Interview with Dr. Richa Bansal

She completed her M.B.B.S from Padma Shri DY Medical College & her M.S from Lokmanya tilak Medical College & Hospital. And further pursued her Doctorate from Tata Memorial Hospital, Mumbai. She is one of the key opinion leaders in her field among the medical community. Her surgical expertise is performing all the supra major gynecological, oncological procedures including open laparoscopic & robotic surgeries for gynecological cancers. In general words, She treats the cancer of the Ovary, cancer of the uterus, basically Cancer of all genetics & she has a special interest in treating gynecological cancer, especially in young women. She has also conducted a lot of awareness sessions for the prevention of Cancer & spreading awareness about cancer & common symptoms of cancer & how can women prevent it. 

What are some common gynecological cancers that you come across in young women in India? 

Earlier Cancer used to happen only at elderly age but now at times, it's happening to younger women as well. It’s mainly because of lifestyle changes. For example, cancer of the uterus were generally in old women but these days it’s also in younger women. Maybe the reason is Obesity, PCOS, Infertility, Delaying first childbirth beyond 35 years of age, and less number of children; because breastfeeding protects cancer of the uterus & cancer of the Ovary. With the changes in our social & cultural practices, younger women also now have cancer. Some cancers happen in younger women like the Germ cell tumor of the Ovary, and cervical cancer. 

What are some early signs & symptoms that women need to watch out for? 

Early signs especially for gynecological Cancer are abnormal vaginal bleeding, changes in your regular periods, vaginal discharge, Constipation, loose motion, unexpected weight loss, and loss of appetite. For Breast Cancer, the feeling of lump or pain in the breast, changes in the appearance of the breast or nipple are signs & symptoms which requires attention.

What are the other self-examination or examinations for the detection of cancer at an earlier stage? 

Cervical cancer is the second most common cancer that happens to women in India after breast cancer. Screening tests help in preventing it. The screening for Cervical Cancer is most recommended by international societies & women must go for screening from the age of 35-65. There are two tests; Pap tests and the HPV test. These tests are available in metropolitan cities. If one is doing a Pap test then it should be conducted every 3 years & if one is doing both the Pap & HPV test then it should be 5 years. The period between the two tests is from 3-5 years.

For Breast Cancer, yearly mammography after 45 years of age, and self-examination after 30 years of age, almost once in a month.

For the cancer of the uterus, there is no particular screening test for women. But if there is any abnormal bleeding after the age of 40 immediate consultation is necessary. A proper biopsy is necessary rather than curing it with medicines. Post-menopausal bleeding i.e. any bleeding after menopause is abnormal & should seek medical attention. 

In the case of Ovarian Cancer, there is no screening test. Symptoms like abnormal abdominal pain, constipation, loose motion, and abdominal fullness is important. If these things are persistent then consult a doctor. 

How effective are the vaccines of cervical cancer in prevention at a later stage? 

1 woman dies every 8 mins because of Cervical Cancer. Daily 350 women die of cervical cancer. The main cause is a genital infection caused by the virus called Human papillomavirus(HPV) which is sexually transmitted. 90% of couples will get clear of the infection from genital areas in 6 months to one year but in a few 5-10% this remains persistent. The safety & efficiency of the vaccines in preventing Cervical Cancer has been proven worldwide. Scientific data has stated that these vaccines are safe & very preventive in Cervical cancer. The ideal age for this vaccine is 10-15 years. A woman can receive a vaccine any time before marriage. The women should also undergo screening. Vaccines are easily available. 

Is there enough awareness among people regarding vaccines? 

Doctors are conducting many awareness programs for creating awareness, and a lot of hospitals conduct free checkups. Awareness is less among people. We can use social media for creating awareness. The cost of the vaccine is around 2500-3000. The state of Punjab & Sikkim has these vaccines in their school health program so that young girls can get them. 

How important is family history in gynecological cancer? 

Breast Cancer & Ovarian Cancer are most likely to be hereditary. Almost all 15-20% of ovarian cancer & 10% of breast cancer are hereditary. It's important to know the family history for the treatment. It is called hereditary cancer syndrome. A blood test of the close relatives of the patient and doctors can offer them certain interventions like removal of both ovaries, hormonal medications, and mastectomy. The characteristic of this cancer is that they occur at a younger age compared to the general age. It's important to conduct these tests. 

Why should women prefer gynecological oncologists rather than their regular gynecologists? 

Training is an important factor. The oncologists are trained about the disease and the treatment required. Oncologists know the basic nature of cancer. They will remove other structures such as lymph nodes to remove the risk of spreading. 

In Ovarian Cancer, it requires major hydro reductive surgery for all the tumors to be removed. Any tumor left behind in the surgery can adversely affect the survivor. Gynecologists have been trained in minimal access surgeries for cancer of the uterus. The patients get the benefit of Key-hole Surgery by gynecologists. 

What are some common myths that women have? 

There are many myths related to mensuration, religious beliefs, and hygiene. 

A lot of awareness sessions & counseling are necessary. Only then discussing the problems in the family would become normal & probably they would seek help earlier. 

There was a big social issue where the daughter of the survivor could not find a guy for her marriage because of stereotypes related to cancer. 

A myth is that Cancer is incurable. The treatment makes it even worse. It’s not like that. A lot of advancements are now available and patients are treatable. A lot of cancer is curable.