India is rapidly losing its women to the deadly disease of cancer. Ovarian and cervical cancer is the most common Gynecological Cancers of women. Ovarian cancer remains the most lethal gynecological malignancy. Only marginal improvement has happened in its survival. Cervical cancer is the second most common cancer in women after breast cancer. All cancer in women require early diagnosis to avoid complication, long treatment and increased cost of treatment.

Dr. Kapil Kumar, Director, Surgical Oncology (Cancer), Fortis Hospital, Shalimar Bagh, New Delhi elaborates on the early symptoms, risk factors, preventive measures and diagnosis of the silent killer. Dr. Kumar runs a special Cancer OPD in Amritsar at Amandeep Hospital, Lawrence Road on every Last Sunday of the Month from 10:00 am to 2:00 pm to raise awareness and diagnose the disease at an early stage. For appointment – 9810065202/ 9654557311

Ovarian Cancer
Cancer of ovaries is the fifth most frequently occurring fatal cancer in women after lung, breast, colon and pancreas. 75% of patients are diagnosed in advanced stage (III or IV). It is suggested that every woman should have a periodic pelvic examination, pelvic ultrasound and Ca 125 levels to diagnose ovarian cancer. Major risk factors of this cancer includes- increasing age, infertility, family history of ovarian cancer, personal history of breast cancer, increased BMI > 30, early menarche and late menopause, using talcum on perineum, galactose consumption, etc.

 Watch out for these symptoms of Ovarian Cancer
• Abdominal discomfort
• Indigestion
• Bloating
• Pain in abdomen
• Changes in bladder / bowel function, decreased appetite and other mild digestive disturbances which may be present for several months before the diagnosis.

Cervix Cancer
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal vaginal bleeding, pelvic pain or pain during sexual intercourse. Risk Factors include – first sexual intercourse at an early age (< 16 yrs), multiple sexual partners, lower socio-economic status, Human Papilloma Virus (HPV) infection, sexually transmitted diseases, smoking etc.
Symptoms
• Abnormal vaginal bleeding
• Menorrhagia (menstrual periods with abnormally heavy or prolonged bleeding)
• Post-coital (sexual intercourse) bleeding
• Inter-menstrual bleeding, postmenopausal bleeding; malodorous vaginal discharge and weight loss.
• Advanced stage may present with obstructive flow of urine, leg oedema (a condition characterized by an excess of watery fluid collecting in the cavities or tissues of the body), chronic boring pelvic pain, backache, bladder and rectal symptoms.
• Any suspicious lesion of the cervix should be biopsied.

Screening
• Routine screening of the adult female population with pap smears.
• All women who are 3 yrs after the onset of vaginal intercourse, or no later than 21 yrs should undergo an annual Pap test and pelvic examination. Prophylactic HPV vaccination represents a potential means of reducing the burden of cervical cancer and its precursor lesions.

Status of gynecology cancer care in India:
• Large population with poor access to health care.
• Educational programs needs to be conducted in schools to increase awareness on the risk factors and symptoms for early detection of these cancers.
• Increase in accessibility of screening tools like Pap smear, trained personnel.
• Use of existing health care givers to its efficient utilization.

About the author- Dr. Kapil Kumar, Director, Surgical Oncology (Cancer), Fortis Hospital, Shalimar Bagh, New Delhi