Gynaecological Oncology
Gynaecological cancers — cervical, endometrial, ovarian, vulvar and vaginal — are most treatable when detected early. At Balaji Horizon, our gynaecological oncology programme focuses on screening, early diagnosis, premalignant management, risk-reduction counselling and structured referral to high-volume tertiary oncology centres for definitive treatment. We coordinate multidisciplinary care without compromising the patient's care continuum. The programme is led by Dr. Priyadatt Patel — senior gynecologist and advanced laparoscopic surgeon — in collaboration with regional oncology, radiology and pathology partners.
Balaji Horizon is not a primary gynaecological oncology centre. Our role is structured early detection, premalignant condition management, genetic risk counselling, and seamless referral coordination with established tertiary oncology centres for any patient who requires chemotherapy, radiation, or complex oncological surgery. We believe patients benefit from continuity rather than fragmentation — we remain involved as the patient's primary gynaecologist throughout the cancer care journey.
Gynaecological cancers we screen for and detect
- Cervical cancer — the most preventable gynaecological cancer through HPV vaccination and structured screening. We follow WHO and FOGSI guidance.
- Endometrial cancer — typically presents as postmenopausal bleeding or abnormal uterine bleeding. Endometrial biopsy and transvaginal ultrasound are first-line.
- Ovarian cancer — the most lethal gynaecological malignancy because of late presentation. We use risk-stratified screening for high-risk women (BRCA carriers, Lynch syndrome, strong family history).
- Vulvar and vaginal cancers — uncommon but identifiable on careful examination. We perform colposcopy and vulvoscopy when indicated.
- Gestational trophoblastic disease — including hydatidiform mole, with structured follow-up of beta-hCG.
Cervical cancer screening
Cervical cancer is largely caused by persistent infection with high-risk HPV. With structured screening and vaccination, mortality is reduced by over 80%. Current guidance:
- Ages 9–14 (girls) — HPV vaccination, ideally before sexual debut. Two-dose schedule.
- Ages 15–26 (women) — HPV vaccination if not previously vaccinated. Three-dose schedule.
- Ages 30–65 — HPV co-testing (HPV DNA + cytology) every 5 years, or cytology alone every 3 years. FOGSI 2024 guidance.
- Ages 65+ — screening may be discontinued if prior screening has been negative.
Abnormal results are triaged by colposcopy, with directed biopsy and pathology review. Premalignant conditions (CIN 2/3) are treated by LLETZ/LEEP excision in-clinic. We do not delay treatment of high-grade lesions.
Endometrial cancer evaluation
Postmenopausal bleeding is endometrial cancer until proven otherwise. We evaluate every case with:
- Transvaginal ultrasound to measure endometrial thickness (4 mm threshold in postmenopausal women)
- Endometrial biopsy (Pipelle aspiration in-clinic for most cases)
- Hysteroscopy with directed biopsy when ultrasound or aspiration is inconclusive
- Pathology review and discussion of staging at our internal MDT
- Referral to tertiary oncology for confirmed cases requiring surgical staging, chemotherapy or radiation
Genetic risk and family history counselling
5–10% of gynaecological cancers are hereditary. Women with concerning family history (multiple primary cancers, early-onset cancers, Ashkenazi Jewish ancestry, known BRCA or Lynch syndrome in family) benefit from:
- Detailed three-generation family history
- Referral for BRCA1/BRCA2 and Lynch syndrome genetic testing
- Risk-reduction counselling — including risk-reducing salpingo-oophorectomy timing (typically age 35–40 for BRCA1, 40–45 for BRCA2)
- Personalised screening — annual transvaginal ultrasound + serum CA-125 for ovarian risk; annual endometrial biopsy for Lynch syndrome
- Fertility preservation counselling before risk-reducing surgery, where appropriate
Accurate staging at diagnosis determines treatment strategy and prognosis for all gynaecological cancers. Multidisciplinary review at a centre with high case volume is associated with better survival outcomes.
When to consult
- Any postmenopausal bleeding
- Persistent abnormal uterine bleeding
- Persistent abdominal bloating, early satiety, urinary frequency (possible early ovarian symptoms)
- Persistent pelvic pain
- Family history of breast, ovarian, endometrial or colorectal cancer
- Known BRCA, Lynch syndrome or other genetic predisposition
- Abnormal cervical screening result
- Vulvar itching, lesion or pigmentary change
Frequently asked questions
Do you treat gynaecological cancers here?
We perform screening, premalignant management, genetic risk evaluation and early-stage surgical biopsies. Definitive cancer treatment (radical surgery, chemotherapy, radiation) is performed at established tertiary oncology centres where case volume and multidisciplinary infrastructure deliver best outcomes. We coordinate the entire care journey alongside the oncology team.
Is HPV vaccination still useful after age 26?
Yes — recent guidance extends HPV vaccination benefit up to age 45. Effectiveness is highest before sexual debut, but unvaccinated women in the 27–45 age range still gain meaningful protection. Individual benefit should be discussed at consultation.
When should BRCA testing be considered?
When there is personal or family history of early-onset breast cancer (under 50), male breast cancer, ovarian cancer at any age, multiple primary cancers, triple-negative breast cancer under 60, or Ashkenazi Jewish ancestry with any breast/ovarian cancer.
Can ovarian cancer be detected early?
There is no validated population-level screening test for ovarian cancer in average-risk women. For high-risk women (BRCA carriers, Lynch syndrome, strong family history), risk-stratified screening with annual transvaginal ultrasound and CA-125 may be offered. Risk-reducing surgery is the most effective intervention in confirmed BRCA carriers.
Consult Dr. Priyadatt Patel
Senior Gynecologist · Screening · Premalignant Management · Referral Coordination
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
