10 July 2004	Saturday	21 Jamadi-ul-Awwal 1425

KARACHI, July 9: A meeting of Gynaecological Oncology Group on Friday called for regular checkup of elderly women who are prone to develop cancer of uterus.

The meeting, attended by senior gynaecologists as well as oncologists of the city, observed that cancer body of uterus - a disease of elderly women - is easy to be diagnosed and also holds good prognosis if reported earlier followed by immediate and proper treatment.

Dr Afshan Malik of Liaquat National Hospital, speaking on the occasion regretted that despite better chances of treatment, the aged women usually report the symptoms when the cancer may have already reached in advanced stage.

Dr Kaneez Fatima of Sindh Government Qatar Hospital said that Federation of International Obstetricians and Gynecology (FIGO) has enhanced the staging of this disease, adding that the new FIGO staging is more logical and provides more information regarding prognosis of disease.

She said that all women after menopause should report to their family physician if they experience bleeding from the genital tract. They should be thoroughly investigated to find out the causes of bleeding. The family physicians should see them with sympathy and refer them to any qualified gynecologist.

Dr. Zainab of Liaquat National Hospital said all women with the history of diabetes, hypertension and obesity must ensure regular screening as this group is at high risk to develop uterine cancer.

Dr. Sabeen Ahmed of Sindh Government Qatar Hospital said that all women with diagnosis of uterine cancer should be treated aggressively. An early laparotomy should be performed, she said, adding that all relevant examinations are including sampling from other organs as further management is dependant on the histopathology report.

According to the speaker, initial surgery is associated with good results. It was further maintained that all gynecologists must make sure that uterus and all secondary deposition with lymph nodes are adequately examined. Dr. Sabeen further mentioned that radiotherapy and chemotherapy is recommended in advanced stages of the uterus cancer.

Dr Fizza Ahsan of Liaquat National Hospital referred to possibility of the recurrence of the disease even after removal of the tumor within months to years. It was recommended that the recurrence be treated through mode of radiotherapy and at times is deemed fit in form of chemotherapy.

She strongly warned against half-hearted chemotherapy and radiotherapy mentioning that multi-disciplinary approach is recommended for better outcome. Prof. Serajuddaula Syed of Sindh Medical College said that whenever a gynecologist sends a specimen after curettage of hysterotomy, he should write a small medical history of patients. It is not a good practice to divide uterus into two pieces and send it to two different pathologists.

For proper reporting, a pathologist need the whole specimen. The initial diagnosis depends on good histopathology report and management depends on histology and the type of tumor.

He said that there are many cases where the patient died because of wrong staging and pathology of specimen. It is very helpful to pathologist if the clinical findings are known to him.

Dr Yasmin Wajahat, in her concluding remarks, emphasized that all patients with cancer need a lot of counselling and sympathetic management. Patient with advance cancer should not die in pain and must be treated with good pain-relieving drugs, she stressed. -APP