Overview of Gynaecological Cancers
Consultant Gynaec Oncology and Gynaecology Laparoscopic and Robotic Surgery
Fortis Hospital, CG Road, Bangalore
April 26, 2026
Dr. Punyashree R M, Consultant Gynaecologic Oncology and Gynaecology Laparoscopic and Robotic Surgery at Fortis Hospital, Bangalore, walks through cervical, endometrial, ovarian and vulvar cancer: aetiology, prevention, diagnosis, staging and management, including India's low-cost HPV vaccine and sentinel lymph node mapping technique.
Questions Doctors Asked Dr. Punyashree R M
Real questions from the live masterclass, answered by Dr. Punyashree R M, Consultant Gynaec Oncology and Gynaecology Laparoscopic and Robotic Surgery.
What are the preventive measures for PCOS?
Asked by Dr. Innocent (Kenya)
PCOS is a lifestyle disease. If you correct the lifestyle, your hormones should be under control. We explain to patients what's causing the imbalance rather than putting them on hormonal pills upfront, and give them 3 to 4 months to work on diet, exercise, stress management and sleep, alongside antioxidant medications. 60 to 70 percent of our patients come back at the end of 3 months saying they're having regular cycles.
— Dr. Punyashree R M
Is fertility-sparing treatment appropriate for ovarian cancer?
Asked by Dr. Tiffle
Fertility-sparing treatment is done only if the lady desires fertility, the disease is early, confined to one single ovary, with no peritoneal deposits and no malignant cells in the ascites. Even at stage 1B we'd do a diagnostic laparoscopy to check the other ovary, because imaging might miss small deposits. For germ cell tumours we always do fertility-sparing surgery because they're highly chemosensitive; for other tumours the decision has to be tailor-made.
— Dr. Punyashree R M
How do we manage advanced stage cervical cancer?
Asked by Dr. Kifle (Ethiopia)
If it's an advanced stage, stage 3 or 4, treatment is usually chemotherapy with radiation therapy. Squamous cell carcinomas are radiosensitive, and chemotherapy is given as a radiosensitiser to get a better response. If there's stage 4 disease with distant metastasis, systemic therapy is needed. Even after this, if there's residual disease and the patient's performance status is good, we'd still go back and remove the residual disease.
— Dr. Punyashree R M
Which technique do you recommend for sentinel lymph node biopsy?
Asked by Dr. Isaya (Tanzania)
We use ICG dye and do the procedure robotically or laparoscopically with a 4K camera using the Firefly technique. We always open the retroperitoneal spaces first and get everything ready before injecting, because if there's bleeding during dissection after injecting, you won't be able to locate the sentinel node properly. If you're implementing this for the first time, do a pilot study of at least 25 cases each for endometrial and cervical cancer before using it as your standard method.
— Dr. Punyashree R M
What are the post-operative morbidities associated with radical hysterectomy with lymph node dissection?
Asked by Dr. Isaya (Tanzania)
The most common complication is urinary issues, in about one or two out of every hundred patients we operate on, because we try carefully to identify and spare the inferior hypogastric nerve. Unlike axillary lymph node dissection, we don't see lymphoedema with the same frequency after pelvic lymph node dissection. We also follow the ERAS protocol, enhanced recovery after surgery, ambulating the patient the same day and starting oral intake within hours.
— Dr. Punyashree R M
Read the Full Article Series
- 1.Overview of Gynaecological Cancers: A Complete Guide
- 2.Cervical Cancer: The Only Cancer That Can Be Eliminated Worldwide
- 3.Why India's HPV Vaccine Costs a Fifth of Gardasil
- 4.Reading an Abnormal Pap Smear: When to Biopsy, When to Just Watch
- 5.Endometrial Cancer Is the Fastest-Rising Cancer in the World
- 6.The Molecular Subtypes That Now Decide Endometrial Cancer Treatment
- 7.When an IVF Patient's Endometrial Biopsy Comes Back Abnormal
- 8.Ovarian Cancer: Why It's Called the Silent Killer
- 9.Why Tubal Ligation Cuts Ovarian Cancer Risk by 64%
- 10.Fertility-Sparing Surgery for Ovarian Cancer: Who Actually Qualifies
- 11.Vulvar Cancer: A Diagnosis Many Women Delay Reporting
- 12.How Sentinel Lymph Node Mapping Actually Works
- 13.Why Nerve-Sparing Radical Hysterectomy Has Fewer Complications Than You'd Expect
Book a Consultation with Dr. Punyashree R M
Book on WhatsAppOr message us on WhatsApp: +91 98182 98669