Gynaecological Oncology: Modern Methods for the Diagnosis and Treatment of Gynaecological Cancers

Gynaecological oncology is the subspecialty of gynaecology dedicated to the prevention, diagnosis, surgical treatment and comprehensive management of cancers of the female reproductive system.

Gynaecological oncologists are specialised physicians who receive advanced training in both gynaecological surgery and oncology, allowing them to provide comprehensive management of these complex conditions.

This specialised approach is particularly important, as accurate staging of the disease and the selection of the most appropriate treatment can significantly influence the course of the disease and patient survival.

Gynaecological cancers affect different organs of the female reproductive system and present with varying characteristics and treatment needs.

Cervical Cancer

Cervical cancer is strongly associated with infection by the human papillomavirus (HPV). The disease can largely be prevented through regular gynaecological screening with Pap smear (Pap test) and HPV testing, which allow the detection of precancerous changes before they develop into cancer.

Endometrial Cancer

Endometrial cancer is one of the most common gynaecological cancers and occurs most frequently after menopause. A common symptom is abnormal vaginal bleeding, which should always be evaluated by a specialist.

Ovarian Cancer

Ovarian cancer is often referred to as a “silent cancer”, as early symptoms may be mild and non-specific. Abdominal bloating, pelvic pressure, or changes in bowel habits may represent early signs that require medical assessment.

Vulvar and Vaginal Cancer

Vulvar and vaginal cancers are less common but also require specialised diagnosis and treatment.

Prevention and early diagnosis are key factors in the successful management of gynaecological cancers.

Regular gynaecological examinations can detect abnormalities even before symptoms appear. Key preventive examinations include:

• Pap smear (Pap test)
• HPV testing

• Pelvic ultrasound
• Gynaecological clinical examination

Early diagnosis allows treatment at an early stage of the disease, significantly increasing the chances of successful therapy.

The treatment of gynaecological cancers is based on a personalised approach that takes into account:

• the type of cancer
• the stage of the disease
• the patient’s overall health
• the woman’s reproductive wishes

The main treatment options include:

Surgical Treatment

Surgery is often the primary treatment for many gynaecological cancers. The goal of surgery is the complete removal of the tumour and accurate staging of the disease.

In recent years, minimally invasive techniques have significantly changed surgical practice.

Laparoscopic and Robotic Surgery

Laparoscopic and robotic surgery allow complex procedures to be performed through small incisions, offering several advantages for patients:

• reduced blood loss
• less postoperative pain
• faster recovery
• shorter hospital stay

Robotic surgery also provides greater precision of movement and improved visualisation of the surgical field, which can be particularly important in oncological procedures.

Chemotherapy and Radiotherapy

In some cases, surgical treatment is combined with chemotherapy or radiotherapy, either before or after surgery, in order to reduce the risk of cancer recurrence.

The most appropriate treatment combination is determined individually for each patient.

Targeted Therapies and Immunotherapy

In recent years, the development of targeted therapies and immunotherapy has opened new possibilities in the treatment of certain gynaecological cancers.

These treatments target specific mechanisms involved in the growth of cancer cells, helping to improve treatment outcomes.

The management of gynaecological cancers often requires collaboration between a multidisciplinary medical team, which may include:

• gynaecological oncologists
• medical oncologists
• radiation oncologists
• radiologists
• pathologists

Collaboration between specialists allows a comprehensive evaluation of the disease and the selection of the most appropriate treatment strategy.

After completion of treatment, regular oncological follow-up is essential.

Follow-up appointments may include clinical examination, imaging tests and laboratory investigations, depending on the type and stage of the disease.

Appropriate follow-up helps ensure early detection of possible recurrence and the maintenance of the patient’s overall health.