Gynaecological oncology is a specialized field of medicine focused on diagnosing and treating cancers of the female reproductive system. This includes cancers of the ovaries, uterus, cervix, vulva, and vagina. It involves a multidisciplinary approach, combining surgery, chemotherapy, radiation therapy, and sometimes immunotherapy or targeted therapy, depending on the type and stage of cancer.

Ovarian Cancer: Often diagnosed at a late stage due to vague symptoms. It may involve surgery and chemotherapy.

Cervical Cancer: Often associated with HPV (Human Papillomavirus) infection. Treatment typically includes surgery, radiation, and chemotherapy

Endometrial (Uterine) Cancer: The most common cancer of the female reproductive organs, often detected early due to abnormal vaginal bleeding.

Vulvar Cancer: Rare, but treatment often involves surgery, and radiation may be used in advanced stages.

Vaginal Cancer: Also rare, typically treated with surgery and radiation.

Advances in gynaecological oncology have improved early detection (e.g., Pap smears for cervical cancer) and the development of targeted therapies, which aim to treat cancer with fewer side effects than traditional treatments.

The treatment modalities for gynaecological cancers depend on the type, stage of the cancer, and the patient’s overall health. The main approaches include:

Primary Treatment: Surgery is often the primary treatment for early-stage gynaecological cancers, aiming to remove the tumor or affected organs. This may include

Hysterectomy: Removal of the uterus, commonly used for endometrial or cervical cancer.

Oophorectomy: Removal of one or both ovaries, typically for ovarian cancer.

Lymphadenectomy: Removal of lymph nodes to assess the spread of cancer.

Radical Surgery: In advanced cases, more extensive procedures may be required, such as removal of surrounding tissues and organs (e.g., bladder or rectum).

External Beam Radiation: Delivers high-energy radiation to the tumor area from outside the body. Often used for cervical, endometrial, and vaginal cancers.

Brachytherapy: : A form of internal radiation where a radioactive source is placed inside or very close to the tumor. This is commonly used for cervical and vaginal cancers.

Radiation may be used as adjuvant therapy to shrink tumors before surgery or to target any remaining cancer cells post-surgery.

Systemic Treatment: Chemotherapy uses drugs to kill cancer cells or stop them from dividing. It is commonly used for ovarian cancer, and advanced stages of cervical, endometrial, or vulvar cancers.

Chemotherapy may be used before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to kill any remaining cancer cells.

Common drugs used include cisplatin, carboplatin, paclitaxel, and docetaxel.

Endometrial and Ovarian Cancers: Some cancers, such as endometrial cancer, may be hormone-sensitive. Hormone therapy can involve drugs that block or lower the body’s estrogen levels, which some cancers rely on for growth.

Selective Estrogen Receptor Modulators (SERMs), aromatase inhibitors, and progestins may be used in specific cases.

Targeted therapies aim at specific molecules involved in cancer cell growth and survival. These therapies are typically used in cases of advanced or recurrent cancers and may include:

PARP inhibitors for ovarian cancer (e.g., olaparib).

Angiogenesis inhibitors to prevent blood supply to tumors (e.g., bevacizumab).

Monoclonal antibodies that target specific cancer cell markers.

Immunotherapy works by stimulating the body’s immune system to recognize and fight cancer. It is being increasingly used for various types of cancers, including cervical and ovarian cancers, especially those that are advanced or recurrent.

Checkpoint inhibitors (e.g., pembrolizumab, nivolumab) can help the immune system attack cancer cells by blocking checkpoint proteins that prevent immune cells from recognizing cancer cells.

A team of specialists, including gynaecologic oncologists, radiologists, pathologists, surgeons, and radiation oncologists, often work together to design a personalized treatment plan. The treatment strategy may change over time based on the patient’s response to treatment and any side effects.