I would assume that in a tertiary referral centre, in a place that I work at, the majority of patients are not cervical cancer that come to us. I would presume that around 20-30% of the patients that attend the surgical department is cervix and the rest is ovary and uterus. The cervical cancer patients that come to us are more advanced cases which have already spread from the cervix to the nearby structures. The few that are restricted or confined within the cervix are the ones that we can consider surgery for and the rest we would consider for radiotherapy with or without chemotherapy.

What surgical options do you have?

The surgical options for cervical cancer can range from a loop biopsy all the way to removal of the uterus with nearby structures. This can be done by an open technique, a laparoscopic technique and now, with the recent innovation, a robotic technique.

What are the results and costs using surgical treatment?

The laparoscopic and robotic surgery route would have the best effect on patients because the morbidity and the hospital stay are much lower, post-operative pain is much lower. But they are expensive and they require sophisticated infrastructure compared to the open technique.

With an increase in screening, you are starting to train more surgeons in the field?

In our hospital we have a training programme, a Fellowship programme, for gynae-onco surgery where the trainees get trained in cervical cancer as well as other organs, the surgeries involved, the screening techniques involved.

How do multidisciplinary meetings work at your hospital?

The surgical team, the gynae-onco surgical team, is just a part of the gynaecological disease management group. The other components of the group are radiation oncology, medical oncology then we have the pathology and the radiology. All together they consist of the disease management group in gynae cancer and every decision is taken after a meeting, a discussion of the patient records and everything.