Chapter 07 — The Craft
Speciality 07 · Gynaecologic OncologyFertility conversations held early. Dignity kept throughout.
Cancers of the ovary, uterus and cervix are operated here by Dr. Harshit Patel alongside dedicated gynae-oncology colleagues — combining radical surgical training with the sensitivity these diseases and their treatments deserve, from the first question about children to the last follow-up.
Cancers of the female reproductive organs
Ovarian cancer rewards boldness: when cytoreduction removes all visible disease, survival measurably improves — which is why these operations demand stamina, patience and a team willing to work toward completeness. Uterine cancer, by contrast, is often caught early by its own warning sign, bleeding after menopause, and staged precisely with sentinel-node technique.
Cervical cancer surgery — radical hysterectomy by Wertheim’s principle — balances radicality against bladder and bowel function, because the pelvic nerves that serve them run exactly where the dissection goes.
For young women with early disease, fertility preservation is not an afterthought: selected cases can be treated while keeping the possibility of children alive, planned jointly before any operation.
And after surgery comes the part few discuss honestly — menopause arriving overnight, in a woman of thirty-five or fifty-five. Managing it well is part of this service, not someone else’s problem.
Signals women should never dismiss
Most will have innocent explanations — hormones, stress, ordinary life. Checking costs one visit; not checking can cost years.
- ①Bleeding after menopause — even one spot, even once, always checked.
- ②Bleeding between periods, or periods turned unpredictably heavy.
- ③Bloating lasting more than two weeks — especially new, persistent, unlike your normal.
- ④Persistent pelvic pain, dull or sharp, staying beyond your cycle.
- ⑤Unusual vaginal discharge — watery, blood-stained, or different in colour and smell.
- ⑥Pain during intercourse that is new rather than lifelong.
- ⑦An ovarian lump or cyst found on ultrasound — most are benign, but complex ones need expert review.
- ⑧An abnormal Pap smear or positive HPV report — needs proper evaluation, not panic.
Cancers we treat together
✳Ovarian Cancer
Optimal cytoreduction pursued deliberately — completeness is the strongest predictor we can influence.
✳Uterine & Endometrial
Staged surgically with sentinel-node technique — thorough without over-treatment.
✳Cervical Cancer
Radical hysterectomy with nerve-aware technique, coordinated with radiotherapy when indicated.
✳Vulvar Cancer
Function-preserving excision with inguinal nodal staging where required.
✳Gestational Trophoblastic Disease
Molar pregnancies managed within chemotherapy-sensitive protocols — highly curable when followed properly.
✳Fertility-Preserving Pathways
Selected early disease treated while keeping future pregnancy possible — decided jointly, early.
Dignity is not decoration. It belongs inside good medicine like suture belongs inside a wound.
Operations performed here
- ✳Staging laparotomy & laparoscopyPrecision staging — open or keyhole — so every later decision stands on solid ground.
- ✳Optimal cytoreduction for ovarian cancerSystematic removal of all visible disease, however long the careful work takes.
- ✳Radical hysterectomy (Wertheim’s)Cervical cancer cleared with parametrial tissue while protecting bladder and bowel nerves.
- ✳Pelvic & para-aortic lymphadenectomyNodal clearance performed to map extent and guide adjuvant therapy.
- ✳Sentinel node techniquesIn endometrial and vulvar cancer — full information through minimal surgery.
- ✳Fertility-preserving proceduresSelected early cases — the uterus or ovary kept when oncology safely allows it.
From first visit to full recovery
Consultation & examination
Heard fully, examined gently, explained without euphemism.
Ultrasound & markers
Imaging and blood markers build the first honest picture.
Joint planning
Operated alongside gynae-oncology colleagues — two specialities, one plan.
Surgery
Staging or cytoreduction performed to standard, not to convenience.
Adjuvant therapy when needed
Chemotherapy or radiation added only where evidence says they help.
Menopause care & survivorship
Hormone guidance, bone health, surveillance — the years after, looked after too.
Families usually ask…
No — the overwhelming majority of cysts are benign, functional and self-resolving. What raises attention is complexity on ultrasound, solid areas, rising blood markers, or persistence across cycles. Those get proper workup; simple ones get reassurance.
In selected early-stage disease, yes — fertility-preserving surgery keeps the uterus or an ovary in function, with close follow-up. It depends entirely on stage and type, which is why the conversation happens before the first operation, not after it.
Periods end; if ovaries are removed, menopause begins immediately and deserves active management — sleep, bones, mood, hormones discussed openly. Intimacy and normal activity return with healing; life continues whole.
Persistent high-risk HPV infection causes nearly all cervical cancer — which makes it one of the most preventable cancers there is. Vaccination, regular Pap/HPV screening and early treatment of precancerous change interrupt the story before cancer writes itself.
Because these operations sit at the meeting point of two crafts — radical oncological resection and deep pelvic anatomy. Joint operating brings both to the table for you, in the same theatre, under the same plan.