siliconindia | | APRIL 202519training, making it difficult for general gynecologists to perform them without further specialization. In regions lacking Gynecological Oncologists, general gynecologists may collaborate with other surgical specialists. However, extensive research consistently indicates that patients with gynecological cancer have significantly better outcomes when treated by a Gynecological Oncologist.The Intrinsic Approach to TreatmentDr Neha says, "Multidisciplinary treatment and care for cancer patients are essential, hence all healthcare professionals involved in a patient's care must agree on a treatment plan. This collaboration helps determine whether surgery or chemotherapy should be performed first, especially in cases like advanced ovarian cancer. Surgical procedures may also require follow-up treatments such as radiation or chemotherapy. To facilitate this process, we hold regular meetings with a multidisciplinary tumor board that includes gynecologists, medical oncologists, radiation oncologists, radiologists, nuclear medicine experts, and pathologists".As a surgeon focused on ovarian cancer, she has seen significant advancements in radical surgeries, shifting from chemotherapy-first approaches to extensive surgeries aimed at complete disease removal. One key development is HIPEC (Hyperthermic Intraperitoneal Chemotherapy), which improves survival rates by circulating heated chemotherapy in the abdomen post-surgery. Today there is also comprehensive testing available for genetic abnormalities in ovarian cancer patients, benefiting about 20 percent of the Indian population with targeted therapy. In endometrial cancer, sentinel lymph node biopsies are replacing complete lymph node dissections to reduce complications, and there have been improved survival rates in advanced and recurrent cases with immunotherapy. For cervical cancer, prevention through routine screening and HPV vaccination is emphasized. Advancements in radiation therapy have also improved tumor control while minimizing side effects.It is essential to adopt a patient-centric approach when treating cancer patients, as each patient is unique. Treatment must be individualized based on the specific tumor biology of every patient. Dr Neha states, "When discussing a patient-centric approach, it is crucial to inform all patients about their disease, its extent, the prognosis, and the available treatment options. This is not simply a matter of saying, `Do this, there are no other options'. Clear communication is vital in this context. When a patient arrives at our care, addressing her nutritional needs throughout her treatment, whether it involves surgery, chemotherapy, radiotherapy, or a combination of these modalities, is equally important. We place substantial emphasis on the patient's nutritional, psychological, and emotional well-being, involving clinical psychologists to support both the patient and her family during this stressful time. While it is important to avoid giving false hopes, we should also refrain from presenting an excessively bleak outlook, since there have been significant advancements in cancer treatment. Another crucial aspect of care is rehabilitation which is crucial in the recovery of patients undergoing extensive cancer surgeries".Technological Side of TreatmentArtificial Intelligence (AI) is a useful tool in the arsenal of an oncologist. In situations where the expertise of a seasoned radiologist or pathologist is not available, AI can assist by screening the patients. However, it is essential to interpret its results with caution, and the expertise of the treating oncologist remains paramount. Dr Neha is a certified robotic surgeon, and robotic surgery is an extremely advanced tool that assists surgeons in the surgical management of patients with early-stage endometrial carcinoma, select cases of ovarian cancer, and occasionally for suspicious ovarian masses that need to be removed and sent for analysis during surgery. Additional benefits of robotic surgery include less blood loss, shorter post-operative hospital stays, quicker patient recovery, and reduced post-operative pain, infections, and less likelihood of hernias. The role of a Gynecological Oncologist can be emotionally draining, especially when they come across patients with advanced cancers, some of whom cannot be saved, but Dr Neha finds strength in reminding herself that she does everything possible for the patient and that she does it sincerely. She says, "The greatest satisfaction in this field comes when I can cure a patient or at least alleviate the suffering of a cancer patient, watching them leave healthy and return to me with a smile. That, to me, is the most significant accomplishment anyone can achieve".Future PlansTrends in gynecological oncology are shifting towards specialized and personalized care, emphasizing on tailored treatments rather than a one-size-fits-all approach. Additionally, advancements in this field focus on radical and ultra-radical surgeries when necessary, and avoiding them when they are not required. This strategy aims to maximize cure rates while minimizing morbidity, allowing for de-escalation of unnecessary treatments and escalation when essential.She concludes, "My approach emphasizes treating all aspects of a patient's well-being, rather than concentrating solely on the disease itself. Ultimately, my goal is to heal the patient as a whole, and not just the disease". TOP 10PROMINENTONCOLOGISTS IN INDIAGYNECOLOGIC2025
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