Frequently Asked Questions

Fertility preservation during the treatment of gynaecological cancer depends on the type of cancer you are suffering from and the stage you are in. Based on your condition, your gynaecological oncologist will prepare a treatment plan and will suggest different options to preserve your fertility if feasible.

Gynaecologic oncologists are specially trained in diagnosing and treating cancers of the female reproductive organs. They have a complete understanding of the normal physiology of these organs and the effects of a cancerous change in them. Hence they are best suited to offer total care right from diagnosis to management to the women with gynecologic cancer or its precursors and the complications ensuing therefrom. They also play a pivotal role in coordinating care between other specialties like radiation and medical oncology whenever required in the treatment of gynecologic cancer.

Some of the common risk factors of gynaecological cancer include – HPV infection. Use of tobacco. Post menopausal hormone replacement therapy. Obesity. Reduced immunity due to certain diseases or drugs. Family history of breast, ovarian, uterine or colon cancer or certain genetic mutations.

There are no specific symptoms of gynaecologic cancer. However depending on the site of the tumor several signs and symptoms if that women should look out for if persistent include - Irregular periods or abnormal vaginal discharge Post-menopausal bleeding Bloating Pain in the pelvic/abdominal area Frequent urination Feeling full Lump in abdomen.

Cancers that arise from the reproductive organs of women are known as gynaecological cancers. These include - Cervical Cancer Endometrial Cancer Ovarian and fallopian tube Cancer Vaginal Cancer Vulva Cancer Gestational trophoblastic tumours.

While radiation therapy is usually targeted at cancer cells, however, during the process, healthy cells also get affected leading to several acute but temporary side effects such as - Skin irritation in the form of redness & dryness along with hyperpigmentation (darkening). Sunburn-like reactions. Pain & difficulty in swallowing - mainly to solid, spicy and hot foods. Nausea/Vomiting/Diarrhoea - in abdominal/pelvic cancer treatments. Fatigue. Occasionally cough, dry mouth, change in voice & taste, local loss of hair in cancers of head/neck & brain region. Patients are advised not to self-medicate and follow the skin care & mucositis protocols advised by the department. Most of these effects disappear within 2 to 3 weeks post-completion of therapy.

If used to treat ovarian cancers, women are often at high risk of facing sterility. But, if radiation is used on other parts of the body, then it is unlikely that it will affect the reproductive system. Similarly, in males, if radiation is directed on the testicles then it can lead to sterility, else it is unlikely to cause any problems. It is also recommended that pregnant women must avoid undergoing radiation therapy as it may harm their babies.

Most people often fear that radiation can cause cancer. While it is true that increased exposure to radiation can increase cancer risk, however, radiation oncologists are trained in planning the treatment and only use adequate radiation with safety precautions to limit a patient’s exposure to radiation.

Once it is decided that you will require radiation treatment to improve your outcomes, firstly a planning process will ensue which could include the preparation of an immobilization cast of the affected area in the body. In this an aqua-plastic material takes the shape of the body to ensure that part of the body is totally fixed. Following this, you will undergo a planning CT &/or MRI &/or PETCT scan to help the radiation oncologist to mark the exact area to focus treatment on as well as the regions that need to be spared of any dose of radiation. Once the plan is finalized, you will be started on treatment which is a painless process with no apparent discomfort. Treatment lasts up to around 5-8 mins depending on cancer. Such treatments are usually done 5 days a week and may last just one week sometimes even going up to 7 weeks depending on the disease parameters.

Depending on the type of cancer and patient-related characteristics, there are usually three types of radiation therapy procedures - External Beam Radiotherapy (EBRT) - wherein radiation beams are focussed on the tumour from a distance. Modern machines known as linear accelerators produce high energy X-rays, which can be focussed down to the site of cancer using techniques such as 3DCRT, IMRT, IGRT or Rapid Arc/VMAT to ensure most of the dose reaches the tumour and almost known of the dose enters the normal surrounding tissues. Brachytherapy(Internal Radiation) - wherein the miniaturized radiation source inside specialized applicators is placed inside the tumour or immediately adjacent to it. Sometimes this requires the physician to perform the procedure under mild sedation or anaesthetic cover to enable proper placement of the applicators. This procedure has the advantage of being able to give a maximal dose to the tumour and a rapid dose fall-off ensuring normal tissues are spared. Intra-operative Radiotherapy - This newer method is useful in certain cancers, where following a surgical exploration, a high dose of radiation can be delivered to the tumour bed under direct visualization. As this procedure is done in the same sitting as that of the primary surgery, it gives the added advantage of maximizing positive outcomes as well as reducing the total overall treatment times for the patient.