Gynaecological cancers were being treated in the department of Obstetrics & Gynaecology for several decades. Dr Paranjothy was interested in trophoblastic tumours and many of the stalwarts of yesteryears were well versed in radical hysterectomy for cervical cancer. Reproductive Medicine Unit separated off in 1996 but the remaining three units retained their status quo. Dr Lakshmi Seshadri had training in colposcopy in Sydney and Dr Alice George worked with Prof Margret Davies in Adelaide. The department decided on sub-specialisation and Dr Abraham Peedicayil went to the Mayo Clinic to do a fellowship in gynaecologic oncology from 2008 to 2011. The three general units were re-organised in to five functional units in December 2010. Thus OG Unit I was designated as the gynaecologic oncology unit and all women’s cancers were referred to this unit headed by Prof Alice George. Prof Lakshmi Seshadri moved in to this unit along with Drs Rachel Chandy and Anitha Thomas. Dr Abraham Peedicayil joined this unit on his return and took over the headship. After Drs Alice and Lakshmi retired, Drs Vinotha Thomas, Ajit Sebastian and Dhanya Thomas also joined as junior faculty.
The department started a 2-year institutional gynaecologic oncology fellowship in 2013 with Drs Rachel and Anitha as the first batch of fellows. This programme was upgraded to a University Fellowship in January 2015 with Drs Ajit Sebastian and Dhanya Thomas as the fellows. In order to start the MCh course the unit separated off to become a full-fledged department in July 2015. The 3-year MCh course was started in 2016 with Drs Anitha Thomas and Priya Bhati as the first batch of MCh trainees.
The department works in close collaboration with medical oncology, radiation oncology, radiology, pathology and palliative care departments. A weekly multidisciplinary meeting is held to discuss difficult cases, review the images & biopsy reports and plan treatments. Many a time, intra-operative consultations are sought from colorectal surgery, urology, vascular surgery and plastic surgery so that complex operations can be undertaken to remove all gross tumour. We have also kept up with advances in the field such as endoscopy, sentinel node mapping and hyperthermic intraperitoneal chemotherapy (HIPEC).
Regular home visits are held to follow up on patients who default treatment and to check on how they are doing after their treatments. The department now has a social worker who helps with mobilising finances, psychosexual counselling and scheduling hospital visits. We also have an oncology nurse who helps with wound care, stoma care and patient follow up. Both of them help with end of life care as well.
We also have a cancer screening clinic where early detection as well as primary prevention are emphasised. We hope to work more closely with community health departments (CHAD, RUHSA), family medicine and community nursing.
Every year, the department organises a survivor meet where cancer patients with their spouses are invited for a time of sharing, education and celebration. We believe in wholistic care and upholding the integrity and personhood of the patient.
Robotic surgery has been an unfulfilled dream. In the future, we hope to expand and consolidate our clinical services, improve our patient follow up, be involved in cancer research and be a part of a larger cancer centre in one of the new campuses.