India has made significant progress in healthcare over the years, but there are still concerning disparities in women’s healthcare. One of the critical health issues affecting women today is gynecological cancers, which greatly impact their quality of life. Fortunately, advancements in interdisciplinary and interprofessional care over the past few decades have significantly improved the average life expectancy of patients with these cancers. Amongst many gynecological oncologists who are dedicated to providing essential care and support to women diagnosed with gynecological cancers, Dr Neha Kumar, Senior Gynec Oncologist, Amrita Hospital Faridabad is one of the coveted leaders who notably draws attention.

The Professional Trajectory
Dr Neha Kumar has a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree from Maulana Azad Medical College in New Delhi, where she received the Best MBBS Student Award. Then, she pursued a Master’s degree in Obstetrics and Gynecology at the University College of Medical Sciences in New Delhi, followed by a super specialization in Gynecological Oncology (M.Ch) at Tata Memorial Hospital in Mumbai. Since that time, she has dedicated her practice exclusively to Gynecological Oncology, focusing on the management and treatment of gynecological cancers.

Her commitment to becoming a Gynecological Oncologist stems from the necessity of specialized training, that is vital for effective practice today. Gynecological Oncologists undergo three years of dedicated training on gynecological cancers, covering both the medical aspects and complex surgical procedures vital for patient care, such as bowel resections and peritoneal excisions. These advanced techniques are not typically included in standard OBGYN residency training, making it difficult for general gynecologists to perform them without further specialization. In regions lacking Gynecological Oncologists, general gynecologists may collaborate with other surgical specialists. However, extensive research consistently indicates that patients with gynecological cancer have significantly better outcomes when treated by a Gynecological Oncologist.

The Intrinsic Approach to Treatment
Dr Neha says, “Multidisciplinary treatment and care for cancer patients are essential, hence all healthcare professionals involved in a patient’s care must agree on a treatment plan. This collaboration helps determine whether surgery or chemotherapy should be performed first, especially in cases like advanced ovarian cancer. Surgical procedures may also require follow-up treatments such as radiation or chemotherapy. To facilitate this process, we hold regular meetings with a multi disciplinary tumor board that includes gynecologists, medical oncologists, radiation oncologists, radiologists, nuclear medicine experts, and pathologists”.

As a surgeon focused on ovarian cancer, she has seen significant advancements in radical surgeries, shifting from chemotherapy-first approaches to extensive surgeries aimed at complete disease removal. One key development is HIPEC (Hyperthermic Intraperitoneal Chemotherapy), which improves survival rates by circulating heated

chemotherapy in the abdomen post-surgery. Today there is also comprehensive testing available for genetic abnormalities in ovarian cancer patients, benefiting about 20 percent of the Indian population with targeted therapy. In endometrial cancer, sentinel lymph node biopsies are replacing complete lymph node dissections to reduce complications, and there have been improved survival rates in advanced and recurrent cases with immunotherapy. For cervical cancer, prevention through routine screening and HPV vaccination is emphasized. Advancements in radiation therapy have also improved tumor control while minimizing side effects.

It is essential to adopt a patient-centric approach when treating cancer patients, as each patient is unique. Treatment must be individualized based on the specific tumor biology of every patient. Dr Neha states, “When discussing a patient centric approach, it is crucial to inform all patients about their disease, its extent, the prognosis, and the available treatment options. This is not simply a matter of saying, ‘Do this, there are no other options’. Clear communication is vital in this context. When a patient arrives at our care, addressing her nutritional needs throughout her treatment, whether it involves surgery, chemotherapy, radiotherapy, or a combination of these modalities, is equally important.

We place substantial emphasis on the patient’s nutritional, psychological, and emotional well-being, involving clinical psychologists to support both the patient and her family during this stressful time. While it is important to avoid giving false hopes, we should also refrain from presenting an excessively bleak outlook, since there have been significant advancements in cancer treatment. Another crucial aspect of care is rehabilitation which is crucial in the recovery of patients undergoing extensive cancer surgeries”.

Dr Neha’s approach emphasizes treating all aspects of a patient’s well-being, rather than concentrating solely on the disease itself

Technological Side of Treatment
Artificial Intelligence (AI) is a useful tool in the arsenal of an oncologist. In situations where the expertise of a seasoned radiologist or pathologist is not available, AI can assist by screening the patients. However, it is essential to interpret its results with caution, and the expertise of the treating oncologist remains paramount. Dr Neha is a certified robotic surgeon, and robotic surgery is an extremely advanced tool that assists surgeons in the surgical management of patients with early-stage endometrial carcinoma, select cases of ovarian cancer, and occasionally for suspicious ovarian masses that need to be removed and sent for analysis during surgery. Additional benefits of robotic surgery include less blood loss, shorter post-operative hospital stays, quicker patient recovery, and reduced post-operative pain, infections, and less likelihood of hernias.

The role of a Gynecological Oncologist can be emotionally draining, especially when they come across patients with advanced cancers, some of whom cannot be saved, but Dr Neha finds strength in reminding herself that she does every thing possible for the patient and that she does it sincerely. She says, “The greatest satisfaction in this field comes when I can cure a patient or at least alleviate the suffering of a cancer patient, watching them leave healthy and return to me with a smile. That, to me, is the most significant accomplishment anyone can achieve”.

Future Plans
Trends in gynecological oncology are shifting towards specialized and personalized care, emphasizing on tailored treatments rather than a one-size-fits-all approach. Additionally, advancements in this field focus on radical and ultra-radical surgeries when necessary, and avoiding them when they are not required. This strategy aims to maximize cure rates while minimizing morbidity, allowing for de-escalation of unnecessary treatments and escalation when essential.

She concludes, “My approach emphasizes treating all aspects of a patient’s well-being, rather than concentrating solely on the disease itself. Ultimately, my goal is to heal the patient as a whole, and not just the disease”.

Awards & Certificates
•Dr K.C. Goyal Award (Gold Medal) for Best M.B.B.S. Student
•Lt. Governor’s Rolling Trophy for Best All Round M.B.B.S. Student
•Gold Medals in Anatomy, Physiology, Second Professional, Microbiology, Third Professional, Pediatrics, ENT
•Kusum Pandit Award for Best Thesis in college, entitled “Comprehensive
Evaluation of women with Recurrent Pregnancy Loss: a search for multifactorial etiology”
•Third Prize for poster entitled “Retrospective review of patients with early stage adenocarcinoma and adenosquamous carcinoma of uterine cervix after surgery” at AGOICON Conference, New Delhi, 2016
•ECFMG Certified, Cleared Step 1, Step 2 and Step 2 CS of USMLE