Timely medical decisions shape gynaecological cancer outcomes

This article is authored by Dr Rohit Raghunath Ranade.

One important challenge in ovarian and endometrial cancers is delay in recognising symptoms, obtaining a diagnosis and initiating appropriate care. Ovarian cancer symptoms are often non-specific and may be mistaken for gastrointestinal or urinary problems, contributing to delays in diagnosis. Endometrial cancer can often present as abnormal uterine bleeding, especially after menopause, which should prompt timely medical evaluation. Early consultation, appropriate referral and specialist-led care can support more personalised treatment planning and improve patient outcomes.

Gynaecological Cancer (Image by Freepik)

In India, women’s health care decisions and access to timely care may be influenced by financial dependence, family responsibilities, social norms, limited autonomy and unequal access to health services. These barriers contribute to delays in symptom evaluation, diagnosis and treatment, including for ovarian and endometrial cancers.

For ovarian cancer, symptoms may include persistent bloating, abdominal discomfort, feeling full quickly while eating, or changes in urinary habits. For endometrial cancer, abnormal uterine bleeding, especially postmenopausal bleeding, is often an important warning sign that should not be ignored.

Bridging these gaps requires more than improving access to health care. It also requires timely evaluation, appropriate referral and early involvement of specialist teams. Gynaecological oncologists play a central role in confirming diagnosis, staging the disease and coordinating personalised treatment plans through multidisciplinary care involving medical oncologists, radiation oncologists, pathologists, genetic counsellors and specialised nurses.

For women with endometrial cancer, molecular testing, including assessment of mismatch repair status and other tumour-specific markers where appropriate, can provide valuable prognostic information and guide treatment planning.

In ovarian cancer, germline and somatic BRCA1/2 testing, along with Homologous recombination deficiency (HRD) testing can help inform treatment decisions as well as assessment of hereditary cancer risk. In appropriate cases, genetic counselling can also help family members understand potential inherited cancer risk.

Treatment options have expanded considerably, particularly for women with advanced or recurrent disease. Alongside surgery, chemotherapy and radiotherapy, selected patients may be eligible for targeted therapies, immunotherapy, maintenance treatment or clinical trials, depending on cancer type, stage, biomarker status, previous treatment and overall health.

Women and caregivers should discuss available options with the treating oncologist to understand which approach is most appropriate for their individual circumstances.

Improving outcomes in gynaecological cancers require more than medical advances alone. It calls for greater awareness, earlier recognition of symptoms, timely access to specialist care, and informed conversations about biomarker testing and treatment choices. When women are empowered to seek cancer care early and are supported throughout their treatment journey, both survival and quality of life can be improved.

Cancer care does not end when treatment is completed. Long-term follow-up, monitoring for recurrence, management of treatment-related side effects, and support for quality of life are important components of survivorship care.

(The views expressed are personal)

This article is authored by Dr Rohit Raghunath Ranade, consultant gynaecological oncologist and robotic surgeon, Mazumdar Shaw Medical Center, Narayana Health City, Bengaluru.