Uterine cancer has to be treated holistically: Dr. Rani A Bhat
When women are obese, it not only affects their reproductive function like irregular menstrual bleeding, they can also have difficulty to conceive and if not guided properly or advised well, these women are at the risk of developing endometrial cancer as well.
Shahid Akhter, editor, ETHealthworld spoke to Dr Rani A Bhat, head & senior consultant, division of gynaecological oncology, HCG, Bengaluru, to know more about the latest advancements in endometrial cancer care and the growing burden of obesity and its impact.
Obesity is exploding all over the world. After the USA and China, we are one of the leading countries in obesity including malnutrition, we have seen that there is a high incidence of obesity in India. Obesity is there in childhood and it is seen in adults of reproductive age group. When women are obese, it not only affects their reproductive function like irregular menstrual bleeding, they can also have difficulty to conceive and if not guided properly or advised well, these women are at the risk of developing endometrial cancer as well.
Gynae oncology: challenges
When we see young women in the reproductive age group ending up with endometrial cancer because of obesity, that is because obese women have a menstrual condition called polycystic ovarian disease which is a hormone-related condition. They will not have a menstrual cycle for three months to six months and over the period of months they can end up with uterine cancer. So these are young women who are very anxious to become pregnant and now they have landed up with uterine cancer.
When there is a high-level of fat in the body it is converted to hormones which has an effect on the uterus and causes cancer. Once the uterus has cancer, it has to come out so when I see these women, the biggest challenge I face is “will I lose a chance of being a mother because there is only one uterus and what my in-laws and society will think about it.”
Gynaeoncology: Latest advancements
Reproductive age women with obesity and uterine cancer is not just one modality kind of treatment. There are various things which we have to tackle. One that obesity is the main cause leading to endometrial cancer, second is to treat cancer, and the third is that they are very anxious to become pregnant. So is there any chance that we can fulfill that factor for that lady. When it comes to uterine cancers especially in obese women, it is not only cancer but they also have other medical conditions like high blood pressure or diabetes. With modalities that we have for cancer, we can tell the women whether we have to remove the whole of the uterus including the ovaries or only the uterus and leave behind the ovaries which give her an option later to have surrogacy.
Having a good investigation is very important prior to surgery. Today we have robotic surgery which is a blessing for the obese women, where we perform the major surgery through a tiny hole, this will help them to recover faster from the surgery and mobilise them the very next day.
Gynae oncology @ HCG
Uterine cancer has to be treated holistically. We include a dietician, a physiotherapist, and yoga to guide them about their diet and exercise post-surgery. If we do not take this part into consideration and advise women to lose weight after surgery they are at risk of developing recurrence again. We need a reproductive medicine facility also so that we can guide her to that and yes she does have an option to have her pregnancy later.