG performance status of <1, and no ascites on CT scan at recurrence were classified as AGO score positive (Harter 2006). Subsequently, the DESKTOP II trial suggested that patients with a good performance status, absence of ascites at the time for secondary cyto-reductive surgery, more than 12 months of platinum-free interval, isolated site of recurrence, and the possibility of complete resection of disease were likely to benefit from the secondary cyto-reductive surgery (Harter 2011). The 3rd trial (SOC-1 trial) randomly assigned 356 patients with recurrent ovarian cancer in first relapse to either chemotherapy, or cyto-reductive surgery and chemotherapy (Zhang R 2020). There was a clinically meaningful (5.5 months), and statistically significant prolongation in the PFS (17.4 vs 11.9 months; HR 0.58) for the combination of cyto-reductive surgery and chemotherapy arm. The eligibility criterion was different from the first two studies. The SOC1 investigators selected patients if the platinum-free interval was at least 6 months, and an integrative model score was <4.7. However, at the time of management of our patient, results of the randomized trials were not available. We based our decision on the available data from DESKTOP I and II trials. The patient fit both the AGO score positive and the subsequent criterion developed after DESKTOP II trial. Our patient lived more than 5 years after the cyto-reductive surgery without a subsequent recurrence in the abdominal cavity.

Taken together, the three randomized trials comparing chemotherapy with or without cyto-reductive surgery suggest that there may be a benefit for surgery in carefully selected patients who can undergo potentially complete (RO) resection in women who have recurrent platinum-sensitive ovarian cancer. Although, results of randomized trials should not be compared, however, it would be useful to note that the magnitude of benefit seen in the DESKTOP III trial (HR 0.75), is similar to the recently reported SOLO2 study. The later study compared the OS in patients with platinum-sensitive ovarian cancer, but who also had a BRCA mutation, and who were treated with the PARP inhibitor, olaparib and had a median OS of 51.7 months compared to 38.8 months in the placebo arm with a HR of 0.74 (Poveda 2020). Although, olparaib is the standard of care for maintenance treatment in patients with BRCA mutated platinum-sensitive ovarian cancer, the cost of drug and the overall cost of management remains very high. Cyto-reductive surgery in carefully selected patients, with a potential to achieve R0 resection may be an alternative, especially for patients with BRCA negative platinum sensitive ovarian cancer in first relapse.

In conclusion, we report the case of a patient with HBOCS, and highlight the recent developments in the systemic and surgical management of patients with ovarian cancer.

Table 2

SCS: Secondary cyto-reductive surgery; CT: Chemotherapy; OS: Overall survival; HR: Hazard ratio; PFS: Progression-free survival

Conflict of Address

Ikram Burney:

Principal Investigator for the hospital site for Astra-Zeneca sponsored PREDICT study Served on the advisory board for Astra Zeneca Other authors declare no conflict of interest

Author’s contribution:

Dr Juhaina Al Hinai – Data curation; Writing – original draft.

Dr Moza Al Kalbani – Surgical Oncology management, Methodology; Writing – review & editing.

Dr Marwa Al Riyami – Pathology reporting, methodology; Writing – review & editing.

Dr Abeer Al Sayegh – Clinical Genetics management, methodology; Writing – review & editing.

Dr Ikram A Bunrey - Conceptualization; Formal analysis; Supervision; Writing – original draft; Writing – review & editing.

Informed Consent:

All data are anonymised, and patient identification is not possible.

For more details: https://ijcimr.org/editorial-board/

[cancer-surgeon-in-ahmedabad]

Gynecological cancers in Ahmedabad,Gujarat | Dr. Nitin Singhal

Gynecological cancers in Ahmedabad,Gujarat, including cervical, ovarian, uterine and vaginal and vulvar cancers, represent approximately 1 in 5 of all cancers diagnosed in women. However, cervical cancer is more common in premenopausal women, while the incidence of uterine and ovarian cancer increases in the perimenopausal years  and vaginal and vulvar cancer are uncommon and occur mostly in older women. , the diagnosis is made. They affect. Despite the high morbidity and mortality of gynecological cancers, cervical and uterine cancers have high survival rates .

Women with gynecological cancer face personal interpretations of cancer, physical effects of the disease, long and transient side effects of treatment, and reactions from family and friends. Indeed, they experience various stressors such as financial difficulties and relationship problems. Although great advances have been made in cancer treatment during the past decade, treatment strategies are still debilitating to patients' lives as they cause cardio-respiratory impairment, pain, fatigue and reduced immune function. In addition, psychological stress, anxiety, depression, fear of recurrence and sleep disturbances are other symptoms of post-cancer treatment that reduce the quality of life in these patients.

As such, some influential organizations suggest that the goal of any cancer treatment should be to improve quality of life as well as improve survival. There are many studies on quality of life in gynecological cancer. Short-term effects are usually related to health, while long-term effects include psychosocial and work-related issues in addition to general well-being. For example, a recent study on long-term quality of life in women with gynecological cancer reported that the main determinants of poor health-related quality of life were co-morbidity, deprivation, lack of availability and satisfaction with social support, and psychological . The results were .

A recent review of 10 studies involving 972 Gynecological Cancer in Ahmedabad,Gujarat patients on psychosocial interventions to improve sexual functioning, quality of life, and psychological outcomes reported that such interventions were effective in reducing depressive symptoms and quality of life in this population. were effective. were effective. were effective. Can improve the mental aspect. Despite these, it appears that more studies are needed to provide sufficient evidence on quality of life in women with gynecological cancer. Fortunately, recent developments on electronic communications allow such information to be collected through web-based platforms.

As such it is argued that the use of electronic devices may ease data acquisition, and accelerate information transfer between patients and physicians and is a new area in cancer research which can even reduce the burden of patients in filling out various questionnaires, especially those that are long and time-consuming.

[drelsamenezesclinic]

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[useless-englandfacts]

Following the news that Kate Middleton has in fact been diagnosed with cancer, I’d like the take the time to offer some information on cancer in afab people and some charities to support.

Cancer is a very personal and scary thing to face, and according to Cancer Research UK, every two minutes in the uk someone is diagnosed with cancer. Over 182000 women in the uk are diagnosed every year.

Almost half of all cancer cases are diagnosed at stages 3 & 4, and screening rates for breast and cervical cancers have fallen in the last few years in England and Scotland.

According to The Eve Appeal, around 60 afab people are diagnosed with gynecological cancers alone every day in the uk, and 21 of them will not be able to receive appropriate treatment in time.

People around the world are woefully uneducated about cancer as a whole, but the stigma and lack of proper knowledge given to the public and young afab people about our own bodies means that we often go under diagnosed, or are too afraid or ashamed to see a doctor until it’s too late.

I’ll be listing some informational pages to help people learn about the signs of breast and gynecological cancers that I believe every young person with an afab reproductive system needs to know. On the pages from The Eve Appeal and Breast Cancer UK there is also information for transgender and intersex people.

All of these sites have information on how to identify possible markers of cancer, information on how to get tested, and on how to donate to their charities. I highly suggest everyone regardless of gender identity have a look through to potentially help yourself or a loved one.

-Roe

[snarltoothed]

huh, cool

[kinkykinard]

It’s over.

It’s finally over.

I’m free.

Had my final appointment at the cancer clinic today.  It was a pelvic exam and colposcopy to make sure that I was all healed up inside after the hysterectomy and that there were no traces of any abnormalities.  I’d been anxious about the appointment for WEEKS.

It wasn’t my surgeon who saw me, it was one of her associates, but she was so kind and understanding and empathetic that I felt good about it going into the procedure. The procedure itself was super un-fun given how one of the symptoms of menopause is vaginal dryness/atrophy.  All the lube in the world didn’t make that speculum go in any easier and it hurt like hell, but once it was in place it was fine.

After a thorough look and feel and a LOT of anxiety on my part, the doctor pronounced me fully healed and fit to return to all activities.  She said that there is no need for them to see me again, that this is it, but that if I have any concerns come up or any questions in the future or issues related to any pelvic health, to give them a call back and they’d take me back on without question.

That said, though, I never need another pelvic exam.  I never need another pap test.  I never need to deal with all of the menstrual bullshit again.  I can bid cancer goodbye and good riddance.

It’s actually, finally over.

[snackerdoodle]

(Inspired by this post, but separate to avoid derailing.)

I’m going to get more personal here than I would really like to, but I know a lot of other people have had awful gynecologist experiences, and I hope sharing both the negative and positive experiences could help.  

I have had three Pap smears. The first two were traumatic, not in a hyperbolic way but in an “I cried about them to my therapist when trying to face the idea of having to get another one and she specifically called it medical trauma” kind of way. 

For me, they were extremely painful, and I was told “no it isn’t,” both by the doctors in the moment and by everything I was able to look up about Pap smears afterwards. Counterintuitively, I was also told that if it was painful, it was because I was doing something wrong. The only people I saw saying Pap smears hurt were other women who had had terrible gynecologist appointments and who were also planning on never going back.

After my first experience, I did what you are supposed to and warned my next doctor that my last experience was painful. Some warning signs that I should have left and found a different doctor include that she acted inconvenienced by that idea, and then was actively annoyed by my admission that I’d never had penis-in-vagina sex, because that would presumably have made it easier to insert the speculum. I went through with the procedure with her anyway, and she somehow couldn’t reach my cervix at first and guilted me for it while actively rooting around in my vagina. I felt like I had to go through with it once it had started, but I kind of wish I had exercised my rights and called it quits. Which is something you can absolutely do. If you’re uncomfortable with the way your doctor is talking to you, or if you think something is going wrong and your doctor is ignoring your needs, you can call off the whole thing and go somewhere else.

Aside from the physical pain and misplaced blame, in both of my bad experiences I was explicitly told that part of the problem was that I wasn’t having “real sex” (referring, of course, to penis-in-vagina sex). If anyone ever asks, I will confidently tell them that the most homophobic experiences I’ve had have been in the gynecologist’s office. 

After years of being nagged by my primary care doctor and multiple therapy appointments, I researched my options and was able to find a specifically LGBTQ+ aligned clinic. In my research, I also found that, while gynecologists seem to understand and discuss the need for trauma-informed practice, it is hard to find gynecologists who describe themselves as trauma informed.

At my third Pap smear, I explained my past experiences to the doctor. After listening, the doctor gave me a list of options that could suit a variety of comfort levels. These included a traditional Pap smear, the doctor trying to swab my cervix without using a speculum, and me self administering the test in private, also without a speculum. I chose the last one, and she gave me a swab and detailed instructions on what to do. The only risk to this approach was the possibility that I might not get a usable sample. In that case, I would have to come back to the office to try again. I was able to get a usable sample on the first try, and it was so quick and easy that I’m honestly baffled that this isn’t how Pap smears are usually administered.

Some green flags at this appointment included that I was given space to explain my past experiences, I was not criticized or judged for those experiences, and the conversation about what I needed happened before any move toward the exam table. In fact, that doctor never even touched me. I was also given clear explanations of my options, and the doctor explicitly included the option of leaving the office without getting a Pap smear at all.

Pap smears do not have to be painful or traumatic, and I’m angry that I had to have the first two experiences before the third. I understand that there is probably a reason the traditional method is preferred, but I strongly believe that by actually presenting patients with options and treating us with respect, getting a Pap smear can become a significantly less awful experience. And if patients don’t feel dehumanized and abused for experiencing pain during an objectively unpleasant procedure, they might actually get the tests done. 

I have been one of the women who considered just never getting any more Pap smears, in spite of the risks, and I’m glad I had an experience that changed my mind. I hope others who have had negative experiences, or even who are worried about it, are given the choices I was and are able to advocate for themselves and be heard and respected.

[thescrumblingmidwife]

I don't know if this is your department but what would happen if a complete hysterectomy was medically necessary (cancer) in the middle of puberty?

Hi Anon,

This is technically not my department - a patient undergoing this would be under the care of a gynecologic oncologist, and a fertility specialist will also probably be a part of the team.

That said, I can discuss the physiology of what would happen:

Uterine cancer in an adolescent is exceedingly rare, and a total hysterectomy would be a treatment only of last resort. The result of a hysterectomy is that the person would become unable to become pregnant.

If the uterus is taken but the ovaries are spared, the person would still go through puberty as normal, developing female secondary sex characteristics, but they would just never menstruate. They would still ovulate, and could theoretically produce a biological child using in vitro fertilization (when eggs are retrieved surgically and fertilized outside the body) and a surrogate to carry the pregnancy.

If both ovaries also had to be removed in addition to the uterus (exceedingly, very very, super rare), the young person would become permanently sterile (no more eggs), and need to receive estrogen hormone replacement therapy to ensure proper growth and health. Estrogen isn't just responsible for the menstrual cycle or for feminizing features - it's also important for bone and cardiovascular health.

For those who are wondering how rare this is:

The annual incidence (how many people per year get a thing) of gynecologic cancers in adolescents (age <18) is 6.7 per MILLION. Of those, 87.5% are of the ovary and only 2.5% are of the uterus. So, out of a MILLION adolescent AFABs, 5.6 people will get ovarian cancer, and 0.2 will get uterine cancer.

That's 2 out of 10 MILLION!

The good news is the survival rates for these cancers is very high!

(Source: Wohlmuth, C., & Wohlmuth-Wieser, I. (2021). Gynecologic Malignancies in Children and Adolescents: How Common is the Uncommon?. Journal of clinical medicine, 10(4), 722. https://doi.org/10.3390/jcm10040722)

---

If this is your situation, Anon, I am very sorry to hear about it. I wish you good health and excellent care!

[adityamantri]

Cervical cancer

Cervical cancer is a type of cancer that develops in the cervix, which is the lower part of the uterus that connects to the vagina. It is the fourth most common cancer in women worldwide and  can affect women of all ages. However, it is most often diagnosed in women between  35 and years of age.

 Causes of cervical cancer:

 The main cause of cervical cancer is infection with  human papillomavirus (HPV), a sexually transmitted virus. There are more than 100 different types of HPV, and some types can cause cervical cancer. Other factors that can increase the risk of  cervical cancer include smoking,  a weakened immune system,  a family history of cervical cancer, and  multiple sexual partners. 

 Symptoms of cervical cancer:

 Cervical cancer does not necessarily cause symptoms in its early stages. As the cancer progresses, symptoms may include abnormal vaginal bleeding, pelvic pain or discomfort, pain during intercourse, and unusual vaginal discharge. It is important to note that these symptoms can be caused by other diseases, so it is important to consult a doctor to get a proper diagnosis. 

 Prevention and early detection of cervical cancer:

 The most effective way to prevent cervical cancer is  the HPV vaccine. The HPV vaccine protects against the types of HPV that cause most cases of cervical cancer, as well as against other types of HPV that can cause other types of cancer. The vaccine is recommended for  males and females between  9 and 26 years of age.

 Regular cervical cancer screening is also important for early detection. A Pap test is a test that checks for abnormal cells on the cervix. It is recommended that women start regular Pap tests from the age of 21. In addition, the new  HPV test can also detect the presence of the virus that causes cervical cancer. Women should discuss with their healthcare provider which exams are right for them. 

 Treatment of cervical cancer:

 Treatment of cervical cancer depends on the stage of the cancer and other factors such as the woman's age and general health. Treatment options may include surgery, radiation therapy, chemotherapy, or a combination of these treatments.

  In summary, cervical cancer is a common female cancer  that can be prevented by vaccination and detected early by regular screening. Women should consult with their health care provider to determine  appropriate screening and vaccination. If cervical cancer is diagnosed, early treatment can lead to a better outcome.

For more information Visit: www.oncorelief.in

[surgicaloncology]

Specialty Surgical Oncology Hospital and Research Centre

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Phone/Mobile Number- 8268880185 Website URL-https://specialtysurgicaloncology.com/

[staticespace]

A Warning About Post-Menopausal Bleeding

Text Transcription:

I am a Family Doctor and I want to keep a promise made to a patient.

Julie was a healthy, post-menopausal woman in my care who came in for a periodic health examination. One of my routine questions, in what is called the "Review of Systems", was to ask if she had experienced any vaginal bleeding.

She said "No" but then laughed and added, "Other than when my period came back for a few months last year".

All health care professionals are taught early on that 'vaginal bleeding in a post-menopausal woman is Cancer of the Uterus until proven otherwise'. This comment by Julie was, therefore, a red flag (no pun intended) prompting further questions, an examination and an ultrasound of her pelvis.

Julie was surprised to see me so concerned, especially since the symptoms had not recurred over many months.

Sure enough, a pelvic ultrasound and tissue sampling confirmed Cancer of the Uterus.

Julie underwent a hysterectomy and radiation therapy. She is now healthy, cancer-free and is expected to stay that way.

After all this was done, Julie sat ME down for a talk. She told me she'd had no idea a 'short return' of her period after menopause was a danger signal. Furthermore, she addressed the topic with friends over coffee and discovered that, out of 20 women, NONE of them knew this symptom was abnormal! She admonished me to "Tell women this! Don't assume we know it!"

From that day on, I have kept Julie's advice in mind when talking with post-menopausal patients. But recently my wife suggested that I should take this to a wider audience.

So, Julie, this is for you:

If you are a post-menopausal woman and your period 'comes back' or you have even one episode of vaginal bleeding, TELL A HEALTH CARE PROFESSIONAL and insist on having it investigated!

Wishing you all good health and long lives.

— Sheila Toll on Facebook, posted September 2nd of an unknown year.

End Transcription.

I think this may also apply to people whose periods stopped earlier on, pre-menopause. So yeah, if the bleeding stops for years or something, but then 'comes back', you gotta check that out.

Be safe out here.

[drgopalsharma]

Dr. Gopal Sharma - Best Breast Cancer Doctor in Delhi

In today’s fast-paced world, finding the right healthcare professional is crucial, especially when it comes to battling a life-threatening disease like cancer. If you are searching for the Best Cancer Specialist in Delhi, look no further than Dr. Gopal Sharma, one of the leading oncologists in the region, currently practicing at MAX Hospital.

Dr. Gopal Sharma has built a strong reputation through his dedication, expertise, and compassion toward his patients. In this blog, we will explore why he is considered one of the top cancer specialists in Delhi, what you should consider when choosing an oncologist, and how the right treatment can impact cancer recovery.

Understanding Cancer and Its Treatment

Cancer is a complex group of diseases characterized by the uncontrolled growth and spread of abnormal cells. If left untreated, it can cause serious harm and even lead to death. However, with advances in medical technology, various treatments such as chemotherapy, surgery, radiation therapy, and immunotherapy have given hope to millions of patients worldwide.

Delhi, being a hub of medical expertise, houses some of the finest oncologists. Among them, Dr. Gopal Sharma has made a name as the Best Cancer Specialist in Delhi, especially for his specialization in medical oncology.

Why Choose Dr. Gopal Sharma: The Best Medical Oncologist in Delhi NCR

When you are diagnosed with cancer, you want to make sure that your treatment is in the hands of the best. Dr. Gopal Sharma, regarded as the Best Medical Oncologist in Delhi NCR, offers personalized and comprehensive cancer care. His commitment to each patient’s unique needs has made him a trusted name in oncology.

Top Reasons Why Dr. Gopal Sharma is the Best Cancer Specialist in Delhi

Extensive Experience: With over two decades of experience in oncology, Dr. Gopal Sharma has treated thousands of cancer patients with remarkable success rates.

Advanced Treatment Techniques: Dr. Sharma stays updated with the latest advancements in cancer treatments, offering cutting-edge therapies to his patients.

Compassionate Care: Patients consistently appreciate his empathetic approach and his ability to explain complex treatments in a manner that is easy to understand.

Multidisciplinary Team: At MAX Hospital, Dr. Gopal Sharma leads a team of specialists who collaborate to provide holistic cancer care.

Patient-Centered Approach: His patient-centric approach ensures that treatment is tailored to the specific needs of each individual, optimizing outcomes.

Specializations: Best Breast Cancer Specialist in Delhi NCR

One of the key areas of expertise for Dr. Gopal Sharma is breast cancer treatment. Breast cancer is one of the most common cancers affecting women today, and early detection, coupled with the right treatment, can significantly improve survival rates.

As the Best Breast Cancer Specialist in Delhi NCR, Dr. Gopal Sharma provides comprehensive care for patients with breast cancer, from diagnosis through treatment and recovery. He has helped countless women in their fight against breast cancer, offering advanced surgical options, chemotherapy, and targeted therapies.

Why Dr. Gopal Sharma is the Best Breast Cancer Doctor in Delhi

Advanced Diagnostic Techniques: Early and accurate diagnosis is critical for successful treatment. Dr. Sharma uses advanced imaging techniques, biopsies, and genetic testing to detect breast cancer in its early stages.

Customized Treatment Plans: No two patients are alike. Dr. Sharma provides personalized treatment plans based on the type, stage, and molecular characteristics of the cancer.

Surgical Expertise: When surgery is necessary, Dr. Gopal Sharma is highly skilled in performing breast-conserving surgeries and mastectomies, ensuring optimal patient outcomes.

Post-Treatment Care: After the treatment, Dr. Sharma and his team focus on post-operative care and monitoring to ensure that patients recover fully and have a lower risk of recurrence.

Gynecologic Oncologist Specialist Doctor

Women diagnosed with gynecological cancers such as ovarian, uterine, or cervical cancer can also benefit from the expertise of Dr. Gopal Sharma. As a Gynecologic Oncologist Specialist Doctor, Dr. Sharma offers treatments that are tailored specifically to the needs of women.

Ovarian Cancer Treatment: Early-stage ovarian cancer can often be treated successfully with surgery, chemotherapy, and targeted therapies. Dr. Sharma uses a multidisciplinary approach to ensure the best treatment outcomes.

Cervical Cancer: With advancements in screening and vaccines, cervical cancer is now more preventable. However, for those diagnosed, Dr. Gopal Sharma’s approach includes a combination of radiation, surgery, and chemotherapy.

Best Liver Cancer Specialist Doctor in Delhi NCR

Liver cancer is one of the more aggressive types of cancer, and timely treatment is essential. Dr. Gopal Sharma is known as the Best Liver Cancer Specialist Doctor in Delhi NCR for his expertise in treating both primary liver cancers and metastases to the liver.

Liver Cancer Treatment Options

Surgical Resection: For operable liver tumors, Dr. Sharma provides expert surgical resection to remove cancerous tissues.

Transplantation: In advanced cases, liver transplantation may be an option. Dr. Sharma works closely with transplant surgeons to offer this life-saving option.

Targeted Therapy and Immunotherapy: With advancements in targeted therapies and immunotherapy, patients with inoperable liver cancer can now benefit from treatments that specifically target cancer cells without harming healthy tissues.

Choosing the Right Cancer Specialist: Key Considerations

When looking for the Best Cancer Specialist in Delhi, it’s important to keep several factors in mind to ensure you receive the best care possible:

Experience and Expertise: Your doctor should have significant experience treating the type of cancer you are diagnosed with. Dr. Gopal Sharma specializes in a range of cancers, including breast, liver, and gynecologic cancers.

Hospital Affiliation: Receiving treatment at a world-class facility is important. MAX Hospital, where Dr. Sharma practices, is renowned for its state-of-the-art cancer care.

Patient Testimonials: A doctor’s reputation is built on patient success stories. Dr. Sharma’s patients consistently praise his compassionate care and successful outcomes.

Comprehensive Care: Cancer treatment requires a team of specialists. At MAX Hospital, Dr. Sharma works with radiologists, surgeons, and pathologists to ensure holistic care.

Best Breast Cancer Doctor in Delhi NCR: Comprehensive Care

One of the biggest concerns for patients diagnosed with breast cancer is finding the right specialist. As the Best Breast Cancer Doctor in Delhi NCR, Dr. Gopal Sharma offers not only top-notch medical treatment but also psychological and emotional support to his patients, ensuring that they feel confident and supported throughout their cancer journey.

Conclusion: Trust the Best Cancer Specialist in Delhi – Dr. Gopal Sharma

Finding the right oncologist is crucial to achieving the best outcomes in cancer treatment. Dr. Gopal Sharma, the Best Cancer Specialist in Delhi, brings years of expertise, cutting-edge treatments, and a patient-centered approach that ensures you receive the care and attention you deserve.

At MAX Hospital, Dr. Sharma and his team are dedicated to providing comprehensive cancer care, from diagnosis through recovery. Whether you are looking for the Best Breast Cancer Doctor in Delhi, a Gynecologic Oncologist Specialist Doctor, or the Best Liver Cancer Specialist Doctor in Delhi, you can trust Dr. Sharma’s expertise to guide you on the path to recovery.

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Ovarian Cancer Signs: Expert Insights from the best Gynecologic Oncologist in Delhi

 Ovarian cancer is a type of gynecologic cancer that begins when genes regulating cell growth mutate, causing abnormal cells to multiply rapidly and form a tumor. Detecting ovarian cancer in its early stages is challenging due to the small size and deep location of the ovaries within the abdomen, making growths difficult for doctors to feel. Additionally, early symptoms often resemble those of other conditions, leading to frequent misdiagnosis. Consequently, only 20% of ovarian cancer cases are discovered in the early stages, when treatment is most effective.

The highest incidence of ovarian cancer occurs in women in their early to mid-60s, but women of all ages can develop the disease. Factors such as fertility treatments, obesity, endometriosis, and a family history of ovarian, breast, or uterine cancer can increase the risk. The absence of routine screening tests further complicates early diagnosis, with only 19% of cases detected early. Once ovarian cancer spreads within the pelvis and abdomen, it becomes more challenging to treat, although not impossible. Early-stage ovarian cancer, confined to the ovary, has a higher likelihood of successful treatment.

Given these challenges, it is essential for all women to be vigilant about the signs and symptoms of ovarian cancer and to consult the best gynecologic oncologist in Delhi if they experience any of the following:

· Alterations in Menstrual Cycles

· Abdominal Bloating or Increased Size

· Appetite changes

· Abdominal or pelvic pain

· Unexplained Weight Loss

· Digestive Issues

· Swelling in the Legs

· Frequent Urge to Urinate

· Persistent Fatigue or Low Energy Levels

What Are The Early Signs And Symptoms Of Ovarian Cancer?

Alterations in Menstrual Cycles Abdominal Bloating or Increased Size Appetite Changes Abdominal Or Pelvic Pain Unexplained Weight Loss Digestive Issues Swelling in the Legs Frequent Urge to Urinate Persistent Fatigue or Low Energy Levels

Ovarian Cancer Treatment in Delhi

Visit Dr. Kanika Batra Modi for Ovarian Cancer Treatment in Delhi

Early detection of ovarian cancer significantly improves treatment results, but recognizing the signs and symptoms can be challenging. As the disease progresses, symptoms may appear, but many women ignore the warning signs because they mimic other, less serious conditions. It is important for women to pay close attention to their bodies and be alert for changes in their health. Unusual symptoms should not be ignored. Being aware of these symptoms and seeking timely medical advice can lead to an early diagnosis and more effective treatment.

Ovarian cancer can affect your menstrual cycle in several ways, including:

· Missing a period

· Heavier-than-usual bleeding

· Spotting or bleeding outside of your regular period

· Unusual vaginal discharge

While irregular periods are not necessarily a definitive sign of ovarian cancer, they can increase your risk. Some women diagnosed with ovarian cancer report experiencing more frequent menstruation or spotting between periods. If you are pre-menopausal and suddenly have irregular cycles or more period pain than usual, it is essential to schedule an appointment with your gynecologist. For post-menopausal women, any unexpected bleeding should be thoroughly investigated.

Unlike usual bloating around your menstrual period or after eating certain foods, persistent bloating is a common sign of ovarian cancer. Approximately 72% of women with ovarian cancer report experiencing bloating. This bloating can feel like:

· Feeling as though you are pregnant

· Making your clothes dig into your waist

· Difficulty buttoning or zipping pants

Abdominal bloating is a common symptom among women with ovarian cancer. Many initially mistake their abdominal distention for issues related to age, fluid retention, or dietary habits. The bloating associated with ovarian cancer can range from mild to severe, often leading some women to need larger clothing. This bloating might also come with digestive disturbances or changes in appetite.

Changes in your appetite can often be one of the first signs of ovarian cancer. Many women may feel unusually full after eating only a small amount of food, leading to difficulty finishing even a small meal. Some women may also experience nausea and vomiting after eating. These appetite changes can also result in unintended weight loss. If you notice a persistent loss of appetite or feelings of fullness after small meals, it’s important to seek medical advice promptly, as they can often be misdiagnosed initially as acid reflux or another digestive condition.

Pelvic discomfort is often mistakenly attributed to menstrual cycles or digestive issues, but it can also be a sign of ovarian cancer, especially if the pain is new or increasing in intensity. Tumors spreading in the abdomen or pelvis can irritate tissues, causing pain in the lower back. Abdominal or pelvic pain is a common symptom reported by individuals with ovarian cancer. The nature of the pain can vary widely; some describe it as intense pressure, while others liken it to menstrual cramping or a squeezing sensation.

The pain’s cause can also differ depending on the individual. As tumors grow, they may exert pressure on other parts of the body, including the bladder, bowels, rectum, and spine, leading to varying degrees of discomfort.

Unexplained weight loss of more than five percent of your body weight over six to twelve months when you are not on a diet or have not changed your exercise habits, should prompt a consultation with your physician. Nearly 40 percent of people first diagnosed with cancer report unexplained weight loss. Advanced ovarian cancer may also cause cachexia, a syndrome resulting in weight loss and muscle wasting.

Gastrointestinal symptoms are common among women diagnosed with ovarian cancer. These symptoms, which can mimic irritable bowel syndrome (IBS), include abdominal bloating, pain, diarrhea, and constipation. Women experiencing these symptoms for three weeks or more should discuss ovarian cancer testing with their doctor.

Fluid retention in the ankles, feet, or lower legs can be an early sign of ovarian cancer. As swelling progresses, the skin may appear stretched or shiny, and swollen areas may remain indented after applying pressure (pitting edema). Although leg swelling can be caused by other health concerns, ovarian cancer is known to cause edema.

Ovarian tumors or swelling can lead to urinary disturbances because of the bladder’s close proximity to the ovaries. Changes in bathroom habits, including more frequent urination or a greater sense of urgency, are common among individuals with ovarian cancer. Additionally, some people experience a burning sensation during urination or feel their bladder is still full even after urinating.

Women with ovarian cancer may also experience unexplained exhaustion, along with pain or pressure in the lower back or pelvis. This discomfort can occur when fluid accumulates in the pelvis or when the tumor spreads in the abdomen, directly irritating tissues in these areas. This persistent fatigue, which doesn’t improve with rest and disrupts your ability to engage in regular activities, can be a sign of ovarian cancer. It’s important to consult your healthcare provider if you experience ongoing fatigue.

Potential symptoms of ovarian cancer are often overlooked until the disease has progressed. If your examination or imaging tests indicate a possibility of ovarian cancer, your healthcare provider will likely recommend consulting with a gynecologic oncologist, a specialist in cancers of the female reproductive system.

Dr. Kanika Batra Modi, the best gynecologic oncologist in Delhi, utilizes advanced surgical techniques, targeted treatments, and the latest therapeutic options to deliver exceptional care to her patients.

Booking an appointment with Dr. Kanika Batra Modi, the best gynecologic oncologist in Delhi, ensures that you receive the highest standard of care.

Whether you are seeking the best gynecologic oncosurgeon in Delhi or looking for the best ovarian cancer treatment in Delhi, Dr. Kanika Batra Modi is dedicated to providing personalized, state-of-the-art care to help you achieve the best possible results.

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