Gynaecological Oncology Program

Gynaecological cancers affect the uterus, ovaries, cervix, vagina and vulva. The Gynaecological Oncology Program at Nanavati Max Institute of Cancer Care brings gynaecological oncologists, radiation oncologists, medical oncologists, oncopathologists, radiologists, interventional radiologists, nuclear medicine specialists and geneticists together to plan care around each woman's diagnosis, stage and individual needs. The programme also focuses on organ, function and fertility preservation in suitable patients.

Why Choose Nanavati Max Hospital for Gynaecological Oncology Treatment in Mumbai

Four aspects shape how gynaecological cancer care is planned, alongside the treatment options available for individual cancer types.

A Multidisciplinary Cancer Care Team

Gynaecological cancer treatment can involve surgery, chemotherapy, radiation therapy and other forms of treatment. The programme brings specialists from gynaecological oncology, medical oncology, radiation oncology, oncopathology, radiology, interventional radiology, nuclear medicine and genetics together to support an individualised treatment plan. This multidisciplinary approach helps different aspects of a patient's diagnosis and treatment to be considered together.

Robotic and Ultraradical Surgical Expertise

The surgical team offers robotic surgery using the Da Vinci Xi system, alongside laparoscopic and open approaches where appropriate. The programme also performs complex and ultraradical cytoreductive surgery for selected patients with advanced ovarian and endometrial cancers. These procedures may involve multiorgan resections depending on the extent of disease.

The centre is among the few centres in India offering ultraradical cytoreductive surgery for ovarian and endometrial cancers.

HIPEC for Advanced Ovarian Cancer

For selected patients with ovarian cancer, HIPEC (hyperthermic intraperitoneal chemotherapy) may be given following surgery. This involves delivering heated chemotherapy directly into the abdominal cavity after removal of visible disease. It may form part of treatment for appropriately selected patients with advanced ovarian cancer.

Fertility and Organ Preservation Where Possible

Preserving fertility and organ function can be an important consideration, particularly for younger women. Where the cancer type and stage permit, treatment may include conservative or fertility-sparing surgery. For some cervical cancer and vaginal cancers, non-surgical treatment approaches may also help preserve organs and function.

Types of Gynaecological Cancers We Treat

Gynaecological oncological cancers arise in different parts of the female reproductive system and can behave differently from one another. Treatment is therefore planned according to the type and stage of cancer and the individual patient's circumstances.

Cervical Cancer

Cervical cancer is the second most common cancer in women in India after breast cancer. Persistent infection with certain types of human papillomavirus (HPV) is a major cause. Cervical cancer is largely preventable through HPV vaccination and appropriate screening, and precancerous and early-stage disease may not cause noticeable symptoms.

Uterine (Endometrial) Cancer

Endometrial cancer develops in the lining of the uterus. Its incidence is increasing in India, including among younger women. Abnormal vaginal bleeding can lead to diagnosis at an earlier stage in many patients. Obesity and hormonal factors can contribute to risk, while some high-risk histological types require more intensive, multimodal treatment.

Ovarian Cancer

Ovarian cancer is often diagnosed at an advanced stage because its early symptoms can be vague or non-specific. Treatment may involve cytoreductive surgery and combination chemotherapy, with HIPEC considered for selected patients. A personal or family history of ovarian, breast or uterine cancer can be relevant when assessing risk. Genetic counselling and testing may also be considered, particularly when hereditary cancer is suspected.

Targeted therapies and immunotherapy may also have a role in selected patients depending on the cancer type and its molecular or clinical characteristics.

Germ Cell Tumours

Germ cell tumours are a type of ovarian tumour that occur predominantly in younger women. When appropriate, fertility-sparing surgery may be possible, with preservation of the unaffected ovary and uterus.

Vulvar Cancer

Vulvar cancer affects the external genitalia. It can be associated with HPV infection and certain vulval skin conditions. Depending on the extent of disease, surgery may be planned to remove the cancer while preserving normal anatomy and function where clinically possible. Treatment may include wide local excision, vulvectomy and lymph node surgery, with reconstructive procedures in selected cases.

Vaginal Cancer

Vaginal cancer is uncommon and is often treated with radiation therapy. Certain less common subtypes, including vaginal melanoma, can behave more aggressively and require specialist management.

Gestational Trophoblastic Neoplasia

Gestational trophoblastic neoplasia is an uncommon group of cancers associated with pregnancy-related events, including molar pregnancy and, less commonly, other pregnancy outcomes. Persistent vaginal bleeding after a pregnancy event can be a warning sign. These cancers can be highly responsive to treatment, including when the disease has spread, but require timely specialist care. Fertility preservation may be possible in many patients.

Symptoms to Watch For

Symptoms vary according to the type of gynaecological cancer, and some may also occur with non-cancerous conditions. However, persistent or unusual symptoms should be assessed by a doctor.

These may include:

• Abnormal vaginal bleeding, including unusually heavy periods, bleeding between periods or bleeding after intercourse
• Any bleeding or spotting after menopause
• Abnormal vaginal discharge, particularly if it is blood-stained, brownish or foul-smelling
• Persistent abdominal, pelvic or lower back pain
• Abdominal distension or persistent bloating
• Feeling full quickly after eating
• Persistent nausea, vomiting or changes in bowel habits
• A new abdominal or pelvic mass
• Swelling of the legs
• Itching, a growth, ulceration, pain or colour change involving the vulva
• Difficulty passing urine, increased urinary frequency or blood in the urine
• A new lump or swelling in the groin
• Persistent cough or breathlessness
• Loss of appetite or unexplained weight loss
• Persistent weakness or fatigue

Risk Factors

Risk factors vary between different gynaecological cancers. These may include:

• Human papillomavirus (HPV) infection
• Hormone replacement therapy without appropriate medical supervision
• Obesity
• Tobacco use or smoking
• A family or personal history of breast, ovarian, uterine or colorectal cancer
• Certain immunocompromised states, including HIV infection and post-transplant status
• Endometriosis
• Polycystic ovary syndrome
• Use of tamoxifen for breast cancer treatment
• Certain inherited genetic mutations associated with increased cancer risk

Having a risk factor does not mean that a woman will develop cancer. Risk assessment depends on the individual's medical and family history.

How Gynaecological Cancers Are Diagnosed and Staged

Diagnosis depends on the suspected cancer and may involve a clinical examination, imaging and tissue sampling. Depending on the situation, investigations may include ultrasound, CT, MRI or PET-CT to assess the tumour and determine whether it has spread. A biopsy or endometrial sampling may be required to confirm the diagnosis.

For some cancers, blood tests and tumour markers may also support the overall assessment, but these tests are interpreted alongside clinical findings and imaging rather than used on their own.

Once cancer is confirmed, staging determines how extensively the disease has spread. The stage, together with the cancer type, tumour characteristics and the patient's overall health, helps the multidisciplinary team decide on the most appropriate treatment approach.

Treatment Options Explained

Treatment for gynaecological cancers is often multimodal, meaning that surgery, chemotherapy, radiation therapy, immunotherapy or targeted treatment may be combined according to the type and stage of cancer.

Surgery

Surgery is a major component of treatment for many gynaecological cancers and can range from minimally invasive procedures to complex operations involving multiple organs.

The surgical team has more than 35 years of experience in treating gynaecological cancers, including complex and advanced cases. The programme also has extensive experience in ultraradical cytoreductive surgery for selected advanced ovarian and endometrial cancers.

Depending on the cancer type and individual circumstances, surgical procedures may include:

Cervical cancer

• Radical hysterectomy for selected early-stage cancers
• Exenterative surgery for selected recurrent cases
• Conisation and ablative procedures for precancerous or pre-invasive lesions

Uterine cancer

• Total hysterectomy with bilateral salpingo-oophorectomy and tailored lymph node dissection
• Open, laparoscopic or robotic surgery where appropriate
• Pelvic and para-aortic lymphadenectomy
• Ultraradical cytoreductive surgery for selected advanced disease
• Surgery for uterine sarcomas

Ovarian cancer

• Surgical staging
• Primary cytoreductive surgery
• Interval cytoreductive surgery
• Secondary cytoreductive surgery
• Ultraradical surgery with multiorgan resection
• Bowel resection, diaphragmatic stripping or excision
• Extensive lymphadenectomy
• Peritonectomy
• Resection of selected liver or splenic metastatic lesions
• HIPEC for suitable patients following surgery

Germ cell tumours

• Conservative fertility-sparing surgery with preservation of the unaffected ovary and uterus where appropriate

Vulvar cancer

• Wide local radical excision
• Hemivulvectomy
• Radical vulvectomy
• Groin lymph node dissection
• Reconstructive surgery in selected cases

Risk-reducing surgery

For women at high risk of ovarian or uterine cancer because of a significant family history or specific genetic mutations, risk-reducing surgery may include prophylactic bilateral salpingo-oophorectomy with or without hysterectomy.

Preventive and pre-invasive procedures

• Cervical screening
• Pap smear
• HPV testing
• Liquid-based cytology
• LEEP
• Conisation
• Selected ablative procedures

Chemotherapy

Chemotherapy uses medicines that travel through the bloodstream to treat cancer cells throughout the body. Depending on the cancer type and stage, it may be given before surgery, after surgery, alongside radiation therapy or as the main treatment when cancer has spread to distant sites.

Radiation Therapy

Radiation therapy may be used as a primary treatment, after surgery or alongside other treatments, depending on the cancer type and stage. It has an important role in the treatment of cervical and vaginal cancers and may also be used for selected vulval and uterine cancers.

Internal radiation, or brachytherapy, is used for appropriate cervical and vaginal cancers. Modern radiation techniques allow treatment to be planned and delivered with greater precision while limiting exposure to surrounding tissues.

Immunotherapy and Targeted Therapy

Immunotherapy works by helping the immune system recognise and attack cancer cells. It is increasingly used for selected gynaecological cancers, depending on the cancer type and individual clinical factors.

Targeted therapies act on specific molecular features involved in cancer growth. For example, PARP inhibitors may be used in selected patients with ovarian cancer. The suitability of immunotherapy or targeted treatment depends on the tumour characteristics and overall treatment plan.

Technology at the Cancer Institute

Gynaecological cancer care may involve advanced imaging, minimally invasive surgery and precision radiation therapy depending on the type and stage of cancer.

The programme offers robotic surgery using the Da Vinci Xi system for selected gynaecological cancer procedures. The Cancer Institute also has access to advanced imaging including PET-CT, CT Scan and MRI, which can support cancer diagnosis, staging and treatment assessment.

For radiation treatment, available technologies include IMRT, IGRT and 3D-CRT, while specialised brachytherapy is used for appropriate gynaecological cancers. The Varian Halcyon system combines image guidance with advanced radiation delivery techniques, including IMRT and IGRT.

Support Services During and After Treatment

Cancer treatment can affect physical health, nutrition, emotional wellbeing and daily life. Supportive services can therefore form an important part of care during treatment and recovery.

Depending on individual needs, patients can access nutrition services, physiotherapy and rehabilitation, patient and family counselling, palliative care and cancer supportive care alongside their treatment. The Cancer Survivorship Program also supports patients as they transition from active treatment to recovery and longer-term follow-up.

Genetic counselling is also available for individuals and families where an inherited cancer risk is suspected. Counselling can help patients understand genetic testing and the implications of results for their own care and family members.

Cost of Gynaecological Cancer Treatment in Mumbai

The cost of treating a gynaecological cancer varies according to the diagnosis and treatment plan. Factors that may influence the overall cost include:

• Type and stage of cancer
• Type of surgery required
• Whether surgery is open, laparoscopic or robotic
• Number of chemotherapy cycles required
• Number and type of radiation treatments
• Length of hospital stay
• Diagnostic investigations
• Additional procedures such as HIPEC or reconstructive surgery
• Supportive medicines and care required during treatment

A personalised estimate can be discussed after the diagnosis and recommended treatment plan have been assessed.

Planning Your Visit

Getting a Second Opinion

If you have already been diagnosed or advised to undergo treatment elsewhere, you can seek a second opinion from the gynaecological oncology team before making a treatment decision. This can be particularly useful when the recommended treatment is complex or when fertility or organ preservation is an important consideration.

What to Bring to Your First Appointment

If you have already undergone evaluation or treatment elsewhere, bring your previous biopsy and histopathology reports, CT, MRI or PET-CT scans and reports, records of treatment already received and a list of your current medicines. Insurance documents can also be carried if applicable.

If another doctor has referred you, bring the referral or consultation notes available to you. Having previous reports and imaging available can help the specialist review your diagnosis and treatment history more efficiently.

For Patients Travelling from Outside Mumbai

Patients travelling from outside Mumbai can use the hospital's Outstation OPD and video consultation services to connect with cancer specialists before travelling. The Cancer Institute also provides a second-opinion pathway for patients who have already received a diagnosis elsewhere.

Frequently Asked Questions

1. Why choose a dedicated gynaecological oncology programme over a general gynaecology department?

A dedicated gynaecological oncology programme focuses specifically on cancers of the female reproductive system and brings together specialists involved in surgical, medical and radiation oncology. This multidisciplinary approach can be particularly valuable when treatment involves complex surgery, multiple treatment modalities or advanced disease.

2. How can I schedule an appointment at gynaecology oncology hospital in Mumbai?

You can book an appointment online with a gynaecological oncology specialist in Mumbai through the hospital's appointment system. If you have a previous diagnosis, keep your medical reports, pathology results and imaging available for review.

3. What should I expect on my first visit?

Your gynaecologic oncologist will review your medical history, previous reports and imaging and may recommend further examination or investigations depending on your situation. If cancer has already been diagnosed, the specialist will discuss the diagnosis, stage and available treatment approaches and explain the next steps.

4. Do you treat patients travelling from outside Mumbai?

Yes. Patients travelling from outside Mumbai can use the hospital's Outstation OPD and video consultation services to connect with cancer specialists before travelling. Second-opinion services are also available for patients who have already received a diagnosis elsewhere.

5. Why should I choose a gynaecology oncology hospital in Mumbai?

Cancer hospital Mumbai is known for its advanced medical infrastructure and renowned healthcare professionals. Gynaecology oncology hospitals in Mumbai offer state-of-the-art facilities, experienced oncologists, and comprehensive care for women with gynaecological cancers. Choosing a cancer hospital in Mumbai ensures access to high-quality treatment and personalised care.