Guide to Gynecologic Oncology
Understand gynaecologic oncology, the speciality treating female reproductive cancers (cervical, ovarian, uterine, vaginal, vulvar). Learn about key cancer types, screening methods, risk factors, and modern treatment options like targeted therapy and immunotherapy.
Introduction
If you or someone you love has questions about gynaecologic oncology, you’re not alone. This speciality focuses on cancers of the female reproductive system—cervical, ovarian, uterine (endometrial), vaginal, and vulvar. Knowing what’s normal for your body, which symptoms matter, what screening tests can (and can’t) find earlier, and how treatment decisions get made can feel overwhelming. This guide puts everything in one place, in plain language, so you can feel prepared and empowered.
We’ll cover what gynaecologic oncology is, the main cancer types, risk factors you can change, symptoms to watch for, screening and early detection, how diagnosis and staging work, and the range of treatments available today—from minimally invasive surgery to immunotherapy. You’ll also find practical tips on fertility, sexual health, survivorship, and getting the right care team. Throughout, we include up-to-date insights from major cancer organisations and examples to help you make sense of next steps.
Consult a Top Gynaecologist for Personalised Advice
What Is Gynaecologic Oncology and Who Needs It?
This specialist field focuses on dedicated, expert care for cancers of the female reproductive system.
Gynaecologic oncology is the medical speciality devoted to diagnosing and treating cancers of the female reproductive
organs. These specialists are OB-GYNs who receive additional years of training in complex pelvic surgery,
chemotherapy, radiation coordination, and clinical trials, making them uniquely qualified to manage both cancer and
women’s health issues together.
The role of a gynaecologic oncologist vs. OB-GYN
- OB-GYNs handle routine care (Pap/HPV tests, contraception, pregnancy care) and common gynaecologic conditions.
- Gynaecologic oncologists step in when there’s a strong suspicion of cancer (e.g., a suspicious ovarian mass on
ultrasound, a biopsy showing pre-cancer or cancer) or for complex pre-cancers like high-grade cervical dysplasia.
Studies suggest outcomes improve when initial surgery for ovarian or endometrial cancer is performed by a
gynaecologic oncologist, due to accurate staging and specialised techniques.
When to seek a specialist
- You’ve had a biopsy showing cancer or high-grade pre-cancer.
- Imaging shows a complex ovarian mass, a rapidly growing fibroid-like mass, or enlarged lymph nodes.
- Postmenopausal bleeding or abnormal bleeding hasn’t been explained by the initial evaluation.
- Your doctor recommends surgery and suspects cancer may be involved.
How multidisciplinary teams work
Care is most effective when it’s team-based. A typical team includes a gynaecologic oncologist, pathologist, radiologist,
radiation oncologist, medical oncologist, genetic counsellor, fertility specialist, and supportive care (nutrition, mental
health). Weekly tumour boards review complex cases to tailor plans. This team approach ensures the right therapy at
the right time, reduces unnecessary procedures, and opens doors to clinical trials.
The Main Gynaecologic Cancers at a Glance
The types of gynaecologic cancer vary widely in origin, behaviour, and standard treatments.
Gynaecologic cancers arise in different tissues, behave differently, and are treated with different strategies.
Cervical cancer
- Starts in the cervix, almost always caused by a persistent high-risk HPV infection.
- Preventable with HPV vaccination and screening.
- Common symptoms: abnormal bleeding (especially after sex), unusual discharge, or pelvic pain.
- Treatments: surgery for early disease; chemoradiation for locally advanced disease.
Ovarian, fallopian tube, and primary peritoneal cancers
- Often grouped together; many start in the fallopian tubes.
- Frequently diagnosed at later stages because early symptoms are vague (bloating, pelvic/abdominal pain, feeling full
quickly). - Treatments: surgery and chemotherapy; targeted therapy (e.g., PARP inhibitors) for some patients, especially with
BRCA mutations.
Uterine (endometrial) cancer
- The most common gynaecologic cancer in many regions often presents early due to postmenopausal bleeding.
- Risk is linked to obesity, unopposed oestrogen, and Lynch syndrome.
- Treatments: surgery is primary; radiation, chemotherapy, hormonal therapy, and immunotherapy for higher-risk or
advanced disease.
Vulvar and vaginal cancers
- Rare; associated with HPV and age-related changes.
- Symptoms: persistent itching, pain, changes in vulvar skin, bleeding.
- Treatments: surgery, sometimes radiation and chemotherapy.
Less common: GTD and others
Gestational trophoblastic disease (e.g., molar pregnancy, choriocarcinoma) arises from pregnancy-related tissue and is
often highly curable with chemotherapy. Primary peritoneal cancer behaves like ovarian cancer and is treated similarly.
How common are these cancers?
Incidence varies by region. In the United States, uterine (endometrial) cancer is the most common gynaecologic cancer,
followed by ovarian and cervical cancers, while HPV vaccination is reducing cervical cancer among younger cohorts.
Globally, cervical cancer remains a leading cause of cancer death in women in low- and middle-income countries, underscoring the importance of vaccination and screening.
Risks You Can Change—and Those You Can’t
Knowing your risk factors can empower you to focus on effective prevention strategies.
Understanding risk helps you focus on prevention and timely checks.
- HPV, smoking, and modifiable risks
- HPV drives most cervical cancers and a portion of vaginal and vulvar cancers. HPV vaccination (ideally before sexual
debut) can prevent the majority of HPV-related cancers. - Smoking increases cervical cancer risk and impairs immune clearance of HPV.
- Obesity and diabetes increase the risk for endometrial cancer by affecting oestrogen and insulin levels.
- Long-term unopposed oestrogen (without progesterone) raises endometrial cancer risk; combination birth control pills,
however, reduce ovarian and endometrial cancer risk.
Family history and inherited syndromes
- BRCA1/2 mutations increase the risk of ovarian/fallopian tube cancer and can influence breast cancer risk. Risk-reducing salpingo-oophorectomy is often recommended after childbearing.
- Lynch syndrome (hereditary nonpolyposis colorectal cancer) increases endometrial and ovarian cancer risk. Women with Lynch syndrome may consider earlier screening and preventive surgeries.
- If multiple family members have gynaecologic or related cancers, ask about genetic counselling and testing.
Life-stage prevention roadmap
- Teens/young adults: HPV vaccination; tobacco avoidance.
- 20s–30s: Safer sex practices; Pap/HPV screening as advised; discuss contraception benefits/risks.
- 40s–50s: Maintain healthy weight; manage diabetes; know postmenopausal bleeding is never “normal.”
- 60s+: Keep up with screening recommendations and report new symptoms promptly.
Symptoms You Shouldn’t Ignore
Early detection, often through recognising persistent symptoms, is crucial for better treatment outcomes.
Most gynaecologic cancers are more treatable when caught early. Listening to your body matters.
Red flags by cancer type
- Cervical: bleeding after intercourse, bleeding between periods, persistent watery/bloody discharge with odour, pelvic
pain. - Endometrial: postmenopausal bleeding; unusually heavy or prolonged periods; spotting between periods.
- Ovarian/fallopian: persistent bloating; pelvic or abdominal pain; trouble eating/feeling full quickly; urinary
frequency/urgency; symptoms more than 12 times per month for several weeks. - Vulvar: itching, burning, pain, skin colour or texture change, lump/ulcer that does not heal.
- Vaginal: abnormal bleeding, discharge, painful intercourse.
How long to wait
If new symptoms persist longer than two weeks—especially bleeding after menopause, postcoital bleeding, or
progressive bloating/pelvic pain—don’t wait. Contact your clinician promptly. If symptoms persist beyond two weeks,
consult a doctor online with Apollo24|7 for further evaluation, or arrange an in-person gynaecologic visit if available in
your area.
Tracking symptoms
Keep a brief log:
- What the symptom is and when it started.
- Frequency (daily? weekly?), severity (0–10 scale).
- Triggers and what helps or worsens it.
- Any weight changes, fever, or fatigue.
Bringing this to your appointment speeds up evaluation.
Screening and Early Detection: What Works
While screening is highly effective for cervical cancer, there is currently no general screening for ovarian cancer.
Pap and HPV testing
- Cervical cancer screening saves lives. Depending on age and local guidelines, a Pap test every 3 years, HPV testing
every 5 years, or co-testing every 5 years are common strategies. - HPV vaccination doesn’t replace screening—continue as recommended.
- Abnormal results lead to follow-up tests like colposcopy and biopsy.
No general screening for ovarian cancer
- Currently, there’s no effective population screening test for ovarian cancer. Pelvic ultrasound and CA-125 blood tests
haven’t shown benefit for average-risk women and can lead to unnecessary procedures. - For high-risk individuals (e.g., BRCA), periodic assessments and preventive surgery are discussed with specialists.
Genetic testing and high-risk clinics
If you have a strong family history or known mutations (BRCA, Lynch), a genetic counsellor can help interpret your risk and advise on testing, preventive surgery, and tailored surveillance. Routine blood tests (like complete blood count, kidney/liver function) are often part of baseline assessments; Apollo24|7 offers convenient home collection for tests such as complete blood count or liver and kidney function to support care coordination. Note: CA-125 is generally used for monitoring, not routine screening.
From Suspicion to Diagnosis: Tests and Staging
Accurate diagnosis and staging are essential steps, determining the extent of the cancer and the subsequent treatment
plan.
Initial evaluation
- Clinical exam: A pelvic exam assesses the cervix, uterus, ovaries, and vaginal/vulvar tissues.
- Imaging: Transvaginal ultrasound for uterine or ovarian issues; MRI helps define soft tissue; CT scans assess spread to
abdomen/pelvis or lungs; PET/CT may be used in select cases. - Biopsies: Cervical colposcopy-guided biopsy; endometrial biopsy for abnormal bleeding; dilation and curettage (D&C)
when needed; needle biopsy of suspicious lymph nodes or masses. Procedures like LEEP or cone biopsy may be both
diagnostic and therapeutic for cervical pre-cancer.
Staging
Cancers are staged using the FIGO system:
- Stage I: Confined to the organ (e.g., cervix, uterus, ovary).
- Stage II: Spread to adjacent structures (e.g., cervix to upper vagina).
- Stage III: Spread to regional tissues/nodes.
- Stage IV: Distant spread (e.g., liver, lungs).
Accurate staging often requires surgery. For ovarian cancer, staging includes sampling of lymph nodes, omentum, and
peritoneal surfaces.
Pathology and biomarkers
Pathology reports classify tumour type and grade. Biomarkers guide therapy:
- BRCA1/2 and homologous recombination deficiency (HRD) for ovarian cancers (impacts PARP inhibitor use).
- Mismatch repair deficiency (dMMR)/microsatellite instability (MSI-H) in endometrial cancers (impacts
immunotherapy). - PD-L1 status in cervical cancer can guide immunotherapy choices.
Ask your team whether tumour profiling is appropriate for you.
Treatments Explained: Surgery, Radiation, Medicines
Treatment plans are highly personalised and may combine surgery, radiotherapy, chemotherapy, and newer targeted
therapies.
Surgery
- Minimally invasive approaches (laparoscopy/robotic) reduce recovery time for many endometrial and early ovarian
procedures. - Fertility-sparing options may be possible in select early cervical or endometrial cancers (e.g., radical trachelectomy for
early cervical cancer; hormonal therapy with close monitoring for atypical hyperplasia or early endometrial cancer). - For advanced ovarian cancer, either primary debulking surgery or neoadjuvant chemotherapy followed by interval
debulking may be recommended; complete or near-complete tumour removal improves outcomes.
Radiation therapy
- External beam radiation therapy (EBRT) and brachytherapy (internal radiation) are commonly used for cervical and
endometrial cancers—sometimes alone, often with chemotherapy (chemoradiation). - Side effects can include fatigue, bowel/bladder changes, and skin irritation. Pelvic floor therapy and dietary adjustments
can help.
Systemic therapies: chemo, targeted, immunotherapy
- Chemotherapy remains the backbone for ovarian and advanced cervical/endometrial cancers. Common agents include carboplatin and paclitaxel.
- Targeted therapy:
- PARP inhibitors (e.g., olaparib, niraparib) can extend remission in BRCA-mutated or HRD-positive ovarian cancers.
- Bevacizumab (anti-angiogenic) may be used in ovarian and cervical cancers.
- Immunotherapy:
- Pembrolizumab and other PD-1 inhibitors may benefit PD-L1–positive cervical cancer and dMMR/MSI-H endometrial
cancers.
- Pembrolizumab and other PD-1 inhibitors may benefit PD-L1–positive cervical cancer and dMMR/MSI-H endometrial
Ask about clinical trials; many promising combinations are being studied.
Side effects and supportive care
- Common: fatigue, nausea, hair loss, neuropathy, early menopause.
- Support: anti-nausea meds, scalp cooling for hair preservation in some settings, neuropathy prevention strategies, bone
health monitoring, and mental health support. If your condition does not improve after trying recommended supportive measures, book a physical visit to a doctor with Apollo24|7 or your local oncologist for further evaluation.
Living Well: Survivorship, Fertility, and Support
Managing life after treatment involves ongoing monitoring and supportive care for long-term health.
Follow-up care and recurrence signs
- After treatment, follow-up visits are typically every 3–6 months initially, then less frequent over time, varying by cancer
type and stage. - Watch for new or returning symptoms (e.g., bleeding, bloating, persistent pelvic/abdominal pain, unexplained weight
loss) and report promptly.
Sexual health, menopause, and pelvic floor care
- Cancer treatment can affect libido, lubrication, and comfort. Non-hormonal lubricants and moisturisers, vaginal dilators
after pelvic radiation, and pelvic floor physical therapy may help. - Discuss menopausal symptoms (hot flashes, vaginal dryness); non-hormonal options exist, and in select cases, local
oestrogen may be considered with oncologist guidance.
Fertility and family planning
- Before treatment, ask about fertility preservation: egg/embryo freezing, ovarian tissue freezing, or ovarian transposition
before pelvic radiation. - Fertility-sparing surgeries are possible in selected cases; multidisciplinary care with a reproductive endocrinologist helps
optimise outcomes.
Lifestyle, mental health, and community
- Exercise and nutrition can support energy and recovery; a Mediterranean-style diet is often recommended for overall
health. - Anxiety and depression are common; counselling, support groups, and mind-body practices (e.g., mindfulness, yoga)
can help. - Consider telehealth for some follow-ups; Apollo24|7 or similar services can coordinate check-ins and routine labs at
home to reduce travel burden.
Conclusion
Gynaecologic oncology brings together expertise in women’s health and cancer care to treat complex conditions with precision and compassion. While hearing the word “cancer” is frightening, many gynaecologic cancers can be prevented, found early, or treated effectively—especially when you understand your risks, keep up with screening, and act on persistent symptoms. Today’s treatments go beyond traditional surgery and chemotherapy to include targeted and immune-based therapies tailored to tumour biology, offering more options than ever before.
If you’re navigating new symptoms, a recent abnormal test, or a diagnosis, remember you’re not alone. Build a team that includes a gynaecologic oncologist, ask about genetic testing when appropriate, and consider supportive care from nutrition to mental health. For quick questions, second opinions, or to coordinate routine labs, online services like Apollo24|7 can streamline next steps. Most of all, listen to your body and speak up—early action often makes the biggest difference. Your health journey is personal, and with the right information and support, you can move forward with clarity and confidence.
Consult a Top Gynaecologist for Personalised Advice
Consult a Top Gynaecologist for Personalised Advice
Dr. Revathi S Rajan
Obstetrician and Gynaecologist
24 Years • MBBS, DGO, DNB.FFMM
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Kolkata
Dr Utsa Basu Clinic, Kolkata
Dr. Navin Srinivasan
Gynaecological Oncologist
9 Years • MBBS, MS DNB(OBS-GYNAE), MCH (GYNAE ONCOLOGY)
Bengaluru
Apollo Clinic Mahadevapura, Bengaluru
Dr. Prashant Chandra Das
Surgical Oncologist
15 Years • MBBS (MKCG Medical college) MCh (Surgical Oncology, Kidwai memorial institute of Oncology, Bangalore) MS (General Surgery, BHU Varanasi) Fellowship in Minimal Access Surgery ( FMAS). ESSO Course On Minimally Invasive Esophagectomy & Gastrectomy (UMC, Utrecht, Netherlands). Trained in Robotic and Laparoscopic Cancer Surgery.
Bhubaneswar
Apollo Hospitals Old Sainik School Road, Bhubaneswar
(25+ Patients)
Consult a Top Gynaecologist for Personalised Advice
Dr. Revathi S Rajan
Obstetrician and Gynaecologist
24 Years • MBBS, DGO, DNB.FFMM
Bengaluru
Apollo Clinic, JP nagar, Bengaluru
Dr. Rupam Manna
Radiation Specialist Oncologist
4 Years • MBBS MD(RADIO THERAPY)
Barasat
Diab-Eat-Ease, Barasat
Dr. Sreeparna Roy
Obstetrician and Gynaecologist
8 Years • MBBS , MS (OBSTETRICS & GYNAECOLOGY), Fellowship in Infertility, Endoscopy & Ultrasonography), Fellowship in Laparoscopy & Hysteroscopy,DRM
Kolkata
Dr Utsa Basu Clinic, Kolkata
Dr. Navin Srinivasan
Gynaecological Oncologist
9 Years • MBBS, MS DNB(OBS-GYNAE), MCH (GYNAE ONCOLOGY)
Bengaluru
Apollo Clinic Mahadevapura, Bengaluru
Dr. Prashant Chandra Das
Surgical Oncologist
15 Years • MBBS (MKCG Medical college) MCh (Surgical Oncology, Kidwai memorial institute of Oncology, Bangalore) MS (General Surgery, BHU Varanasi) Fellowship in Minimal Access Surgery ( FMAS). ESSO Course On Minimally Invasive Esophagectomy & Gastrectomy (UMC, Utrecht, Netherlands). Trained in Robotic and Laparoscopic Cancer Surgery.
Bhubaneswar
Apollo Hospitals Old Sainik School Road, Bhubaneswar
(25+ Patients)
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Frequently Asked Questions
1) What are the early signs of ovarian cancer?
Common early signs include persistent bloating, pelvic or abdominal pain, feeling full quickly, and needing to urinate more often. If these symptoms occur more than 12 times in a month, talk to your doctor. There is no general screening test for ovarian cancer, so recognising symptoms matters.
2) Do I still need Pap or HPV tests if I got the HPV vaccine?
Yes. The HPV vaccine is highly effective but doesn’t cover all high-risk HPV types. Continue cervical cancer screening (Pap/HPV testing) according to guidelines recommended by your doctor.
3) Is CA-125 a screening test for ovarian cancer?
No. CA-125 is not recommended for general screening. It may be used to monitor treatment or recurrence, or alongside imaging in certain situations. Discuss tests and their limits with your gynaecologic oncologist.
4) Can I preserve fertility if I have a gynaecologic cancer diagnosis?
In some early-stage cases (e.g., certain cervical or endometrial cancers), fertility-sparing options or fertility preservation (egg/embryo freezing) may be possible. Ask for a referral to a reproductive specialist before starting treatment.
5) When should I see a gynaecologic oncologist?
If you have a biopsy showing cancer or high-grade pre-cancer, a suspicious ovarian mass, or unexplained postmenopausal bleeding, ask for a referral. Seeing a gynaecologic oncologist early can improve staging accuracy and outcomes.