In women, 60 to 65% of all cancers are related to the genital tract and breast. In fact, in India, breast and cervical cancers are the top two commonest cancers in women. “Women are the architects of society,” said Cher. Today, women are at the forefront of every innovation and progress. However, with progress, we have also seen that more and more Indians have been adopting a lifestyle similar to our western counterparts and as a result, we are becoming more and more susceptible to diseases which arise from these “western habits”.
India is already the diabetes capital of the world and the incidence of hypertension and heart diseases is rising exponentially. The same factors and many more, which accounts for these unfortunate illnesses also are contributory to cancers such as breast, ovarian and endometrial (uterine) cancers. The incidence of these 3 cancers has almost doubled in the last 10 years itself and is expected to rise even more faster in the coming decade.
Gynaecologic cancers include cancers of the cervix, uterus, fallopian tubes, ovaries, vulva, vagina and pregnancy related cancers.
Cervical cancer still accounts for 120,000 new cases a year in India translating to one new cancer diagnosed approximately every 4 min. Fortunately cervical cancer can be prevented by vaccines and can also be diagnosed early or even in the precancerous state by doing a Pap smear test. The pap test is a simple test that takes a few seconds to do in the doctor's clinic itself. In the past women with abnormal pap test were called for an elaborate evaluation called colposcopy to visualize the cervix further and then do a biopsy and other treatments. Today, we have portable, miniature, cloud enabled state of the art colposcopes, that we carry with us and can do the colposcopy in any setting. Reports are generated in real time and handed over to patients before they go home. In fact, what we offer is a “see and treat” approach, where we see, identify, evaluate and treat abnormalities, all at one sitting.
Ovarian cancer is another cancer that is rapidly growing. Unfortunately, this “silent killer” is diagnosed late in most cases. There is no real way of diagnosing it early. But we advise women that if you have a family history of women having breast, ovarian or colon cancers, then it's advisable to routinely and yearly do ultrasound tests and blood tests to try and pick up ovarian diseases early. As far as treatment goes, today, India is practically a leader in state-of-the-art surgery and chemotherapy for ovarian cancer. HIPEC, i.e. heated chemotherapy drugs that are put inside the abdomen at the time of surgery, is a new and upcoming therapeutic option for select women with ovarian cancers. HIPEC is offered at an increasing number of centers across India.
Uterine or endometrial cancer, is a disease that's growing very rapidly. In fact, in the decades 2020 to 2040, there is an anticipated epidemic of this cancer. The reason being that this is a disease predominantly arising out of lifestyle issues. Obesity, diabetes, hypertension, stress, irregular food habits, infertility etc. are known high risk factors. Girls with polycystic ovaries are at an increased risk for developing endometrial cancer later in life. As gynae oncologists, we do recommend that women adopt healthy lifestyle and focus on regular dietary habits as well as exercise.
Breast cancers are the number one cancer in India today. It is estimated that 1 in 18 women will have breast cancer by 2030. Self-breast examination (SBE) is an invaluable tool that women can utilize on their own at home. However, its important to visit your doctor to learn the correct technique. Besides this, the clinical evaluation of your breasts by an expert at least once a year and a mammography once in two years should be a mandatory part of every woman's schedule.
The other gynaecologic cancers are much rarer, but with time the incidence is likely to grow. Its important to keep a check on these also. We recommend that, women should make it a point to do a regular check with their doctors. Besides blood tests, a mammography, a sonography, PAP smear and a clinical evaluation from a gynaecologist should be on the list.
Nora Ephron said, “be the heroine of your life” and by all means, celebrate this Women's Day as an ode to woman hood, but also look after yourself and your health. Take out that one day from your life every year and visit your doctor for tests that can help you.
(Dr. Samar Gupte, MD, Gynae-Oncosurgeon)
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